{"id":25,"date":"2015-10-25T22:18:24","date_gmt":"2015-10-26T02:18:24","guid":{"rendered":"http:\/\/projects.nyujournalism.org\/stateofbaltimore\/?page_id=25"},"modified":"2015-11-05T16:39:27","modified_gmt":"2015-11-05T21:39:27","slug":"heroin-and-hope-in-charm-city","status":"publish","type":"page","link":"http:\/\/projects.nyujournalism.org\/stateofbaltimore\/heroin-and-hope-in-charm-city\/","title":{"rendered":"Heroin and Hope in Charm City"},"content":{"rendered":"<p>By Elizabeth Arakelian<\/p>\n<p>November 9, 2015<\/p>\n<p><strong>The Illness <\/strong><\/p>\n<p>Baltimore native James Henry Carr III had a routine in high school: He would go to school, head to work at an oil company afterwards where he made good money, then walk straight to the projects where he would spend the remaining hours of the day selling drugs before school started up again.<\/p>\n<p>&#8220;There were mornings when I went straight to school from selling dope,\u201d recalled Carr. \u201cDidn\u2019t go home, wash up, change clothing, nothing. Went straight to school from hustling.\u201d<\/p>\n<p>Carr sniffed cocaine and used speed to stay awake long enough to maintain his schedule and he managed to graduate high school, even enrolling in community college. However, by the first semester, it was clear his hours were unsustainable and \u201csomething had to go,\u201d he said.<\/p>\n<p>&#8220;So what had to go? Whatever wasn&#8217;t making me no money. So school had to go,&#8221; said Carr.<\/p>\n<p>Carr\u2019s story is not unique in Baltimore where heroin is bought and sold as commonly as sugar at the grocery store. The proliferation of heroin use warranted Mayor Stephanie Rawlings-Blake to convene a task force in October 2014 with the mission of developing tools to combat what is now referred to as the heroin epidemic.<\/p>\n<p>The Mayor\u2019s Heroin Treatment and Prevention Taskforce produced a report in July of this year that estimates that 18,916 people have used heroin in the past year in the city. But it is acknowledged by the report and those in the addiction treatment community, that these numbers are likely a large underestimation since illicit drug use is difficult to track.<\/p>\n<p>While heroin use in Baltimore has thrust the city into the spotlight in recent years, illicit drug use is not unique to Charm City, evident by President Barack Obama\u2019s visit to West Virginia earlier this week to discuss heroin treatment. The state of Maryland also convened the Maryland Heroin And Opioid Task Force And Coordinating Council in February to address the issue statewide. In 2014, Vermont Governor Peter Shumlin declared his state as having a \u201cfully-blown heroin crisis\u201d as the number of deaths from heroin overdose nearly doubled from 2013 to 2014.<\/p>\n<p>\u201cIt is an epidemic that\u2019s taking the country,\u201d said Adrienne Breidenstine, Director of Opioid Overdose Prevention and Treatment at Behavioral Health System Baltimore. \u201cIt\u2019s been a problem that\u2019s been vexing Baltimore for many years, but other communities are seeing a stifling increase in their overdose deaths as well.\u201d<\/p>\n<p>In Baltimore, the areas with the highest number of overdose deaths include West Baltimore, Penn North, South Baltimore, and Park Heights.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143926903\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Though the city&#8217;s sanctioned attack on the heroin epidemic has shed new light on the issue, it is not necessarily a new one.<\/p>\n<p>\u201cMy experience growing up in Baltimore city is that the heroin addiction is not new,\u201d said Selina Scipio, 43, a native of Sandtown. \u201cIt\u2019s been around since the seventies, since I was a little kid and I\u2019ve had several family members that were hooked on heroin.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143897528\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Despite being home to renowned intellectual and medical facilities, rampant heroin use has long contributed to Baltimore\u2019s questionable reputation since the city\u2019s seedier elements have often eclipsed its accomplishments<\/p>\n<p>\u201cAs the city\u2019s doctor, I have seen how heroin ties into the very fabric of Baltimore,\u201d wrote Health Commissioner Doctor Leana Wen in the task force\u2019s report. \u201cIt is impossible to separate heroin use from problems of poverty, violence, incarceration, homelessness, and ill physical and mental health.\u201d<\/p>\n<p>Karen Reese is the CEO of Man Alive Lane Treatment Center, an outpatient methadone clinic that treats more than 600 individuals with methadone and mental health services. Having been with Man Alive since the 1970s, Reese has witnessed first hand the evolution of heroin in the Baltimore City community, but is slow to hold it singularly responsible for the city\u2019s poor reputation.<\/p>\n<p>\u201cI think the image of the city has been tarnished for a long time,\u201d said Reese. \u201cI think Baltimore has had a really bad image for a long time and I think it\u2019s going to take us a while to actually convince people that it\u2019s an okay city. If you want to know my opinion, I think many of the citizens suffer from Post Traumatic Stress Disorder because there is a lot of violence and there\u2019s a lot of anger and I don&#8217;t think there\u2019s a lot of hope.\u201d<\/p>\n<p>It\u2019s impossible to talk about heroin without talking about hope, or more often the lack of it. Losing hope is often instrumental in a person\u2019s decision to use heroin, but having hope can also function as a shield against addiction.<\/p>\n<p>\u201cGetting hooked on heroin is easy,\u201d said Scipio. \u201cIt\u2019s easy to do that. It is a little bit of work to find a vision, to have hope. It does take a little bit of work, but it is 110 percent worth it in the long run.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/144019798\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Carr has also experienced a revival of hope since seeking treatment for his heroin addiction at Man Alive. Ever since he dropped out of community college as a young adult the now 45-year-old Baltimore native said it has been in the back of his mind to return to school. Now, Carr is back in the classroom pursuing his associate\u2019s degree in addiction counseling at Baltimore City Community College.<\/p>\n<p>\u201cMy plans are not to stop there,\u201d said Carr, who hopes to pursue a degree in the social sciences and eventually earn social work credentials so that he can become an addiction therapist himself. \u201cThe sky is the limit.\u201d<\/p>\n<p><strong>The Diagnosis<\/strong><\/p>\n<p>James Henry Carr III remembers the exact day he decided to throw his life away. It was the day after his grandmother\u2019s funeral.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143907506\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Carr\u2019s father passed away a week before he was born and his grandparents raised him since his mother, who had him at 17, was not capable of bearing the responsibility. His grandparents became everything to him so when they both passed away within months of each other from different forms of cancer, Carr wasn\u2019t just sad. He was livid.<\/p>\n<p>\u201cI was lashing out,\u201d recalled Carr. \u201cI wanted to lash out because I wanted people to feel what I was feeling. I wanted people to feel the sadness and the rage all mixed up into one.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143902184\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>That rage festered inside of him, but there was something that would numb it: heroin.<\/p>\n<p>\u201cWhen I was first introduced I was still in high school, 11th grade, junior year. I\u2019ll never forget,\u201d said Carr. \u201cA couple so called friends of mine \u2014 which they were not friends for introducing me to heroin \u2014 offered me some in the bathroom.\u201d<\/p>\n<p>That fateful day in his high school bathroom was not Carr\u2019s first exposure to drugs, though, as he was already selling them.<\/p>\n<p>\u201cI was groomed to be a dealer. That\u2019s what I was groomed for,\u201d said Carr. \u201c A lot of these youngsters on the street they are groomed from when they are younger. Either you are groomed to be a dealer, a hitman, or other things much, much worse. It depends on that child\u2019s psyche.\u201d<\/p>\n<p>Carr\u2019s psyche was severely damaged by the loss of his grandparents and his drug use worsened after their deaths. Eventually Carr was fully immersed in illegal activity beyond heroin use with a number of charges including robbery, assault, battery, attempted murder, and gun possession.<\/p>\n<p>\u201cIt\u2019s a list. I guess the average police officer would say it\u2019s like a laundry list,\u201d said Carr. \u201cAltogether throughout my 45 years on this planet I have given the state of Maryland 12 years of my life.\u201d<\/p>\n<p>Carr used heroin for a total of 25 years. He traces his acting out back to the grief that unnerved him as a child when he lost his grandparents, citing his inability to properly grieve their passings as instrumental in the issues he faces as an adult. Carr suffers from depression, Post Traumatic Stress Disorder (PTSD), and Attention Deficit Hyperactivity Disorder (ADHD).<\/p>\n<p>\u201cMost of the years that I was out there committing all of these atrocious crimes and using heroin I truly believe in my heart that\u2026 if I was given the proper medication treatment and positive individuals in my life that I would not have ended up in prison for a lot of my life,\u201d said Carr.<\/p>\n<p>Carr is a client at Man Alive, a methadone maintenance facility where the philosophy is to not only treat the client\u2019s addiction issues, but mental health as well.<\/p>\n<p>\u201cYou can\u2019t just treat one problem, you have to treat the whole person,\u201d explained Man Alive\u2019s CEO Karen Reese.<\/p>\n<p>Man Alive was founded in 1967 and is the first medication assisted treatment program in the state of Maryland and the second oldest in the country. A physician and recovering addict, who had participated in a methadone study by the founders of methadone, founded the clinic with the aim of treating heroin addiction among Baltimore City residents.<\/p>\n<p>Initially a small, volunteer based program, Man Alive has evolved since Reese joined in the early 1970\u2019s and she has played an instrumental in shifting Man Alive\u2019s focus to treat the whole person, and not just their addiction. The clinic now offers comprehensive mental health services with several counselors, a full-time psychiatrist, and licensed clinical professionals.<\/p>\n<p>\u201cIt saved my life,\u201d said Carr of his experience at Man Alive. \u201cIt really saved my life, because if I wouldn&#8217;t have came when I did, I would have ended up in prison or possibly dead on the street somewhere, in an alley somewhere, definitely.\u201d<\/p>\n<p>Though Man Alive treats the issue of addiction as a disease and not a bad habit, this perspective has historically been challenged by critics who see drug addiction as a choice. However, The city of Baltimore has also accepted that heroin addiction is a disease and is working to erase stigma attached to the topic of drug addiction so that those looking to stop using heroin can seek help without shame.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143902763\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>\u201cWe very much view substance use disorder as a disease,\u201d said Adrienne Breidenstine, Director of Opioid Overdose Prevention and Treatment at Behavioral Health System Baltimore. \u201cThat is a big component of our education campaign and what we\u2019re trying to do to raise awareness. Everything we\u2019ve put out we\u2019re trying to address the stigma.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143906350\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>The stigma of which Breidenstine speaks includes perceptions by the public that substance use is indicative of a lack of willpower or poor moral standing.<\/p>\n<p>\u201cThe stigma associated with substance use is that relapse is an utter failure when really it comes along with managing any disease,\u201d said Breidenstine. \u201cThere are setbacks with managing any disease. It is just all part of the process and there are triggers that people need to respond to and they just don\u2019t learn that until they relapse.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143907507\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>\u201cRelapse is part of recovery\u201d is a common maxim expressed by those within the industry to combat the feelings of worthlessness that individuals battling addiction often feel when their recovery doesn\u2019t go perfectly. Combining counseling with the addiction treatments is aimed at helping users achieve success not defined by their relationship to drugs. This is also a hallmark of the Mayor\u2019s Heroin Treatment and Prevention Task Force\u2019s treatment recommendations which state that \u201cEffective treatment also requires mental health and physical health wrap-around services.\u201d<\/p>\n<p>Though Carr is still currently maintaining methadone treatments, his ultimate goal is to detox so that he can pursue his collegiate dreams and become an addiction counselor, something he only wants to do once he is completely clean. In the meantime, he has found a source of inspiration to motivate him through the hard times: his grandson.<\/p>\n<p><strong>The Treatment<\/strong><\/p>\n<p>It was seven years ago that James Henry Carr III received a call from his daughter that she was going into labor. More than a celebration, this was a turning point in Carr\u2019s life because it was that day in the hospital that he decided to own up to his heroin addiction.<\/p>\n<p>\u201cWhile I&#8217;m sitting there waiting for the nurse to come out and get me and bring me in\u2026 I was sitting back reminiscing thinking about the day Ashley, my daughter, was born,\u201d recalled Carr.<br \/>\n\u201cThen the nurse finally calls my name: \u2018Mr. Carr you can come in now.\u2019\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143912633\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>It was entering the delivery room and getting to hold his grandson first, even before his daughter, that made Carr commit to a new start. Having loved his own grandparents so much, seeing his grandson for the first time, whom he affectionately refers to as his \u2018little partner\u2019 was a wake up call.<\/p>\n<p>\u201cThe bond was there before he was born because of all of the love that my grandparents instilled in me,\u201d said Carr of his grandson. \u201cIt\u2019s ten fold with my little partner and I. Ten fold. Right then and there as I held that boy in my arms, I said, \u2018Yeah, I\u2019m getting myself together. I\u2019m doing it. I\u2019m doing it.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143907508\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Though Carr is on his way to fulfilling his goal of becoming completely clean, there are thousands of heroin users in Baltimore whose lives more closely resemble Carr\u2019s prior to his grandson\u2019s birth. That is something the Mayor\u2019s Heroin Treatment and Prevention Taskforce hopes to change.<\/p>\n<p>Something unique about the city&#8217;s heroin epidemic is that large masses of people are not only using the drug, they\u2019re dying from it. With estimations of one person dying daily from overdoses the task force began distributing Naloxone even before publishing the report in July.<\/p>\n<div id=\"attachment_73\" style=\"width: 610px\" class=\"wp-caption aligncenter\"><a href=\"http:\/\/projects.nyujournalism.org\/stateofbaltimore\/wp-content\/uploads\/sites\/4\/2015\/10\/22334973710_b752ac7cec_z.jpg\"><img loading=\"lazy\" decoding=\"async\" aria-describedby=\"caption-attachment-73\" class=\"size-medium wp-image-73\" src=\"http:\/\/projects.nyujournalism.org\/stateofbaltimore\/wp-content\/uploads\/sites\/4\/2015\/10\/22334973710_b752ac7cec_z-600x400.jpg\" alt=\"Baltimore City\u2019s Mayor Stephanie Rawlings-Blake convened a task force to address the growing heroin epidemic in the city the results of which included the launch of the less than subtle Don\u2019t Die campaign targeted at getting the overdose drug Naloxone into the hands of residents who can help save lives. Photo by Elizabeth Arakelian\" width=\"600\" height=\"400\" srcset=\"http:\/\/projects.nyujournalism.org\/stateofbaltimore\/wp-content\/uploads\/sites\/4\/2015\/10\/22334973710_b752ac7cec_z-600x400.jpg 600w, http:\/\/projects.nyujournalism.org\/stateofbaltimore\/wp-content\/uploads\/sites\/4\/2015\/10\/22334973710_b752ac7cec_z.jpg 640w\" sizes=\"(max-width: 600px) 100vw, 600px\" \/><\/a><p id=\"caption-attachment-73\" class=\"wp-caption-text\">Baltimore City\u2019s Mayor Stephanie Rawlings-Blake convened a task force to address the growing heroin epidemic in the city the results of which included the launch of the less than subtle Don\u2019t Die campaign targeted at getting the overdose drug Naloxone into the hands of residents who can help save lives. Photo by Elizabeth Arakelian<\/p><\/div>\n<p>Naloxone is an overdose drug that prevents the receptors in the brain from binding with the chemicals of heroin, essentially extinguishes the user\u2019s high. Naloxone can be administered to someone overdosing through an injection to the thigh muscle or through a spray to the nasal passage. The task force\u2019s goal is for everyone, especially individuals in high risk communities who are likely to know someone who could overdose, to have Naloxone in their medicine cabinet or car so that they can help should they need to intervene. The City of Baltimore has been administering trainings almost everyday of the week at community events and churches and street teams are deployed to educated citizens with the hopes of equipping every citizen with Naloxone.<\/p>\n<p>\u201cWe distribute Naloxone on the street and we try to put it in the hands of users,\u201d said Adrienne Breidenstine, Director of Opioid Overdose Prevention and Treatment at Behavioral Health System Baltimore. \u201cAnybody can do this. Anybody can save a life.\u201d<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143912958\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>Although relations between citizens and the Baltimore Police Department have been strained since the riots surrounding the death of civilian Freddie Gray just six months ago, Breidenstine said the force has been a \u201csteadfast partner\u201d in terms of fighting the heroin epidemic. Naloxone is in the hands of the Baltimore Police Department which has now incorporated Naloxone trainings into their academy curriculum and annual refresher.<\/p>\n<p>\u201cOur cops are using it. Just Tuesday one of our cops administered Naloxone to someone really early in the morning and saved a life,\u201d said Breidenstine, who partly attributes the success of the partnership to the recently confirmed police commissioner\u2019s experience in implementing the overdose drug in his previous department.<\/p>\n<p>Although heroin related overdose deaths are staggeringly common, they are not overlooked.<\/p>\n<p>\u201cWe are examining our overdose deaths in the city very closely,\u201d said Breidenstine. \u201cWe have an overdose fatality review committee that meets monthly and looks at different cases. Those are really hard meetings because we\u2019re looking at some really heart wrenching cases.\u201d<\/p>\n<p>A major concern of the task force\u2019s has been finding a way to connect users with a treatment source. The task force has taken the initiative to streamline services, such as integrating two emergency phone lines into one crisis information and response line that is staffed 24\/7 with trained and licensed clinical social workers.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143914427\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n<p>The ultimate goal is to have access to care 24\/7, something that the task force hopes it can eventually implement through a stabilization center that would function like an emergency room diversion location where people can find support services they need, sober up, and then be linked to more long term locations.<\/p>\n<p>\u201cThe idea of treatment on demand is that if we\u2019ve got a user on the street, they reach out to a provider and we should be able to get them a bed that day,\u201d said Breidenstine, noting that that doesn&#8217;t always happen in the current system.<\/p>\n<p>Though it is unforeseen how long it will take for the task force to actualize their treatment goals and see quantifiable success in ameliorating the city\u2019s heroin epidemic, the overarching goal is clear: to one day, instead of counting deaths, count success stories like that of James Henry Carr III.<\/p>\n<p><iframe loading=\"lazy\" src=\"https:\/\/player.vimeo.com\/video\/143907505\" width=\"600\" height=\"381\" frameborder=\"0\" allowfullscreen=\"allowfullscreen\"><\/iframe><\/p>\n","protected":false},"excerpt":{"rendered":"<p>By Elizabeth Arakelian November 9, 2015 The Illness Baltimore native James Henry Carr III had a routine in high school: He would go to school, head to work at an oil company afterwards where he made good money, then walk straight to the projects where he would spend the remaining hours of the day selling [&hellip;]<\/p>\n","protected":false},"author":8,"featured_media":67,"parent":0,"menu_order":2,"comment_status":"closed","ping_status":"closed","template":"","meta":{"footnotes":""},"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v21.5 - 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