For decades, overdoses and other substance use-related harms have ravaged our city.

Like communities big and small across the country, Baltimore has been hit hard, but the situation has worsened in recent years as the drug supply continues to change. Today, fentanyl and adulterants like xylazine are unavoidable in the street drug supply. Overdose rates and the incidence of serious wounds have soared.

From 2020 to 2023, an average of 1,000 people died of overdose each year in Baltimore — more than triple the number who died each year a decade previously. In 2024, the death toll remains far too high. A renewed response and new strategies are urgently needed to save lives and help people who use drugs achieve health and well-being.

While connecting people to treatment and support services remains an important strategy, we must redouble our efforts to advance harm reduction approaches to engage people who use drugs and offer tools and information to ensure safety and save lives in our communities. We also must stop shaming and blaming people who use drugs.

Baltimore has relied on a range of harm reduction tools, including community outreach to share information and resources; distribution of naloxone, available as a nasal spray that reverses opioid overdose; drug checking tools like fentanyl test strips and programs that provide syringes and other sterile supplies to prevent infection, wounds and overdose death. These steps are important, but we must do more.

A proven approach that Baltimore desperately needs is the establishment of overdose prevention sites (OPS). Also known as overdose prevention centers or safe consumption spaces, OPS are safe spaces for people who use drugs without fear of judgment or arrest.

People can bring pre-obtained drugs to the OPS and use them under the trained watch of health care professionals where help can be provided if an overdose occurs, preventing overdose death. OPS staff provide information on safer drug use, first aid, therapeutic and wellness activities, connections to treatment and other services and support with meeting other basic needs like housing and food. And if someone decides that they wish to make a change — whatever that change may be — staff are ready and prepared to assist.

The magic of harm reduction and OPS is in their respect for individual autonomy. People who use drugs are used to being looked down upon, being judged. OPS take a different approach, ensuring that people are not stigmatized, that they are provided safe, nonjudgmental spaces and that they are offered services and supported to use them. This provides a powerful opportunity for positive, self-directed change that research has shown people at the more than 200 OPS operating in 14 countries often choose to make.

The benefits are clear. These sites save lives. According to federal research, there has never been a fatal overdose at an OPS. And a Canadian study showed that overdose mortality rates dropped 35 percent after an OPS opened in Vancouver. OPS have also shown strong results in preventing the spread of HIV and hepatitis C and helping people achieve self-defined recovery. OPS give people the time, safety and support to stay alive and achieve positive change. Every Baltimorean deserves that chance, and we owe it to each other to ensure that it is available.

Finally, OPS save money. A Baltimore OPS could save $6 million annually by reducing hospitalization, emergency department use, emergency team times and health costs due to infection and injury. All of this will lead to an increased number of people accessing treatment, recovery and other services, saving lives.

More communities are adding OPS, including in New York City, Rhode Island, Vermont and Minnesota. OnPoint NYC has reversed more than 600 overdoses since opening in November 2021. It has saved approximately $20 million in hospital costs. And it did not increase violent crime, property crime, 911 calls or 311 calls regarding drug use or unsanitary conditions.

September is Recovery Month, a time to celebrate recovery from behavioral health conditions. As Baltimore marks this milestone, we must commit to new strategies to save lives.

Our city is a leader in overdose response, and now is the time to do what we’re called to do next — establish Maryland’s first OPS.

The Maryland General Assembly should also pass legislation authorizing OPS demonstration projects statewide. A demonstration project here would provide important data on the impact of OPS and help us better understand how to deploy this important intervention to other areas of the state, rural, suburban and urban.

As we work to help our neighbors impacted by drug use, we must use new tools that can help us save lives. We say that every life matters. Establishing an OPS would tell every Baltimorean, even those who use drugs, that their life matters, too.

Zach Kosinski is the director of harm reduction at Behavioral Health System Baltimore.