Last month, inside the NoMüNoMü arts space in Baltimore City, local harm reductionists provided tours of a mock overdose prevention site. For harm reduction advocates in Baltimore City, the installation was an experiment in what was possible and what absolutely should exist—places where people who use drugs can use them safely and without fear of arrest or even judgment.
Baltimore Harm Reduction Coalition’s Dave Fell began the tour. Fell moved a dozen or so people through the art space—appropriately decorated with Black Panthers posters and newspapers, a nod to a long tradition of radical, community-oriented healthcare—and into the overdose prevention site (OPS). The installation simulated the intake process, using drugs in the use room, and the ways resources are offered at an OPS.
“When we talk about overdose prevention sites, we are talking about bringing people who are very alienated from organized services in. If there’s one thing you leave with today, it’s that we’re trying to facilitate health, safety, dignity, safe spaces, and just bringing people into love,” Fell told us. “We’re doing this purely out of love for our community, and for ourselves, too, because we’re people who at various points in our lives would definitely have loved to use an overdose prevention site.”
When you enter the site, you’re greeted and you sign in, providing a minimal amount of personal information (mostly a name, or even nickname, and what drug you intend to use that day) and then you wait to be allowed into the room where drug use is allowed (you bring your own drugs, but clean needles and drug testing supplies are provided). In the meantime, there’s a room of couches to wait and relax. Some people also hang out in the room after they’ve used drugs to get settled or come down a little bit. Indeed, Fell noted, some people often hang out, or even show up to just hang and not even use drugs.
An OPS, it becomes clear, is a community space like any other, bringing people together, being there to help or just hear someone out, and providing access to a number of resources—including opportunities to stop using drugs, if someone is interested in that.
The use room itself is not complicated: A table, chair, mirror, lots of light, and a curtain for privacy. The mirror allows the person using drugs to do it more comfortably and safely. In an emergency, the person working the OPS can delicately check in on someone using. If the person using drugs is having any problems—including, most importantly, an overdose—there is someone there to help them. People die of overdose most frequently when they use alone.
During the tour, Baltimore Harm Reduction Coalition’s Harriet Smith stood before a rolling desk full of safer use supplies—with Narcan nearby—and discussed the role of someone working in the use room: “My job here is really just to make sure people are safe. That they feel welcome and they feel like people are caring for them and watching out for them and not all up in somebody’s space—but just up in their space enough to be helpful,” Smith said.
A press conference about OPS was held at the installation. City officials, including Mayor Brandon Scott, spoke out in support. “We owe it to ourselves, to our city, to our neighbors, and to those that we lost to overdose to try new ways that have been proven—even if they’re going to make some folks in our community uncomfortable,” Scott said at the press conference.
Opening up an OPS in the city is something Scott has talked about for a long time. More than two years ago, Scott told me, “There’s nothing that says we can’t [open OPS], so we can do it.” Since then, all that has happened locally is a handful of hearings and now this installation, which begins to make the idea a bit more tangible.
Commissioner of Health Letitia Dzirasa also spoke in support of OPS, noting a frequent talking point about the benefits of OPS: There are over 150 overdose prevention sites around the world, and no one has ever died of overdose in any of them. Dzirasa also pointed towards the decades-long fight to open OPS in the United States which was finally won by New York City. Last year, two OPS opened up, one in Washington Heights and the other in Harlem.
“New York in 2021 became the first and only jurisdiction in America to open an overdose prevention site. It is my hope that we are poised to be the next city to embrace three decades of best practices and more than 100 peer-reviewed studies that have consistently shown the positive outcomes and impacts of overdose prevention sites,” Dzirasa said.
In its first three months, OnPoint NYC’s two sites were used more than 10,000 times and staff reversed almost 200 overdoses.
William Miller Jr., a founder of harm reduction group Bmore POWER, spoke at the press conference, as well. Holding his young son, Miller Jr. brought with him the legacy of his father, William Miller Sr., an iconic harm reductionist who died of overdose in 2020. The Millers have been among those most vocal about the need for OPS for the longest.
“William Glen Miller Sr. started this work,” Miller Jr. reminded everybody. During the installation, a photograph of Miller Sr. sat on a table along with information about the BRIDGES Coalition, a large group of like-minded local organizations advocating for OPS at the state level, who worked together to create the OPS installation.
The OPS installation is an attempt to make real here in Baltimore what is real all over the world (and already operating in cities like Baltimore, illegally). It is a place that likely could have saved Miller Jr.’s father’s life and hundreds of other Baltimoreans’ lives each year. It can be simpler than that, though, Miller Jr. stressed: It’s also about giving people who use drugs their own place to be themselves.
“We can do a lot more to make people [who use drugs] feel good about themselves. And these places will have everything and anything that will make them feel comfortable,” Miller Jr. said. “People who will be using these facilities are people that use drugs—and they’re underserved. And they don’t feel comfortable anywhere else. I think it’s my job to make people who feel underserved feel comfortable.”
This story was made in collaboration with Baltimore Beat.