“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.”
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, pulling him farther and farther away from the person he once was: a supportive husband and father, a hard-working professional, a proud veteran.
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. “Being an addict, it’s more complicated than people think,” said Kelly, 49.
The clinic coordinates with several pharmacies across the city so patients can get their prescriptions filled almost immediately after leaving the van. They don’t need an ID or health insurance to enroll. And there’s just one requirement for them to keep getting buprenorphine through the clinic: They have to demonstrate they’re taking the medication somewhat regularly.
Asked why they sought treatment, many Spot patients said they’re just tired — tired of chasing fentanyl’s dangerous high and living in perpetual fear of withdrawal sickness, wondering whether the next dose would kill them, sometimes even hoping it would. Despite their firm belief in expanding access to the medication, clinic staff are continuously grappling with how best to serve people who aren’t ready to stop using.Always an adrenaline junkie, he competed on his high school’s wrestling team and joined the Marines in 1992. He served eight years on active duty, including stints in Egypt, Thailand and elsewhere around the world.
Kelly’s beloved dog, an elderly, Pomeranian-long haired Chihuahua mix named Annie Oakley, bounded down the carpeted staircase and wriggled across the linoleum kitchen floor, wagging her tail for attention. “I’m trying to do right every day,” he said, stroking the top of Annie’s head. “But sometimes, it’s like you’re damned if you do, damned if you don’t.”
Meanwhile, heroin and fentanyl are readily available for purchase in his neighborhood, which has suffered from rising poverty and population loss in recent decades.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.
An ex-correctional officer at Baltimore’s jail, Johnson said he started using opioids decades earlier when an arrest for marijuana possession derailed his budding law enforcement career. Jackson, 58, said he can’t tolerate shelter environments because he’s a stickler for cleanliness. He takes pride in maintaining a neat appearance. After a career in construction, he still dresses almost exclusively in canvas work pants and sneakers. But on the inside, he struggles to keep his addiction in check and stave off a growing feeling of hopelessness. He recently returned to the Spot van after some missed appointments.
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