A fresh push to legalize overdose prevention centers (OPCs) in Maryland is gaining traction, with Baltimore’s mayor and harm reduction advocates throwing their weight behind the effort. But while the bill’s supporters emphasize its life-saving potential, political and financial hurdles remain.
A Renewed Effort, Backed by Baltimore’s Leadership
Maryland state Sen. Shelly Hettleman has reintroduced legislation to allow six OPCs in areas hit hardest by overdose deaths. The measure, which has repeatedly stalled in committee over the years, would give local governments the option—not a mandate—to establish these sites in collaboration with health officials and community groups.
Baltimore Mayor Brandon Scott, who has long supported the concept, is now making it a legislative priority. His administration is urging lawmakers to act, emphasizing that these centers could help reduce overdose deaths, public drug use, and strain on emergency services.
“This is an evidence-based approach,” Scott said. “With opioid settlement funds coming into the state, we have an unprecedented opportunity to address the crisis in a meaningful way.”
The endorsement from Baltimore’s top official could give the proposal fresh momentum. But whether state lawmakers are ready to embrace OPCs remains to be seen.
Overdose Prevention Centers: Do They Work?
Despite controversy, OPCs have a track record of reducing overdose deaths and improving public health. The model has been successfully implemented in New York City and Rhode Island, where state-sanctioned sites have already reversed thousands of overdoses.
Studies show that OPCs:
- Reduce fatal overdoses by providing immediate medical intervention.
- Lower public drug use and syringe litter.
- Increase access to addiction treatment and health services.
- Ease pressure on emergency rooms and first responders.
Baltimore has the highest fatal overdose rate of any major U.S. city. According to public health experts, an OPC network could save the city millions annually in emergency care costs while addressing racial disparities in drug-related arrests and deaths.
The Political and Legal Roadblocks
The biggest challenge? Politics.
Though Democrats control Maryland’s legislature, past attempts to pass OPC legislation have gone nowhere. Even harm reduction policies that gained traction—such as decriminalizing drug paraphernalia—have faced strong opposition.
Lawmakers are also grappling with a projected $2.7 billion budget deficit. While research suggests OPCs could be cost-saving in the long run, short-term spending concerns might make the bill a tough sell.
Adding to the uncertainty is whether Baltimore could move forward with OPCs independently. Some advocates argue the city has the authority to establish them without state approval, following New York City’s lead. But others, including researchers at Johns Hopkins, believe state-level authorization would provide stronger legal protections.
The Bigger Picture: America’s OPC Landscape
Only three states—New York, Rhode Island, and Minnesota—have formally legalized OPCs. Elsewhere, local governments have attempted to open sites without state backing, often facing legal threats.
In California, Gov. Gavin Newsom vetoed an OPC bill in 2022, citing concerns over implementation. In Pennsylvania, the city of Philadelphia has been embroiled in a legal battle over its efforts to establish a site.
Maryland’s debate is part of a broader national reckoning over harm reduction. While attitudes are shifting, deep-rooted stigma around drug use still shapes policy decisions.
What’s Next?
The bill is headed to the Senate Finance Committee for a hearing, with a companion bill expected in the House. But whether it gains traction will depend on lawmakers’ willingness to take on a politically sensitive issue during a tough budget season.
“I think politicians worry about how this will play with their voters,” said Candy Kerr of the Baltimore Harm Reduction Coalition. “But this isn’t about politics—it’s about saving lives.”
For now, Marylanders watching the crisis unfold can only wait to see if this time, the state is ready to take a new approach.