In the meantime, education and outreach programs can help, said Dr. Christopher Welsh, an addictions psychiatrist at the University of Maryland Medical Center.
Chief among the city's efforts is a program called Staying Alive, which instructs drug users how to avoid overdose, even arming them with a prescription for Narcan, which can overcome the effects of heroin, oxycodone and other opiates. The program, launched in 2004, is based on a concept of harm reduction. Addicts may never halt their addiction, but the harm of their addiction can be minimized.
When the program began, some critics said it would only help people continue to use, but there has been no evidence that it does, said Welsh.
"A lot of these people get to a point where they do want help; but you can't get help when you're dead," he said. "That's really the idea behind this. I have seen people who have been revived and it really helped them come to a point where they realized they wanted to get help."
At a training session yesterday at the offices of Baltimore Behavioral Health in West Baltimore, instructor Nathan Fields showed a mix of clients and staff how to spot the signs of overdose, when to inject Narcan, and how to perform "rescue breathing" on a mannequin named Brad.
At the end of the session, participants received a prescription for Narcan, three syringes, alcohol wipes and a face shield for CPR.
Fields started off by dispelling myths about overdose remedies, such as burning the fingers of a person experiencing overdose, injecting them with salt water and giving them a hard slap to the face.
"Those street remedies are more damaging than the overdose themselves," he said.
Frankie Wells, 46, of Baltimore, who is a client and a manager at Baltimore Behavioral Health, said the training helps people realize they are not powerless if they encounter someone suffering an overdose.
"Just knowing about this can save a lot of lives," he said.
Wells, who has been clean for 15 months after using heroin and cocaine for two decades, knows the impact of overdose intimately. His twin sister died of an overdose in 1999, just a week after leaving a treatment program. People are at higher risk for an overdose when the body has not used drugs for a while.
"They found her in a tub of water," he said. "But God does some things so that someone else can see clearly. I think he wanted me to wake up."
