Heroin has ravaged Baltimore since the early 1960s, fueling desperation and crime in many neighborhoods. Lately, despite heroin’s long history in the city, users say it has become nearly impossible to find, the New York Times reports. Heroin’s presence is fading up and down the Eastern seaboard and in parts of the Midwest that were overwhelmed by it a few years back. It remains prevalent in many Western states. Even New York City, the nation’s biggest distribution hub for the drug, has seen less of it this year. In cities like Baltimore, users who managed to survive decades injecting heroin are now at far higher risk of dying from an overdose. That is because synthetic fentanyl, a deadlier drug much cheaper to produce and distribute than heroin, has all but replaced it. The dramatic rise of fentanyl, which can be 50 times stronger than heroin, has contributed to surging overdose deaths among older people and African Americans.
Federal data show that the rate of overdose deaths involving fentanyl increased by nearly 54 percent in 2017 for people ages 55 to 64, more than for any other age group. “Clients we’ve known for years are dying,” said Derrick Hunt, director of the Baltimore City Needle Exchange Program. The reason fentanyl is everywhere is economic: Dealers and traffickers can make far more money from it than from heroin. Traffickers can order fentanyl from China, or precursor chemicals to make it in clandestine labs, generating more doses with less labor. The number of overdose deaths involving heroin has been dropping, even as overdose deaths over all have kept climbing because of fentanyl. Nationally, there were 7 percent fewer deaths involving heroin in the year ending last September than in the previous year, according to preliminary data from the Centers for Disease Control and Prevention.