Baltimore Harm Reduction Grapples With the Crisis

    Last week, Baltimore City Councilmember Leon Pinkett saw the usual scene surrounding West Baltimore’s Pennsylvania Ave. and North Ave. The underground economy was functioning as usual, with dealing out in the open, the way it has been for decades. That corner is central to the city’s fabled heroin trade, which stretches back more than 50 years to the era of “Little Melvin” Williams. The intersection made international news five years ago when the CVS at Penn-North was looted for pills and burned during the Baltimore Uprising.

    On this day though, amid the coronavirus and after Maryland’s governor announced a “stay at home” order, Pinkett noticed some of the dealers were wearing gloves and masks (or at least, bandanas and other cloth wrapped around their faces) as they did their hand-to-hands, grabbing cash and passing back bags, bupes and anything else their regular clientele comes to purchase each morning.

    Pinkett fired off a frustrated tweet: “Yesterday the Gov. shut down all non-essential biz. Meanwhile this morning @ Penn North drug dealers are wearing gloves & masks. Forgot dealing is an essential biz at least in some parts of #Baltmore. While we’re #flatteningthecurve how about we enforce the law? #accountability.”

    The tweet, in which Pinkett encouraged drug warrior tactics during a pandemic, was roundly criticized. More important than Pinkett getting ratio’d though, was that he had seemingly missed a crucial point: The coronavirus has severely interrupted and complicated Baltimore’s drug trade as well as requiring sellers and buyers to get creative in practicing harm reduction. 

    Whether he’ll “sell out” his regulars to cash in on desperate county-ites is a tough decision.

    It reflects what Filter has learned over the past two weeks. One heroin dealer Filter spoke with, who mostly services Baltimore’s midtown area full of universities and arts districts—“We got the art kids and the old heads”—has stopped making deliveries via dirt bike. He’s not darting around the city but having people come to him outdoors, which gives him time to wash his hands and “reset” between transactions, he said, and not potentially spread the virus around.

    He also characterized growing panic among clientele and dealers. Everybody’s money will dwindle soon and supply has been severely disrupted. There has also been an opportunity to price gouge, especially when selling to panicked (and primarily white) Baltimore County customers who are driving into the city, trying to stock up on dope.

    “They want to buy in bulk,” he said, adding that whether he’ll “sell out” his regulars to cash in on desperate county-ites is a tough decision.

    COVID-19 has also moved local harm reductionists, such as the Baltimore Harm Reduction Coalition (BHRC) to monitor the virus’s effects on the drug economy and reimagine how to do its work, assisting the already-vulnerable while protecting themselves at the same time. It is a crisis within the crisis they’ve already been dealing with for years.

    “Any disruption of the normal flow of the aboveground economy and the underground economy and people’s access to drugs that they trust, that have been expected, is all up in the air now,” Harriet Smith, BHRC’s executive director, said at the organization’s monthly meeting on March 17.

    She was talking to nearly 50 local harm reductionists over the video conferencing application, Zoom. Usually, the monthly meeting is in-person, at the office, where BHRC also held events such as safer snorting practice discussions, fentanyl testing strip demonstrations, or a community-focused space-themed dance party. The online meeting changed topics: homelessness and harm reduction in light of COVID-19.

    “People are talking about quarantine and how we should deal with people who are experiencing alcohol withdrawal and should we limit or alter shelter rules to allow folks to smoke,” BHRC’s legislative advocacy intern, Dave Fell, explained on the call. “Perhaps it would be the best in this situation to temporarily provide people with what they need so that they stay to complete the quarantine if it’s necessary.”

    It was two weeks ago that BHRC began working remotely—except for Smith, who still goes into office each day. She’s there so that people can drop by for supplies if they ring the doorbell or call, text or social media message ahead of time.

    “We are ramping up our efforts using postal mail to get people needed supplies.”

    “Knowing some people do not come inside for any service, much less go to places that might be harder to get into now more than ever, we thought we might need to do some distant, whenever possible not-touching kind of outreach to meet some of the basic needs of folks who are really disconnected from almost every service,” Smith told Filter.

    From the office, Smith also prepares packages of safer use supplies. At the end of the day, she stops by the post office to send supplies to those who have requested them. Requests are increasing, in part because the counties surrounding Baltimore have fewer harm reduction services and those that exist have reduced outreach.

    “We are ramping up our efforts using postal mail to get people needed supplies, particularly naloxone, but also fentanyl testing strips, condoms, and injection drug use supplies, snorting supplies and things like that,” Smith said. “We are definitely prioritizing people who need the supplies directly and less ‘the worried well’ who might want naloxone generally.”

     

    For people who use drugs in Baltimore, the concerns are similar to anywhere else. But there are some specific challenges to this post-industrialized, deeply segregated city whose “opioid crisis” is older than in some other places. People experiencing homelessness who use drugs live in, or temporarily take advantage of, some of the city’s nearly 20,000 vacant homes. 

    It is tough to “social distance” when you don’t have a home and shelters seem scary, because they’re full of people who might be infected, on top of them being hostile towards people who use drugs or do sex work. And the difficulty of gleaning accurate information about the pandemic from peers when so many are staying inside makes many feel even more disconnected.

    “What would I tell someone if they asked, ‘What should I do right now?’,” Fell told Filter. “It’s like, I don’t even know what the answer to that question is, even though it’s within my purview to read and think about this stuff. The infrastructure isn’t there and even small little things like a coffee shop bathroom is taken away in a crisis like this.”

    “Telling their officers to use their discretion doesn’t necessarily mean a moratorium on arrests.”

    And then there are Baltimore’s notorious police. On March 18, Baltimore City State’s Attorney Marilyn Mosby announced that prosecutors in her State’s Attorney’s Office would not prosecute crimes including drug possession, in an attempt to encourage cops to reduce arrests. It’s a decision Smith and Fell praised, though its effects could be more substantive with a more cooperative—and trustworthy—police force. In response to Mosby, the Baltimore Police Department said that it would be “giving guidance to officers in using their discretion.”

    “Telling their officers to use their discretion doesn’t necessarily mean a moratorium on arrests,” Fell said. “It’s like, ‘Use your discretion’ which can mean, ‘You can still hassle these folks.’”

    BHRC members still see one another “IRL” at least once a week. They continue their outreach in Baltimore on Tuesdays and have discussed adding another day because other groups, understandably, are now ramping down their street outreach.

    Wearing gloves and bandanas over their noses and mouths but making sure to “smile with their eyes” and look warm and inviting, BHRC hands out safer use supplies as well as soap, water, and snacks, providing up-to-date information about COVID-19 and checking in on folks.

     

    “There are all the conversations we are prompted to have as people meet us. Those have really ranged from, ‘I’m so glad you’re out here’ to talking about childhood trauma,” Smith said. “And it isn’t exactly the time or place for that talk but there was a real big need just to talk and to digest a little bit of what’s going on with everyone.”

    Last Tuesday, they met a man shaking from dehydration and lack of nourishment who had been staying in a vacant building. His thoughts were a little scattered and he had been fairly disconnected from resources and solid information. They gave him supplies, talked about the coronavirus, and just listened to him.

     

    “The ‘being a listener’ aspect is so important, I mean, it always is with this work, especially doing street outreach, but right now especially,” Fell said. “I love playing that role in street outreach, just being like, ‘Talk to me about anything you want.’ Because you can’t actually be there for the community if you’re not actually listening to the community, if you’re still trying to impose your version of what you think is right.”

    BHRC has also made coronavirus-specific packages with hand sanitizing wipes, water and snacks for handing out to people around Baltimore and a small note that reads, “You are loved, stay safe,” on one side and “Wear gloves, clean your hands, clean your phone, moisturize cracked and dry skin” on the other. They wanted to provide something COVID-specific—a message that was simple, and easy to remember and pass onto others.

     

    “We’re trying to balance the harm reduction call of meeting people where they are and being outside,” Fell said. “And the larger public health call of staying inside and trying to figure out where we fit there. It’s a tough one.”


     

    Photos of BHRC members and supplies courtesy of the Baltimore Harm Reduction Coalition

    • Brandon Soderberg

      Brandon is Baltimore-based reporter covering cops, drugs, and protest. His book, I Got A Monster: The Rise and Fall of America’s Most Corrupt Police Squad is out on St. Martin’s Press later this year.

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