From Corner to Cul-de-sac: Mapping the new approach to the heroin crisis

It was early December and Baltimore was bracing for the first verdict in the Freddie Gray case.

Along Pennsylvania Avenue street dealers chirped out "CB4," likely the name of the heroin mix on the street that week. Others yelled out "loosie," slang for individual untaxed cigarettes, the kind Eric Garner sold illegally prior to being choked to death by New York City cops.


In broad daylight, men—some teenagers, some in their twenties, some much older—sold contraband. Not a cop in sight. Not a glare from the squares in the neighborhood, the ones that don't sell dope, nor get high. Slanging drugs on Pennsylvania Avenue, which cuts through the heart of West Baltimore, is all too normal.

Maryland Delegate Dan Morhaim proposes bills for safe heroin injection sites and a opioid maintenance program, among others, to tackle the state's drug epidemic.

But Google "heroin addiction," hit the news tab on the search, and you'll see a different heroin story. You'll watch your news feed populate with stories of heroin riding shotgun with prescription opioids into leafy suburbs.


On "60 Minutes" and in The New York Times, young white women recount how they graduated from OxyContin and painkillers to heroin.

It shocks us; it's not what we expect. But it's not new. In 1966, The Rolling Stones scored a hit with 'Mother's Little Helper,' a tale of prescription drug abuse by overworked stay-at-home mothers. Pill popping isn't new in the suburbs.

"We know this is happening in communities that have always had an issue with addiction but might not have talked about addiction," says Dr. Leana Wen, Baltimore City Health Commissioner.

With the number of heroin overdoses increasing four-fold nationwide from 2002 to 2013, according to the Centers for Disease Control and Prevention, people are talking.

But of course, heroin isn't new to Baltimore. Unfortunately the drug—and attendant, entrenched problems—have been around here for a long time.

Indeed, Baltimore is home to 19,000 addicts, according to a 2015 city task force report on heroin. And in the first half of 2015, the city accounted for 36 percent of the state's overdoses with only 10 percent of its population, according to a report by the Maryland Department of Health and Mental Hygiene.

Even as April's uprising left stores charred and rage boiling over in the streets, the drug trade was ever-present in Baltimore. When I arrived to report on the uprising, a gang intervention worker told me the heroin on the street leading up to the riots was called "Pacquiao," a reference to the mega fight between Manny Pacquiao and Floyd Mayweather. When I left a week later the heroin was going by the name "National Guard," a reference to the federal troops sent in to keep the peace. Again, it's all too normal.

I came back to Baltimore weeks later. May had turned historically bloody, and claimed 42 lives. At a CompStat meeting at playground on North Carey Street in June, one officer seated a few rows from then-Police Commissioner Anthony Batts said there are 17 known drug locations between where the cops were meeting at that moment and the intersection of Pennsylvania and North avenues, only one block away.

Nearly 19,000 Baltimoreans used heroin in the past year, according to a city task force. Methadone maintenance programs help people quit heroin by substituting prescribed doses of a synthetic opiate that minimizes withdrawal symptoms and reduces cravings. A movement to treat addiction as a public health issue rather than a criminal justice issue has grown over the years. That treatment has to take place somewhere, though, and many methadone patients must come to the clinic every day to have

For decades the drug war was exactly that, a war: surround, contain, seize, capture, apprehend. The carceral state would warehouse addicts and dealers alike. According to Wen, eight in 10 of the inmates in the jails and prisons use illegal drugs.

The strategy has failed. Drug addiction is a disease, part of a matrix of psychological and emotional health issues. The solution isn't more informants, more raids, or larger seizures of dope, nor is it building more prisons.

"Criminalizing a disease doesn't work," said Wen. "Imagine if someone with diabetes goes into a diabetic coma but instead we throw them into jail."

Wen appeared before the U.S. Senate in December to talk about Baltimore's efforts to treat heroin as a public health crisis. Wen is licensed to give Naloxone to any of the city's 620,000 plus residents. Cops are being trained to administer the shots.


A bill to absolve cities and emergency responders of civil liability in administering Naloxone enjoys that rarest of things in Washington, D.C., bipartisan support.

It's hard to believe that the same drug war that sent so many Baltimore residents to prison would have ever been unleashed in upscale suburbs of Baltimore, or the cul-de-sacs in Howard and Montgomery counties. As foreign as heroin addiction seems in those places, a drug war may have looked even more obtuse.

It's also hard to believe that if heroin hadn't migrated to the suburbs, hadn't shown up among the families in their ranch homes and duplexes, hadn't hit the white middle class in their cul-de-sacs that we would be moving away from incarceration and toward treatment.

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