SILVER SPRING, MD, USA - JULY 18, 2012 :
Alex shifts uneasily in the backseat of a car on her way back from a meeting for addicts. She has been released as a part of a program called Maryland Drug Court, where nonviolent offenders are offered a chance to have their felony records expunged after spending consecutive years sober, employed, and attending meetings regularly. Between jail time and rehab, Alex was able to stay sober for a year, a major achievement for those in recovery. Her sobriety wouldn't last, and she was back to using a few months later, and subsequently arrested again.
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.