BALTIMORE, MD, USA - MAY 19, 2011 :
After shooting heroin in the bathroom stall of the dressing room, Alex walks back out to get ready to go back on stage for her set. She says she can't dance nude if she's not high.
Heroin is a huge industry in Baltimore, as it is in many post-industrial towns and cities in the United States. It has seen a huge resurgence in popularity over the last decade, due in great measure to the availability of prescription opioids like oxycontin, which is often a gateway drug.
According to the Centers for Disease Control, in 2002, 100 people per 100,000 were addicted to heroin but that number had doubled by 2013. Rates of addiction in the Northeastern United States have increased dramatically, only slightly outpaced by addiction rates in the Midwest, with the highest addiction increases being reported amongst 18-25-year-olds. The rate of heroin-related overdose deaths increased 286 percent between 2002 and 2013.
This photograph was unposed and undirected by the photographer.