Baltimore City Health Commissioner Letitia Dzirasa was one of several city officials and advocates who expressed support for overdose prevention sites during a press conference Thursday. Image via Charm TV Baltimore/Facebook.

William Miller II shares how his father, who was “at the top of his life,” died from an overdose on Oct. 7, 2020.

The next day, the younger Miller says he was given a blessing: the birth of his own son, William Miller III.

“But he will never get the chance to meet his grandfather. And his grandfather won’t know how his grandson has grown,” Miller said.

During a press conference with Mayor Brandon Scott on Thursday morning, Miller and other advocates and city officials expressed their support for overdose prevention sites, also known as “safer drug consumption spaces.”

For too long, Baltimore, Maryland and other parts of the country have tried to police and prosecute their way out of substance abuse crises without success, Scott said.

But the mayor said substance abuse is a public health crisis, and Baltimore must address it by providing support services – not punishments – for people who use drugs.

“Growing up in Park Heights, I often tell people that we were taught culturally as a city to look down upon those who use drugs, really to the point where we were bred to not even see them as humans,” Scott said. “It wasn’t until I was older and away from Baltimore at St. Mary’s College that I really realized and understood the realities of substance use, and that this was fundamentally an issue of public health and well-being and not one of criminality.”

Baltimore City Health Commissioner Letitia Dzirasa said substance use in the United States spiked 105% from 2010 to 2020, and nationally there were more than 68,000 deaths due to opioid overdoses in 2020.

In Baltimore, 1,028 residents died in 2020 from drug and alcohol detoxification, a 165% increase from 2015, Dzirasa said.

But Dzirasa said overdose prevention sites would drastically reduce the number of people who die from overdoses.

At such sites, people who use drugs could exchange used needles for clean ones, receive on-site monitoring, and receive rapid intervention from health professionals with Naloxone and other tools in case of an overdose.

The sites would also help increase entry to substance use disorder treatment; decrease the frequency with which clients use drugs; reduce public drug use and littering of syringes and other drug paraphernalia; lower the spread of HIV and Hepatitis C; and lead to cost savings from the reduction of disease, deaths and need for emergency medical services, Dzirasa said.

Switzerland opened the first overdose prevention site in 1986. Since then, there are now more than 150 overdose prevention sites worldwide.

In November 2021, New York City became the first U.S. jurisdiction 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.

Rajani Gudlavalleti is the mobilization director for the Baltimore Harm Reduction Coalition and a member of the BRIDGES Coalition.

While advocating in Annapolis for overdose prevention sites over the past five years, Gudlavalleti said legislators told her and other advocates that they “couldn’t think of anyone in Baltimore or in Maryland who would want this on their block.”

So, BRIDGES Coalition started their “Yes On My Block” campaign to raise support for overdose prevention sites.

“We are there for people before they use, with safer drug use supplies,” Gudlavalleti said. “We are there after, with disposal boxes and Naloxone. We are not legally allowed to be there in the moment when our neighbors and loved ones need us the most. In an overdose prevention site, we can be there to intervene on an overdose and provide myriad resources for holistic care in our community.

State Sen. Shelly Hettleman (D-Baltimore County) said that if she is reelected, she plans to reintroduce legislation with Del. Jocelyn Pena-Melnyk (D-Prince George’s County) to create pilot programs of overdose prevention sites across Maryland.

Hettleman said “drug use and substance abuse is an urban, suburban and rural problem.”

“This issue knows no bounds,” she said. “It knows no racial bounds. It knows no economic bounds. It affects everyone and that’s why we need to have an all-in solution to it.”

Marcus Dieterle is the managing editor of Baltimore Fishbowl. He returned to Baltimore in 2020 after working as the deputy editor of the Cecil Whig newspaper in Elkton, Md. He can be reached at