Baltimore is the heroin capital of the United States.
Government agencies estimate that as many as one in 10 of the city's residents are addicted to the drug. Wanda, 42, was one of them.
"I did tricks, I stole, I robbed, I did whatever I had to do to get it," she says of her $50-a-day heroin habit. "The drug was taking control of my life."
Wanda, who asked that her last name not be used, says she began using heroin at the age of 18. Now she is in a treatment program at the Center for Addiction Medicine in downtown Baltimore. She has been drug-free for more than two months.
'I Wanted to Die'
A 27-year-old woman who asked to be identified only as "T" is also undergoing treatment. She says her heroin addiction turned her from a ballet student into an exotic dancer.
"I went from dancing at the Peabody [Institute] to dancing in a strip club — that's how I paid for that habit," she says. "[Heroin] will make you do things you wouldn't expect yourself to do."
Jonathan, 18, says he contemplated suicide before he quit using the drug only last Friday.
"I wanted to die," he explains. "I just wanted to shoot up until it killed me because I'd lost my feeling of self-worth."
Jonathan, who says he spent as much as $140 per day on the drug, is being treated with buprenorphine — a prescribed "substitute drug."
The U.S. Drug Enforcement Agency says the city has the highest per capita heroin addiction rate in the country. Estimates of the total number of addicts in the city vary, but experts agree it's staggering.
In a city of 645,000, the Baltimore Department of Health estimates there are 60,000 drug addicts, with as many as 48,000 of them hooked on heroin. A federal report released last month puts the number of heroin addicts alone at 60,000.
The problem in the city is so acute that the federal government has designated Baltimore part of what it calls a High Intensity Drug Trafficking Area, making it eligible for special federal assistance to local police.
Tom Carr, the director of the Washington/Baltimore HIDTA program — a joint federal, state and local effort — says the heroin epidemic in Baltimore dates back to the 1950s and is now an engrained part of the city's culture.
"It's an old 'heroin town,'" says Carr. "There is an appetite for heroin in Baltimore … It's accepted by all too many people down there as something that's normal behavior."
"It's almost a rite of passage for some," he adds, noting that heroin habits are often passed down from generation to generation.
Purer, Stronger, More Deadly
The narcotic white powder that, according to a February report by the HIDTA, one in every 10 residents of the city snorts, smokes or, more commonly, heats and then injects with needles is significantly more potent than the heroin sold in many other areas of the country.
In the mid-1990s, Baltimore became a key East Coast distribution point for high purity South American heroin. Smuggled into the United States from Colombia, South American heroin is substantially more potent than its East Asian and Mexican counterparts, making it more addictive and more deadly. Last year, there were 304 fatal heroin-related overdoses in Baltimore and a similar number of heroin-related hospital emergencies.
The higher potency, combined with an increased availability and a reduced street price — now pegged at $100 to $120 per gram — is fueling the city's scourge of addiction by helping to draw in new users.