With the help of student computer programmers, Baltimore health officials have launched a text-messaging service to warn residents when deadly batches of drugs are in their neighborhood.
Facing a dramatic rise in overdose deaths due to potent and cheap fentanyl, city officials partnered with the nonprofit Code in the Schools to design a warning system they hope will keep more drug users alive.
"People are using fentanyl without realizing it," said Dr. Leana Wen, Baltimore's health commissioner. "Fentanyl is getting mixed in with heroin, cocaine, prescription drugs. They're overdosing and dying without realizing what they're taking."
Last year, more than 2,000 people died of drug overdoses in Maryland — more than twice as many as two years ago. More than half of those deaths were from fentanyl, which is pouring in from overseas.
The problem is particularly dramatic in Baltimore, where nearly 700 people died from overdoses last year. Of those overdoses, 419 were from fentanyl.
Wen said city deaths from fentanyl have grown by 35 times in just three years.
"A couple weeks ago there was a spike of 20 overdoses in one area within a few hours," she said. "Not everybody will be reached through street outreach, but maybe they can sign up for a text to know when this is in their area.
"The more information we can get out to the most people as fast as we can, the better."
The idea for the "Bad Batch Alert" text-messaging system originated with Michael LeGrand, a software engineer who founded Code in the Schools with his wife, Gretchen LeGrand, the organization's director. The nonprofit runs programs to help students develop computer science skills.
Michael LeGrand had a friend in Florida die after overdosing on a batch of drugs.
"She overdosed about a year ago from a batch of heroin that was tainted with carfentanyl. It killed 10 people," he said. "It got me thinking, 'If there are batches of heroin that are killing large groups of people, shouldn't there be a way to alert them so they know and don't die?'"
LeGrand enlisted the help of five Baltimore teens through the nonprofit to begin creating the service. What emerged was an anonymous system that allows users to receive alerts when there are drug overdoses in their neighborhood.
The service relies on data from paramedics that is analyzed by the Baltimore Health Department. When a spike is detected, a text alert is sent to all the users registered in that area.
The service also allows users to get updates on the locations of needle exchange vans and quick access to a 24-hour crisis help line.
Users can sign up for the service by texting "Join" to 952-BB-Alert.
David Gatewood and Davon Harris, two 18-year-olds from the Park Heights area, helped with the programming needed to build the service.
"A lot of us had barely any background in computer science," Gatewood said. "In the neighborhoods I've lived in, not a lot of people are interested in coding. I never thought I could be a part of something like this."
Harris said he believes the program he helped create could become a model for other cities.
"No one wants to die," he said. "You still make your own decisions. We're trying to help this not be your last decision."
Susan G. Sherman, a professor of health, behavior and society at the Johns Hopkins Bloomberg School of Public Health, called the alert technology "a great idea," but said there could be some challenges.
For instance, many drug users don't have steady phone service because they have pay-as-you-go phones and run out of minutes, she said.
About 19,000 people in Baltimore use heroin, according to city estimates.
"For something like this to be really effective, it needs to be scaled up at a public health level," Sherman said.
She said the effort should be paired with other information for users, like where to find naloxone — which reverses opioid overdoses — and needle exchanges.
"There needs to be harm reduction education with it," Sherman said.
Mike Gimbel, former director of the Baltimore County Office Of Substance Abuse, questioned whether the alerts would work. For those who use heroin, he said, a bad batch "doesn't scare them."
"You assume that the addict would stay away from it, but that's not the way addicts think," Gimbel said.
More than 100 people have signed up to use the service so far. LeGrand said he's doing outreach on streets outside drug clinics and at needle exchanges.
The goal is not only to get drug users to sign up, but also their family or loved ones — who could alert them to trouble.
"My hope is to save a life," LeGrand said. "Somebody loves them and really wants them to stay alive. Every one of these people have the potential to recover."