In the midst of an intensifying local heroin epidemic, The Cincinnati Enquirer has released a four-part series investigating how harm reduction approaches in the city of Baltimore could serve as a model for battling opioid addiction in Cincinnati. According to recent statistics from the Baltimore Department of Health, the city was one of the few places in the United States to see a drop in overdoses in 2016, leading health officials across the country to wonder what exactly health workers have been doing right in the region.

The Enquirer’s latest series on opioid addiction was inspired by reporter Terry DeMio, who has been covering the heroin epidemic in Cincinnati for four years. After witnessing major upticks in overdose deaths across the U.S. Appalachian region, DeMio went searching for solutions in other cities. No matter whom she talked to, Baltimore kept coming up. 

Ultimately, DeMio’s series attributes Baltimore’s downturn in overdose deaths to its multipronged, science-based approach to battling addiction since the early 1990s. For example, the city’s health department has provided needle exchange sites that include HIV and hepatitis C virus (HCV) testing for more than 20 years. In 2004, Baltimore’s health department was one of the first in the United States to fund medication-assisted treatment (which helps quell cravings and ease withdrawal symptoms) for local opioid users. 

Earlier this year, the city made major moves to increase access for all its residents to naloxone, or Narcan, the drug that can help reverse opioid overdoses. Then, in the summer, after witnessing an uptick in deaths related to fentanyl (an injectable prescription drug that can be up to 10 times more powerful than heroin), city health workers sent special outreach teams into the community to warn drug users directly about the dangerous potency of the drug. 

According to local harm reduction advocates, prolonged grassroots efforts have fostered trust between Baltimore health workers and people who inject drugs—which translates into health care for those drug users and has helped slow the spread of both infectious diseases and overdoses. Government support for anti-addiction efforts, under the guidance of health commissioner Leana Wen, MD, have also proved integral to the city’s success. 

So how can other cities employ Baltimore’s strategies to tackle their own opioid epidemics? The Enquirer’s series offers a number of solutions, publishing headlines such as “Reducing the dying by embracing needle exchange” and “Going to the street to arm anti-heroin ‘first responders’” and “Science leads the way to combat addiction, death.” 

Click here to access the Enquirer’s full “Lessons From Baltimore” series.