Over the course of the past few weeks, Baltimore’s Mount Washington neighborhood has become a ground zero of sorts for the debate surrounding how to handle a problem that many say has taken over the city: the resurgence of heroin.
Tensions ran high last week when residents and local professionals packed into the Mount Washington Conference Center for a public meeting concerning a proposed drug and alcohol rehabilitation center just steps from the neighborhood’s main business district.
The Maryland Addiction Recovery Center, which currently operates out of an office on West Road in Towson, has requested to lease a building on Newbury Street in Mount Washington to open a second treatment center. MARC, which was founded in 2013, serves primarily middle- to upper-class patients and families suffering from addictions ranging from alcohol abuse to drug use.
While they emphasize their center is essentially a counseling center that addresses the roots of clients’ addictions, they do prescribe Suboxone, a drug that inhibits the ability of opiates to take effect. The proposal to use the vacant building at the corner of Newbury and Kelly streets is awaiting a decision on zoning pertaining to the number of parking spaces needed to operate a medical clinic, but Mount Washington residents arrived at the meeting ready to do battle.
Representatives from MARC faced questions that ranged from plans for landscaping to how many of their patients reside in Mount Washington and rebuffed accusations that they had been evicted from their original Towson office and that they were misleading the community about the kinds of treatment they offer. The owners told attendees that they had no plans to change the exterior of the building they are seeking to rent, that they could not disclose ZIP codes of patients, that their Towson location is still in operation and that, though they do prescribe Suboxone to aid in the treatment of opiate addicts, they do not distribute the drug out of their offices. Still, several neighbors were far from happy about the possibility of a center for addicts opening up down the road.
“They need help, and they need it here,” Mike Gimbel, former Baltimore County drug czar and current adviser to MARC, told the crowd of concerned residents. Still, many expressed doubts about whether addiction was really a problem in their neighborhood.
But odds are it is, say many experts in the field of addiction treatment.
In summer 2014, the National Geographic channel, in its “Drugs, Inc.: The High Wire,” put into words what many people had known for a long time: Baltimore has a serious heroin problem. Republican Gov. Larry Hogan, who is expected to declare a state of emergency over heroin any day, dedicated part of his State of the State address earlier this month to discussing the situation.
“Throughout Maryland, from our smallest town to our biggest city, it has become an epidemic, and it is destroying lives,” Hogan told the General Assembly on Feb. 4, adding that he has tasked Lt. Gov. Boyd Rutherford with leading the charge to tackle what he called an “emergency” in the state.
One out of every 10 city residents is addicted to the highly dangerous drug, estimates the White House’s High Intensity Drug Trafficking Areas program. While that number has been disputed by some officials, consensus nonetheless is that the rate of addiction is extremely high. According to a 2013 study by the National Institute on Drug Abuse, Baltimoreans accounted for half of all people admitted to treatment programs statewide for heroin addiction in 2012. In that same year, Baltimore City saw more than twice as many heroin-related deaths than any other place in the state. With easy access to extremely pure forms, experts predict that the trend will only grow.
Jewish Alcoholics, Chemically Dependent Persons and Significant Others (JACS) is a New York-based organization that helps addicts and their families around the country. Unlike previous heroin spikes, the heroin being sold on the streets today is exceptionally pure, JACS experts say. As a result, it’s both more powerful and more potent. Also, users are finding alternative ways to ingest the drug into their system. Instead of shooting liquid heroin into their veins through a needle, kids as young as early teens are simply snorting or smoking the drug, alleviating some of the sense of danger surrounding it and making it more appealing to a wider clientele.
“The heroin producers and distributers have made heroin a purer, more powerful substance,” said Jonathan Katz LCSW, director of the Rita J. Kaplan Jewish Community Services for the Jewish Board of Family and Children’s Services in New York. “In other words, it’s not cut as much as it used to be with all kinds of adulterants that required it to be injected to get a high.”
That lack of syringes and needles, he added, can sometimes lead to a false sense of security for the user, making the chances of overdose greater.
The proposal to open the treatment center in Mount Washington cuts to the core of what many experts are urging people to acknowledge: Heroin is no longer the inner-city drug people still picture it as. Many of the city’s addicts come from affluent areas and live relatively privileged lives.
“More money just means better drugs,” said Daniel Brannon, founder of Right Turn/IMPACT, an alcohol and drug addiction treatment program based in Park Heights. A Baltimore native and recovering addict, Brannon himself was one of the first clients at the former Jewish Recovery House, which has since closed. Of the three men who moved into the center together on the first day in 1996, he says he is the only one who lived long enough to get clean.
The Jewish community, he said, has made major strides over the past decades in acknowledging addiction as a problem that exists in the Jewish neighborhoods.
“It used to be that in our communities, in Jewish communities, people didn’t want to talk about it,” said Brannon. “But addiction is everywhere.”
What many people who oppose the opening of treatment centers in their neighborhoods don’t realize, Brannon contends, is that the centers are places where people are not doing drugs. Residents of communities being eyed by potential rehab centers have a choice, he insisted: “You can have our houses or you can have crack houses.”
[pullquote]I feel bad for the people here tonight, because if their kids end up in trouble, where are they going to go?[/pullquote]
The expansion of local treatment options also means more people could get the help they need, said Brannon. Instead of having to pay for a stay at a center in Florida or California, Baltimoreans could pay half the price and receive treatment just minutes from home.
“People have families, people have jobs,” he said. “But at the same time, they need help.”
Howard Reznick LCSW-C, senior manager of prevention education at Jewish Community Services, said the path to the current state of Baltimore’s heroin crisis is chartable.
“Societies go through phases of the drug of choice,” said Reznick. The path to Baltimore’s heroin addiction can be traced through a series of societal changes dating back to the 1950s.
In the ‘50s, Reznick said, valium became the drug of choice for suburbanites and the upper class. Then, in the ‘70 and ‘80s, so-called “uppers,” such as cocaine, surged in popularity. In the 1990s and 2000s, pain medicines, such as oxycodone, became popular again. In some ways, Reznick said, the new spike in heroin use is an extension of the painkiller trend.
A person doesn’t simply wake up one day and start taking a drug like heroin, he said. While every addict’s journey is unique, Reznick described what he called a “well-worn path” to heroin addiction as experimentation with prescription painkillers that eventually leads to the user’s tolerance reaching a level that makes it nearly impossible to achieve that high with the kinds of drugs they can find in friends’ and family members’ medicine cabinets. Seeking a more powerful, cheaper alternative, they turn to heroin.
Unlike cocaine addicts, who generally can sustain an addiction for an average time of three to four years before going over the edge, opiate addicts can live with the addiction for decades.
“You can walk for a much longer time than you can run,” said Reznick of the difference between addictions to uppers compared to the addiction to downers.
Last year, JCS teamed up with a number of other local organizations to form the Jewish Recovery Network, which includes MARC. The organization supports the center’s plans to open an office in Mount Washington.
Although the network focuses a lot of attention on educating school children about the dangers of drug and alcohol abuse in hopes of preventing addiction before it begins, easily accessible treatment is an important tool in any community’s ability to combat addiction.
“It’s obviously incorrect,” said Reznick of the reputation of heroin as an inner-city drug. While the majority of addicts JCS sees are in their 20s, Reznick said it is not at all uncommon for 16- and 17-year-olds to turn to the JRN for help.
“This doesn’t discriminate,” said MARC adviser and former county drug czar Gimbel after the Mount Washington meeting. After an hour-and-a-half of tense debate, his frustration with the lack of community support for the center was clear.
“I feel bad for the people here tonight,” he said, “because if their kids end up in trouble, where are they going to go?”