BALTIMORE, MD, USA - MAY 20, 2011 :
Addiction runs in Alex's family; her mother was an alcoholic, and her father became addicted to crack and abandoned Alex and her mother when she was 10-years-old. She has not heard from him since. Alex has been using heroin for the past three years, introduced to the drug by a roommate. She has been steadily increasing her usage since her mother hung herself almost two years ago.
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.