I’ve worked for 10 years in Baltimore City emergency rooms, and I have seen firsthand how the devastation of opiates affects the city. You cannot drive a mile in this city without seeing a homeless person or panhandler on the corner. Most of them suffer from opiate addiction or some form of mental illness. But I’d like to tell you the story of one of these individuals who I was blessed with taking care of over the years. To protect his privacy, we will call him Tom. He was not born in the city but rather lived a few counties over with his family. Unfortunately, he made poor choices in his life that led to his addiction. But how and why did he end up here in Baltimore like so many others before him? What was his driving factor to come here? The simple answer is that it was the easy access to heroin and fentanyl in the city.

When I first met Tom, he was in his early 20s. He was an angry young man. Every time he came into my emergency room, I knew there would be a fight between Tom and security. He and I established a rapport over time, and he stopped fighting with security. He stopped fighting with all the staff and began to show us who he was. Over the weeks, months and years, he started to open up to us. I knew he loved his mom, and he regretted his life choices. He desperately wanted to be better and not be another addicted homeless man on the streets.

One day, he was just gone. I didn’t see him for months. He just disappeared. I worried about him, I didn’t know how to find him. About a year later, he came back. I was sad to see that he was using, but I was so relieved to see him alive. What shocked me was the reason that he was gone. He was sleeping on a park bench when another citizen lit him on fire while he slept. He showed me his burn scars, and I’ll never forget them. Tom continued to come into the ER for a few years after that. And then one day, I got word that he died from an overdose. It broke a piece of my heart. I watched this young man struggle with good and bad days, and then he finally lost his life to this city.

Why am I telling you his story? His story is one of many in Baltimore, and I am fed up with it. Why does Baltimore have a disproportionally higher rate of opiate deaths than other cities in the state of Maryland? In 2023, Baltimore City saw 1,043 drug and alcohol-related deaths, and 921 were fentanyl-related. In Baltimore County, the annual overdose deaths were in the 300s. From 2017 to 2021, Baltimore accounted for 38% of opiate-related deaths in the state. When I asked Tom and other addicts like him, “Why did you come to Baltimore?” They all said, “It’s just easier to get heroin and fentanyl here.”

The city’s current strategy is to provide Narcan to the public to help prevent overdoses, but what about those who are using by themselves? What about those who are in the cities’ abandoned homes or in the tents on the side streets or in parks? What will the city do when another bad batch of heroin goes through the city and kills more people? This solution will not fix the overdose epidemic.

The poverty level in Baltimore is around 20%. Our schools are the worst in the state. Our gang violence is through the roof. Many of our violent crimes are committed by repeat offenders. This is something I have witnessed firsthand. All of these problems create a perfect storm to feed an opiate epidemic in our great city of Baltimore. How will the city’s leaders fix this?

So, to my elected officials, I implore you to search for the root cause of this and put an end to the easy accessibility of opiates and fentanyl in Baltimore. To have people from other counties flocking here to use heroin and fentanyl because it’s easy to get represents a failure in leadership.

Andrea O’Connor (andreaoconnor92311@gmail.com) is a doctoral student studying nursing practice at Simmons University in Boston. She worked in hospitals in Baltimore as a nurse for 10 years.