A row of seats at the front of Baltimore City Council’s chambers was reserved for harm reductionists on January 13. They were there to celebrate a small but significant shift in how Baltimore deals with the overdose crisis: The introduction of a resolution to hold an informational hearing about safe consumption sites and the possibility of establishing them in Baltimore.
“Let me be clear, Baltimore has had an overdose crisis my entire life and what we have been afraid of or unwilling to do is address it as the public health issue that it is,” said City Council President Brandon Scott at the hearing. “And since 2015 there has been 3,500 fatal overdoses in Baltimore. That outweighs the number of people we lost even to gun violence in Baltimore City. This is about us rehumanizing people and understanding that our brothers and sisters, our mothers and sons who are struggling with addiction are human, and they deserve to be treated fairly and they deserve to get the help that they need.”
20-0189R: Informational Hearing—Overdose Prevention Sites is the beginning of Scott’s brash approach to establishing these sites in Baltimore. Emboldened by Philadelphia’s Safehouse—which in October 2019 won a federal court case against a US Attorney’s attempt to stop it opening—Scott is working in collaboration with local harm reduction advocates, and making an end-run around politically cautious legislators. Scott, who is also running for mayor, announced the resolution with little warning to entities such as Baltimore’s health department, mayor’s office and police department.
“There’s nothing that says we can’t do it,” Scott told Filter in his office, a week before the resolution went public. “So we can do it.”
City Council President Brandon Scott. Photo by J.M. Giordano.
Bills to establish safe consumption sites (SCS) on a state level in Maryland have failed for the past five years (yet another will be introduced in 2020 by state Delegate Shelly Hettleman). Maryland’s Republican governor, Larry Hogan, has in the past called SCS “absolutely insane.”
Meanwhile, a 2017 report, “Safe Drug Consumption Spaces: A Strategy for Baltimore City” published by Baltimore’s Abell Foundation, stated that SCS could be established if the health department declared a state of emergency, with the authorization of the mayor or council.
“Saving the lives of Baltimoreans is worth the risk of making some other government body mad.”
“If the state or the law department or someone else doesn’t think the council has the authority to authorize, then we’ll have the discussion,” Scott said. “But saving the lives of Baltimoreans is worth the risk of making some other government body mad or running the risk of having to defend why we want to save lives.”
Neither the Baltimore Police Department nor the Health Department responded to Filter’s requests for comment about the resolution. The mayor’s office said it is looking into the issue. “The Law Department is in the process of reviewing the resolution,” wrote James Bentley, press secretary for the Mayor’s Office. “As soon as they give us some advisement on the legality of this all we can discuss further.”
One likely supporter is Baltimore City State’s Attorney Marilyn Mosby, who signed onto an amicus brief regarding United States v. Safehouse last year and has spoken publicly, along with Scott, in support of SCS.
Sitting in the front row during the January 13 council hearing and applauding was Harriet Smith, executive director of Baltimore Harm Reduction Coalition (BHRC). Yet Smith’s excitement was hedged, she said. After all, this is just a resolution to hold an informational hearing—nothing more.
“Like, they’re not even supporting it,” Smith told Filter. “I keep reminding myself of that.”
Scott supports SCS, however, and plans to introduce a city ordinance to establish them in Baltimore soon. He is currently working on the legislation and running it by harm reduction groups for feedback.
Since 2015, when the first Maryland state bill to establish safe consumption sites was introduced—by then-Delegate Dan Morhaim, an emergency room doctor—the research-based argument for SCS has received support from local organizations such as Abell Foundation and Open Society Institute-Baltimore (OSI).
The issue for folks out there on the sidewalk doing grassroots work, however, was whether people who use drugs in deeply segregated, majority-black Baltimore, with its profoundly corrupt police department, would trust these sites.
“Baltimore City has been specifically targeted by the racist, anti-black war on drugs for decades,” BHRC’s Community Organizing Coordinator Rajani Gudlavalleti told Filter. “And that positions this city and our country in a different way than places that currently have overdose prevention sites [another term for SCS].”
Community buy-in, Gudlavalleti said, had to involve “organizing within a racial justice framework.” So in 2017, members of BHRC and other harm reduction groups, like peer-run Bmore Power and Charm City Care Connection, worked with groups such as OSI to form the BRIDGES (Baltimore Resources for Indoor Drug-use Grassroots Education and Safety) coalition, doing direct outreach about SCS throughout Baltimore.
During the summers of 2018 and 2019—inspired by Safe Shape, and Vancouver’s Overdose Prevention Society, which Gudlavalleti visited in 2017—BRIDGES set up tents that offered people a sense of what a safe consumption site looks like. These played a part in engaging thousands of residents in support of the idea. BRIDGES also invited city council members to see the tents, and Scott, who had visited Barcelona to see sites there in action, was moved.
This experience also made Scott—one of the subjects of the 2018 violence interrupter documentary Charm City—realize that harm reduction intersected with the public health approach to understanding gun violence that he already promoted.
Now—as SCS go from being what Gudlavalleti jokingly calls, “a thing from Europe,” to something people who use drugs in the US want, to a political reality—it is important that the community input is not once again forgotten.
“With the news of the City Council considering this, it has opened up a lot more public conversation about overdose prevention sites that we as people who have been organizing around this for years now hadn’t seen,” Gudlavalleti said. “And now we’re seeing people having a lot of questions and it’s really important to remember that a lot of those nerves, particularly in Baltimore, are there because there is a lot of distrust and mistrust of systems.”
“Overdose prevention sites already exist in a very informal way. They are the vacant, they are the bando.”
Even the language employed by Scott’s resolution and OSI to describe these sites—“overdose prevention sites” or “overdose prevention services”—is in part politically motivated, if entirely accurate. It is harder to oppose “overdose prevention” than “safe consumption.”
Baltimore harm reductionists are quick to point out that underground SCS are already operated throughout the city by people and peers whom drug users trust: from groups of friends looking out for one another in a basement to health clinicians allowing a patient to “get right” in the bathroom while agreeing to check on them and keep it all hush-hush.
“Overdose prevention sites already exist in a very informal way. They are the vacant, they are the bando,” said Smith of BHRC, using Baltimore slang for abandoned properties. “But wouldn’t it be great if those places either became authorized or those places had stable support? “So let’s really do this. Let’s move a little quicker now because we can’t continue the same timeline and if we do … we’ll lose a lot of people.”
The same week Scott introduced his resolution, OSI brought three representatives of acclaimed SCS programs—Aura Roig of Metzineres in Barcelona, and Beverly Lightfoot and Russell Maynard of Vancouver’s Insite—to Baltimore. They spent the week meeting with local harm reductionists, legislators (including Scott), police and community groups to give a sense of how SCS operate. They answered questions and gave advice—especially on the important issue of maintaining community connections.
“Push back against the gravitational pull of the bureaucracy within the health authority.”
“It’s very important to have those grassroots organizations always there with a strong voice at the table,” Lightfoot said. “People asking, ‘What about these communities themselves?’”
“Constant dialogue keeps it real and keeps it focused, that’s imperative,” Maynard said. “Push back against the gravitational pull of the bureaucracy within the health authority.”
Lightfoot and Maynard, along with Roig, were also part of a public forum on SCS in Baltimore County, which has been hit almost as hard as the city by the overdose crisis. Moderated by Natanya Rabinowitz, executive director of Charm City Care Connection (and author of a report about Barcelona’s overdose crisis and what Baltimore could learn), the forum included John Torsch of the Daniel Carl Torsch Foundation, one of the few harm reduction groups operating in the county.
Torsch spent the past year visiting a number of safe consumption sites around the world—which he described as “from very informal to totally illegal to world-class, with full wraparound services”—to get informed.
He told Filter that he was excited about Scott’s resolution. It is a possible fix to state-level legislation which hasn’t passed for the past five years, he said—and would help the county too, because many people who use drugs in Baltimore County end up in the city to cop and to use Baltimore’s more robust services.
“It’s unfortunate we’ve been trying for five years to do this statewide, and it’s unfortunate because if you make it a citywide ordinance you’re still opening yourself up for possible state prosecution,” Torsch said. “But I love that Brandon Scott’s taking it to the next step.”
Top photo of sign outside community SCS event by Brandon Soderberg.