Innovative Solutions Are Needed To Tackle The American Opioid Crisis

by Isabella Rolz


On a cold Sunday, I met 32-year-old Anthony Johnson who has been wandering the streets of the Bronx for more than seven years. He told me has no home or family and has lived in multiple shelters, none of which have helped him recover from his devastating reality: heroin and cocaine addiction. A former pickpocket, Johnson now sells recyclables to homeless people, to pay for the drugs he takes each day.

The Bronx is a place that has been struggling for years with a significant number of people with abuse issues relating to ‘hard’ drugs. Unfortunately, these people suffering from drug addiction are already grappling with other social-economic issues such  as homelessness and poverty, often making it easier to  access opioids.

It was a regular morning for Johnson, who slowly pulled a silver cart with empty bottles of Coca-Cola and Spring Water through the Bronx’s quiet forgotten streets- a far cry from the hustle and bustle of Manhattan. I soon realized that he wanted to go unnoticed, as he covered his face with a black beanie hat and grey sunglasses, eyes down on the wet pavement. “This is not enough, I need to look for more trash” he repeatedly said. 

He searched for more bottles in the trash cans outside of a residential building, then continued to a place he would call “very dangerous.” When he found a stash of new bottles; the pessimistic expression on his face changed for a couple of seconds, as I noticed he inspected his accumulating haul. 

Johnson lit a Red Marlboro Red cigarette, that he later threw down onto the now drenched pavement and continued to pull his cart, full to the brim with rubbish. He told me he was hoping to make at least eighty dollars that day, half of which he would spend on heroin and cocaine, and the rest he would use to buy a week’s worth of food.  

Next, we arrived at a parking lot where two old cars seemed to be waiting for him. He approached the first one, where a couple yelled at him “We need twenty.” Johnson opened the car’s trunk to deliver the cans. Then, he approached the second car and did the same. He said goodbye to his clients and pulled his cart away with a mischievous smile.

In 2021, the Center for Disease Control and Prevention (CDC) reported more than 100,000 overdose deaths in the United States. The illicit drug market has evolved dangerously with the widening spread of fentanyls, a family of manufactured synthetic opioids 50 times more potent than heroin or cocaine. 

Fentanyl now accounts for eighty percent of opioid overdose deaths in the United States, according to Benjamin Atkins, Vice President of Communications and Investor Relations at Opiant Pharmaceuticals. “The entire drug supply, including heroin and cocaine, are more vulnerable to being mixed with fentanyl, which is extremely alarming. A small dose can cause a severe overdose in a matter of seconds,” said Atkins. 

An hour later, Johnson waited for his drug dealer to arrive. For about fifteen minutes, he stood outside a pharmacy that was one block away from a park he believes is unmonitored by the authorities. He told me drug addicts often go there to get their fix. The irony of Johnson standing outside a pharmacy, an outlet that –  in another world – could be providing him with medical grade diamorphine alongside the support he desperately needs, is unavoidable. 

Johnson was carrying a small syringe and a bottle, in which he had mixed cocaine and heroin. He pulled out a black coat he had placed at the bottom of the cart to cover his body and injected the dangerous combination of drugs into his arm. “What do I feel when I drug myself? Honestly? Nothing,” he said abruptly and threw the empty syringe to the ground.

As he was firing the syringe to the floor, his hands- which he had shielded with a pair of grey gloves throughout the day, became visible. They were nearly destroyed, covered with exploded blisters and bruises. His light-brown skin now was dry and pink-colored. “Look what drugs have done to my body,” he said as he once again hid his hands under his thick winter gloves.   

Johnson shared with me that he started consuming drugs at 16 and has since been unable to quit – no matter how hard he tries. He accepts that he needs treatment, but he keeps on buying a daily dose of cocaine and heroin to cope with the emotional pain. “I know I need help, but I only feel alive when I’m high on drugs.”

He finished his last cigarette and threw it to the ground with the same impulsive motion he’d tossed the syringe a few moments earlier. He pulled the other stack of dollars he had collected from his sales earlier that day and took his cart as he depressively walked to the exit of the park covering once again his face and looking down into the ground. 

So, what can be done to help people like Johnson?

In New York City, bold steps have been taken to assist recovery, but access is severely limited. Drug addiction has hit marginalized communities in places such as The Bronx hardest because people are less likely to be able to access medical facilities. 

However, experts have worked hard to understand addiction better in recent years and why it is more susceptible to certain people. “We are finding more treatment options, rather than criminalizing drug abusers like in the 80s or 90s,” said Atkins.

Stopping the stigma enclosing addiction is essential to continue finding new and innovative solutions for people like Johnson and thousands of other opioid abusers from marginalized communities; only 1 in 10 people with substance use disorder ultimately receive care.  

Like Opiant Pharmaceuticals, a small pharma company that has worked to develop medicines to reverse the effects of opioids. They’ve implemented vending machines in neighborhoods like The Bronx, with free kits that provide harm-reduction treatment options. In addition, they created NARCAN, a nasal spray for bystanders to use in the event of an overdose. 

Another example is local non-profit organizations funded through donations or public health grants that seek to provide care and reduce harm in active drug-using communities. For example, ATLAS, which stands for Addiction Treatment Locator Assessment and Standards Platform, is an online tool where “people who live in New York City, including residents of the Bronx can search for available addiction treatment facilities near them,” said Shannon Biello, Vice President of ATLAS. 

This resource is freely available to the public and measures and publicly displays information on treatment facilities for people to use when seeking treatment. By transparently providing this information, ATLAS is hopeful that people will feel empowered to find the care that will best support addicts in their treatment journey.

“Now that we began to understand what addiction entails and started to open ways for these people to get access to treatment and a pathway to recovery, we must prevent them from feeling socially isolated, convince them to receive medical treatment, and provide immediate solutions in case of an overdose,” suggested Atkins.

*The name of the main source was changed in this story due to confidentiality reasons. 

Isabella Rolz is a freelance bilingual journalist based between D.C. and Guatemala. Her work has been published in The Washington Post, Open Democracy, Univision, Clarín, and other media outlets. Tweets @isabella_rolz. 


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