In what appears to be just an average building in Charles Village, the upstairs walls of 116 E. 25th St. are lined with a seemingly endless supply of naloxone, wound care supplies, syringes and stems.
On the first floor, meanwhile, members of the Baltimore Harm Reduction Coalition diligently put together kits to ensure that people who use drugs in Baltimore are as safe as possible. As the city experiences the highest fatal overdose rate in the nation, the nonprofit's work is invaluable in fighting the crisis — one that has killed 8,000 residents in the last decade.
"Drugs and sex have been a part of human life since the beginning of time," said Candy Kerr, the organization's communications manager and policy advocate. "They will always be here. They should always be here. We are not enabling; people are doing these activities, and they're going to continue to do them. We are going to make sure that they're doing it in the safest way possible."
The Baltimore Harm Reduction Coalition was formed in 2011, which predates the current fentanyl-driven overdose crisis. But harm reduction is a strategy and philosophy that extends to other vulnerable groups such as sex workers.
The organization's mission is to provide people who perform inherently risky acts with safer alternatives, whether it be clean syringes, stems or other supplies. Something such as abstinence, therefore, is neither a prerequisite nor an expectation.
Through a combination of mail-based services and boots-on-the-ground work, the organization has been able to foster relationships with thousands in the community, said services manager Rachel Luce.
"The most rewarding parts of the job are building relationships with participants," Luce said. "I see the same people every week. I know what they like, and especially just knowing how inconsistent and uncertain the drug supply is and overdose rates are very high, it feels special to have yearslong relationships with people."
In the past three months alone, the organization has had more than 1,200 participants receive their services. It's also provided nearly 60,000 syringes through its syringe service program.
The organization takes pride in all of its services, including a mail-based syringe program for those who therapeutically inject hormones throughout the state of Maryland.
Most of the organization's clients are middle-aged Black men, a demographic hardest hit by the overdose crisis in Baltimore. Yet it also serves a growing number of trans individuals because of its syringe program for those undergoing hormone therapy.
Their services extend far beyond those metrics, though, with the organization also giving out snacks and safe-sex supplies to participants. The organization also leads educational events to teach about the racist history of the war on drugs and overdose prevention strategies.
Kerr said that her own struggles with addiction fueled a desire to control what is often outside of one's control — an impossible task. When it comes to harm reduction, though, it provides tangible evidence that she has the power to make a difference in people's lives.
That desire to help people in need mirrors that of other organizations, such as BMore POWER, that share a similar mission and work alongside allied organizations that are part of the harm reduction framework in Baltimore. There are numerous entities, including the Baltimore City Health Department, that offer a variety of services.
What sets the Baltimore Harm Reduction Coalition apart from the rest, however, is that it's also very active on the policy side of harm reduction. Perhaps most notably, the organization is a staunch supporter of overdose prevention centers, or OPCs, which allow people to use drugs in a safe environment staffed by medical professionals.
Although OPCs may seem radical to some, harm reduction advocates consider it common sense. Studies have proven them to be an effective tool in preventing overdose deaths.
Unfortunately, given the service gaps and lack of policies that work on behalf of those who use drugs, the organization is faced with some harsh realities.
"I'd say the difficult parts are just knowing the systemic oppression against people," Luce said. "There are policies that actively work to make these people's lives really hard. And people who use drugs — their lives are really hard, and they're not living their best lives. It can be very discouraging and demoralizing."
The stigma surrounding drug use also forces the organization to reckon with the fact that their harm reduction principles have to also extend to those they don't agree with or are actively harming the people they work with, Kerr said.
"Most difficult is remembering the humanity of the people that are oppressing — the people trying to kill everybody I know," she said. "Actively meeting politicians, business owners, people who do not like people who use drugs, where they are at."
The Baltimore Harm Reduction Coalition workers acknowledged the job can be challenging, especially given how dangerous the current drug supply is.
But recent developments in politics have prompted additional concerns even though Baltimore's overdose death rate finally seems to be slowing, which experts have at least partially attributed to local harm reduction initiatives.
While Luce said they remain optimistic, even though it's unclear whether that's a pragmatic outlook given the state of the crisis, Kerr said funding lapses are bound to be an issue in the future.
The organization gets a majority of its funding from state grants, which could be jeopardized due to the state reckoning with an anticipated $2.7 billion budget deficit. There are also fears that, in lieu of funding for prevention measures, politicians could rely more heavily on criminalization.
The concerns aren't just limited to the state, either. Although there wasn't much support to begin with during President Joe Biden's tenure, Kerr said she expects things to get worse under President-elect Donald Trump.
The future is unclear, Kerr emphasized, but the organization will not back down.
"When times get hard, I'll tell you what the fuck we do," Kerr said. "We turn up."
Those interested in supporting the Baltimore Harm Reduction Coalition can visit their website at https://www.baltimoreharmreduction.org/.
Editor's note: This article will also be published by the Baltimore Beat as part of a content-sharing partnership. Check it out here.
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