The recent mass overdose in West Baltimore underscored the need to expand drug treatment and harm reduction services, addiction specialists say. But efforts to build out services addressing the opioid crisis often face resistance that some say is rooted in prejudice.
In recent years, tensions with neighborhood groups over the development of new treatment facilities and harm reduction services have divided residents, leading to prolonged legal battles.
To reduce the harms stemming from addiction, city leaders had already started work to allocate over $402.5 million in settlement funds from lawsuits against opioid distributors. Then, a mass overdose in Penn North rekindled local conversations about the city’s struggles with drugs.
Advocates say that proven treatment and overdose prevention work gets stymied in public hearings, courthouses and community association meetings due to stigma of drug use. But neighborhood leaders say their opposition is more complicated than that.
Community associations won a victory earlier this month when a Baltimore judge ruled against plans for an addiction treatment center in the city’s Westfield area. The decision was the latest blow for CMDS, a Howard County health care firm embroiled in a years-long dispute with community associations over zoning laws.
The judge’s decision — which the company plans to appeal — was based on zoning, but the legal saga caused heated conversations between CMDS, City Council members and neighborhood organizations about substance abuse.
The health care company says that residents have made prejudicial comments about people seeking treatment, while community groups say that the firm’s poor reputation is to blame.
“There’s always going to be some people who don’t represent the most enlightened viewpoint, and maybe there were some people who objected to it on the grounds of objection to addicts,” said John C. Murphy, an attorney representing the neighborhood associations. “I don’t think that was the predominant view of the neighborhood associations.”
Residents spoke against the facility at public hearings and sent letters to the Board of Municipal Zoning Appeals making “discriminatory comments,” CMDS’s attorney Lauren McLarney said. The letters emphasized the safety of area residents, the facility’s proximity to Hamilton Elementary/Middle School and its potential impact on commercial and residential areas.
“That fear is rooted in the misconception that drug addicts are somehow inherently dangerous,” McLarney said.
Rochelle Lachance, president of North Harford Road Community Association and a social worker, objects to the proposed facility because of what she called CMDS’s “horrible” reputation for addiction treatment and concerns about the 100+ proposed beds.
“They’re more concerned about the quantity of their treatment for funds versus the quality of their treatment,” Lachance said. “I love everyone, whether they’re addicts or not, but I don’t love people who try to make money off of addicts.”
Kevin Pfeffer, CEO of CMDS, challenged the criticism, telling The Baltimore Sun that the amenities at the proposed clinic are unlike any other Medicaid facility in response.
“It’s just something, whatever they got to say to try to achieve their goal of not having a facility there. If it takes slander, so be it,” Pfeffer said.
Pfeffer added that while the Turning Point addiction treatment center in the Broadway East neighborhood once had a bad reputation, it was before CMDS provided services at that facility. He said the last surveyor to review Turning Point praised the facility’s “level of management sophistication.”
The dispute over the Board of Zoning Appeals action was decided in state court, but a broader case brought by CMDS in federal court seeks more than $2 million in damages under the Americans with Disabilities Act, Fair Housing Act and the Equal Protection Clause. That case is paused until the appeal of state case is finished.
Concerns in Baltimore County
The demand for treatment resonates in Dundalk, which has consistently had the highest rates of overdose deaths in Baltimore County. Residents of Eastwood, a densely populated neighborhood tucked behind Eastern Avenue, said their concern with a planned inpatient facility is more about its size and scope.
Local contractor Ben Cox is looking to replace his Eastern Avenue roofing business with a treatment center more than double the size of the current facility. The proposed three-story building would be located just over 50 feet from the closest residence, backing up closer to the adjacent neighborhood.
“It’s a big issue. Drug treatment facilities are needed,” said Lynne Mitchell, president of the Eastwood Residents & Business Association of Baltimore County. “But this is something that belongs attached to a medical center, or across from, like a hospital, right?”
Mitchell said that the community association had asked Cox to build a smaller facility — “and then I could probably rally some support, because, you know, we understand the issue.”
“We’re an understanding community, we realize these facilities need to exist,” she said. “Of course, there’s a drug problem. But there’s also millions of square feet of commercial property available.”
She did, however, cite fears about the facility being able to let patients “out into the community,” concerns that people in treatment could look into residents’ windows, and uneasiness over a picnic area she said could provide an opportunity for drug sales.
‘Biggest roadblock’
Jessie Dunleavy, a harm reduction advocate, said that stigma surrounding drug use is the “biggest roadblock” to mitigating the problems associated with it.
Dunleavy understands the initial skepticism about harm reduction efforts. She herself was confused when her son started using drugs. “This is just the worst thing you could do,” she remembered thinking. Since reaching out to advocates and professionals, she now realizes his drug use was to mask his pain.
“I realized that his death was entirely preventable,” Dunleavy said. “We have, as a society, we’ve shamed [people who are addicted], pushed them into back alleys and taught them that they have nowhere to turn.”
The same fears translate over to harm reduction services that distribute naloxone and clean syringes to prevent overdose deaths and the spread of bloodborne pathogens like HIV. Toni Torsch, who leads a Baltimore County-based nonprofit helping people who struggle with addiction, said there are neighborhoods and certain places “that we’re not allowed to park our van” because of fears of crime and trash.
Her group, the Daniel Carl Torsch Foundation, was established in honor of her son, who died of a heroin overdose at 24. In addition to connecting people with treatment resources, the group offers mobile harm reduction services like clean syringes and naloxone, as well as essentials like hygiene and first aid kits. The organization is mobile, traveling to areas and encampments where there’s a need.
“We’re doing everything that we can to, you know, lower those fears,” said Torsch. Her group carries out syringe cleanups and gives people who use drugs safe containers to store used needles, which the foundation properly disposes of.
Since launching its mobile harm reduction services, Torsch’s foundation has seen a drastic increase in people requesting to be connected to treatment.
“It takes education and empathy” to change a person’s mind on harm reduction services, she said. Getting people into addiction treatment is important, but “you have to save the person in order to treat them.”
Torsch said that she was impressed by how community-based resources came together in the wake of the recent mass overdose, where 27 people were hospitalized in a short period of time after consuming a particular batch of drugs. She noted, though, that she felt that an overdose prevention center — a site where people can consume drugs under the supervision of medical professionals — could have prevented the “mass casualty” event. A pilot of such a program has been pitched in the state legislature, but never approved.
“I think it’s really a struggle for a politician to say ‘yes,’ let’s vote for this in our neighborhood,” she said. But “I don’t know if we would have experienced that last week, had we had that safety site.”
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