Anthony Kelly trudged through southwest Baltimore, each laboured footstep a reminder of the roofing accident that left him with chronic pain and a raging opioid addiction several years after he returned home from serving in the Marines.
Doctors used metal plates to reconstruct his lower legs and Kelly spent months learning to walk again. So began his plodding journey into the depths of substance use disorder, a downward spiral that would gradually weaken his body and consume his mind.After his prescribed painkillers ran out, Kelly turned to a combination of heroin and cocaine that sometimes cost $500 per day.
The clinic exemplifies an ongoing shift in the nation's approach to stemming overdose deaths, which surged during the pandemic to unprecedented heights as the potent synthetic opioid fentanyl replaced heroin in drug markets across the country. The so-called harm reduction model, which has received endorsement and funding from the Biden administration, offers potentially life-saving services to opioid users, without requiring abstinence in return.
"Being an addict, it's more complicated than people think," said Kelly, 49. "We built this web we're entangled in. We didn't get here overnight and we're not gonna get better overnight. You can't just snap out of it." Buprenorphine, which received federal approval for treatment of opioid use disorder in 2002, binds to opioid receptors in the brain without producing a euphoric high. Often prescribed under the brand name Suboxone, the drug typically comes in orange strips that dissolve under your tongue.
Every Monday morning, the Spot van parks in west Baltimore's Upton community, a historic Black cultural hub once known for its renowned jazz clubs, upscale shops and vibrant nightlife. The Spot program, which launched in 2018, operates under a partnership between the Baltimore City Health Department and the Johns Hopkins University School of Medicine. It typically serves about 900 patients a year. An estimated 40% of them have a recent history of intravenous drug use, almost 75% are Black and more than half are experiencing homelessness or housing instability.
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