At the Clinic Doorstep: Baltimore’s Experiment to Break the Cycle

Part Two of a Three-Part Investigative Series

A City Under Pressure

By mid-morning, the sidewalks outside some Baltimore treatment centers thin out, but the issues linger. Neighbors still see discarded needles, cigarette butts, and the occasional person passed out on a stoop. Police say dealers continue circling the blocks.

City leaders admit the problem is real—but insist it can’t be solved by pushing people away. “You can’t criminalize someone out of addiction,” says Baltimore Health Commissioner Dr. Letitia Dzirasa. “If we want to change the scene outside clinics, we have to change how we deliver care.”

That philosophy has guided a wave of new initiatives across Baltimore. From mobile methadone vans to a city-run Stabilization Center, the goal is to take treatment beyond the clinic walls—and reduce the sidewalk clusters that frustrate residents.

Methadone on Wheels

In 2022, Baltimore launched its first mobile methadone vans, bringing treatment directly into neighborhoods where overdose rates are highest. Each van is staffed with nurses and recovery coaches, dispensing medication and connecting patients to counseling.

“Instead of everyone coming to one building at 7 a.m., we can meet people where they are,” says a spokesperson for Behavioral Health System Baltimore (BHSB), the nonprofit that oversees much of the city’s treatment network. “It cuts down on transportation barriers, and it reduces the crowds that form outside fixed clinics.”

Other cities, including Philadelphia and New York, have reported success with similar programs. A 2021 study in the Journal of Substance Abuse Treatment found mobile methadone significantly improved retention rates among patients who struggled with daily clinic visits.

The Stabilization Center

One of the city’s flagship projects is the Baltimore Stabilization Center, opened in 2019. The facility is designed as an alternative to emergency rooms or jail for people found intoxicated or in crisis.

“When someone is picked up under the influence, instead of being dropped at a hospital ER—or worse, left on the street—they can come here,” explains Dr. Adrienne Trustman, chief medical officer of Behavioral Health System Baltimore, in an interview with WYPR. “They get medical care, showers, food, and immediate connections to treatment.”

The center serves hundreds of people each year, according to the Baltimore City Health Department. Advocates say it reduces the visible suffering often seen outside clinics by giving people another safe place to go.

The Human Link: Peer Navigators

On a recent Tuesday, just outside a West Baltimore clinic, peer recovery coach Adrienne Breckenridge waved down a man she recognized. He had been hanging around the clinic for weeks, clearly struggling.

“Let’s get you inside,” she urged. Within minutes, she was helping him fill out housing paperwork in the clinic’s lobby.

Baltimore employs dozens of peer recovery specialists like Breckenridge—people with lived experience of addiction who can connect patients to jobs, food assistance, or shelter. According to BHSB data, peers engage with more than 20,000 residents a year across various programs.

“Peers are critical,” says Dr. Dzirasa. “They reduce that limbo where people hang around outside because they don’t know where to go next.”

GBRICS: A Regional Safety Net

Perhaps the most ambitious project is the Greater Baltimore Regional Integrated Crisis System (GBRICS), a $45 million, five-year collaboration between hospitals, behavioral health providers, and local governments. Launched in 2021, it creates a regional crisis hotline, 24/7 mobile crisis teams, and walk-in urgent care for behavioral health.

MedStar Health, one of the region’s hospital systems, said in a statement that GBRICS aims to “reimagine behavioral health crisis response” so people in distress don’t automatically end up in jail, emergency rooms, or outside treatment centers.

Police and Public Health Working Together

Even law enforcement has begun shifting its approach. Instead of mass arrests outside clinics, the Baltimore Police Department now coordinates with outreach teams to target dealers rather than patients.

“We try to keep the focus on those exploiting people seeking help,” one police sergeant told Maryland Matters. “The goal is not to chase patients off the sidewalk, but to make sure they’re not preyed upon.”

Still, officers admit the revolving door is hard to stop. As long as demand persists, supply will circle the block.

A Balancing Act

For neighbors, these changes are welcome—but progress feels slow. “I see the vans sometimes, I see the peer workers,” says Denise Thompson, the East Baltimore resident interviewed in Part One. “But outside my window, it still looks the same most mornings.”

Health officials argue patience is needed. “We didn’t get here overnight,” Dr. Dzirasa says. “Baltimore has been dealing with the opioid epidemic for decades. It will take years of investment to truly change the street-level picture.”

The Question Ahead

Baltimore’s experiment is still in motion. Mobile vans are scaling up. The Stabilization Center is expanding. GBRICS is adding new crisis teams. Advocates believe these efforts will, over time, thin out the sidewalk crowds.

But funding is fragile. State budget cuts in 2024 threatened some youth mental health grants, and advocates worry about sustainability once federal dollars run out.

Part Three of this series will examine the future: integrated treatment hubs, housing-first approaches, and whether Baltimore can turn short-term fixes into lasting solutions.

For now, the city’s efforts show one clear truth: the problem outside treatment centers isn’t just about loitering. It’s about systems trying to catch up with a crisis decades in the making.