By Phylica Porter
In Baltimore, the opioid crisis isn’t an abstract statistic—it’s our neighbor, our family member, our friend. Our streets are lined with clinics, treatment centers and mental health facilities—yet overdose after overdose, we fall short of real recovery. That’s because abundance doesn’t equal quality. In fact, Behavioral Health Systems Baltimore (BHSB) reported that Baltimore City and Baltimore County account for more than 63 percent of all intensive outpatient substance use disorder programs (IOPs) in the state. (BHSB) Yet, too many providers deliver no more than empty promises—creating gaps in oversight, community fatigue and, tragically, stagnation in people’s lives.
An oversupply without oversight
Take District 10 for example: neighborhoods such as Cherry Hill, Brooklyn and Westport have a saturated landscape of behavioral health clinics. Cherry Hill and Brooklyn alone account for 3.2 percent of all partial hospitalization facilities (PHPs) in the state, while District 10 as a whole represents 5.6 percent of statewide PHP sites; seven in total. Similarly, Pigtown, Morrell Park and Westport make up 1.8 percent of all IOP providers in Maryland, with another seven sites concentrated in just these communities.
While the volume of treatment facilities can appear to represent access, providers vary in quality, some offering subpar care—if any at all. Some providers have been found to exploit Medicaid systems and a recent investigative report revealed one treatment program tied to multiple patient deaths, raising alarms with oversaturation in provider networks. (WYPR)This oversaturation, combined with loosely regulated licensing, has made our healing ecosystem cluttered rather than effective. When clinics pop up with minimal scrutiny, quality care gets lost—and public trust erodes.
A moratorium with purpose
Recognizing this, I worked closely with Maryland’s Department of Health and the Secretary of Health to institute a moratorium on new enrollments for certain behavioral health services: Psychiatric Rehabilitation Programs (PRPs), Partial Hospitalization Programs and Intensive Outpatient Programs.(achc.org, Maryland.gov Enterprise Agency Template) This wasn’t about shutting down care—it was about hitting pause long enough to ask: Who is doing this right? Who is profiteering at the expense of people’s lives?
Initially set for six months starting July 2024, the moratorium was later extended through July 2025—a critical window to evaluate provider quality and rebuild oversight. (Maryland.gov, Enterprise Agency Template, CBS News) While rural counties are now being considered for reopening (where services remain scarce), Baltimore City—and by extension, Baltimore—remains under the pause to ensure reforms hold. (Maryland.gov Enterprise Agency Template, The Southern Maryland Chronicle)
Exhaustion, not apathy
Let me be clear: our communities aren’t apathetic—they’re exhausted. Families watch loved ones cycle through clinics with no meaningful outcome. Public spaces, once hopeful, feel like ground zero for unmet needs. This burnout is real, and it fuels resistance—even toward solutions like harm reduction that, honestly, could help.
Over the years, we’ve seen public tents of crisis and overcrowded parks become shorthand for failure. When clinics come and go, or fail to deliver results, people stop believing change is possible.
Shifting from enforcement to healing
Historically, responses defaulted to criminal justice: arrest, prosecute, repeat. That approach failed because addiction is not a criminal issue—it’s a public health one. I’ve championed a different path: harm reduction and low-barrier recovery.
Consider the “Spot” mobile health clinics—run by BCHD and Johns Hopkins—which travel into neighborhoods to deliver care where people are. From 2015 to 2019, opioid overdose deaths surged 140 percent (from 354 to 851), with fentanyl accounting for 95 percent of those deaths by 2019. (PMC) That surge coincided with sharp clinic growth—but not better outcomes. The Spot, in contrast, brings medical care directly to people in need, and is a model for embedding outreach in recovery-first, not enforcement-first, frameworks.
What Baltimore needs is real
Here’s what this district genuinely needs—what I am fighting for:
1. Accountability, not accumulation
Licensing must be rigorous. Staffing, outcomes, and community integration matter. Clinics shouldn’t just open—they should prove impact.
2. Healing, not harassment
Harm reduction—like syringe services, overdose prevention, naloxone distribution—must be prioritized, not criminalized. Health-first policies reduce policing, improve safety and save lives.
3. Trust and accessibility
Recovery isn’t one-size-fits-all. Clinics must be embedded in places people trust—churches, neighborhood centers, barbershops. They must speak to cultural realities.
4. Address underlying drivers
Recovery is harder with unstable housing, food insecurity, and unemployment. Comprehensive recovery must include housing, job support and mental health—not just medication.
From process to transformation
Our moratorium wasn’t about stopping care—it was about stopping abuse. It created a vital breathing space for policymakers, residents and honest providers to ask: Which services work? Which exploit? Which do we need more of and which need reform?
This approach is already shifting the conversation. Instead of “another clinic,” we talk about “what’s inside it—and who it really helps.” The pause has pressure-tested licensure, proposed stronger staffing rules, clarified application requirements and introduced better disciplinary measures for noncompliance.(WYPR)
Ending with hope
Every Baltimore resident deserves more than just another clinic building that lines the streets. We deserve care that heals, trust that stays and breakthroughs that last.
The moratorium and the shift toward quality, not quantity, isn’t easy. But it’s necessary. It’s the difference between another failed attempt—another promise broken—and the real turning point where overdose deaths finally begin to fall, trust is rebuilt and communities reclaim both health and hope.
If we measure progress by impact, not infrastructure, we can turn our exhaustion into energy and our skepticism into support. That future is within reach—if we continue demanding quality, not just presence, in our fight against the opioid epidemic.
The opinions expressed in this commentary are those of the writer and not necessarily those of the AFRO.