It’s been 48 hours since Darryll Burrell called an intake counselor and got his childhood friend, Al Jackson, a spot in the drug treatment program Powell Recovery in Fells Point.

But first, Al wants to get his prescription for suboxone - one of the three FDA approved medications that can help block the craving for heroin, filled. 

So, for now, Burrell can only sit and wait and worry. He's in his parked car, outside Maryland General Hospital anticpating Al's phone call.

“He never got this close,” Burrell says. “And I’m still nervous.”

Jackson, who’s 56, has been addicted to heroin since he was 14.

He and Burrell hung out together in South Baltimore when they were kids, shooting dice and playing basketball.  But then, they started drinking at an early age; malt liquor; and smoking marijuana; and popping valium.

By the time they were 14 or 15, they had graduated to heroin, Burrell says.

“We didn’t know it was addictive. We didn’t have a clue what we was putting in our bodies.”

Jackson has been addicted ever since. Burrell is recovering from his addiction and is an outreach worker for Bmore Power, an opioid outreach group.

He says this is it for Al. He has to get treatment.

“You’re either going to get yourself together or you’re going to die on these streets,” he says, “’cause this fentanyl is so powerful.”

State health officials say fentanyl is the leading cause of opioid overdoses in Maryland by far. It’s cheaper and deadlier than heroin and mixed with heroin and cocaine so often that many people say you can’t find heroin without fentanyl anymore.

At last, Burrell’s phone rings. It’s Al.

“Hey, man, can you come get me at the pharmacy,” he asks.

But when Burrell gets there, Al is groaning in pain. His wrist is swollen and his entire forearm is limp. He tells the pharmacist he slipped. She fits him for a brace, but he balks at the cost, $25. He doesn’t have that much.

He says he was “all messed up,” slipped on a curb and “put my hand out to block my face.”

He gets his suboxone prescription filled and leaves the pharmacy, insisting that Burrell take him to an emergency room instead of Powell Recovery.

“I need the hospital, man,” he begs. “I’m going to the hospital.”

But Burrell is having none of it. He says Gina Higgins, a counselor at Powell, is waiting for them with an in-patient bed. They have an appointment.

But Al is wincing with the pain. He wants to put off treatment for his addiction until he can get treatment for his arm.

For people with Medicaid, like Al, opioid treatment programs have doubled in Baltimore, from 15 to 30 over the last six years.

And yet, in 2018, more than 2000 Marylanders died from opioid overdoses, and those are mostly related to fentanyl.

So, what’s stopping Al from getting treatment?

Burrell says the drugs keep users in their “comfort zone.”

“Using, the chase, getting up in the morning – to some people it’s like a job for them,” he says.

But when you take the drugs away, reality sets in.

“You got bills, you got kids, grandkids. All this stuff that was an afterthought, it pops up on you,” Burrell explains. “It’s harder to live a normal life than when you was using drugs because you threw everything away.”

And so, Burrell is trying to pull Al away from his comfort zone and into reality. But it’s a struggle.

As Burrell drives, they bicker back and forth.

Burrell asks, "It scary, ain't it?" "Not about that, man My wrist hurts, man," Al tells him.

But Burrell is not sure. He thinks Al is likely playing the situation. 

They eventually get to Powell Recovery and there are lots of people on the sidewalk, some of whom they know.

Gina Higgins, the counselor, meets them there and tries to get Al processed right away.

"You ready to get better?" she asks Al.

Burrell asks her to send him a list of what his friend needs and drives off.

“I got a good feeling about this,” he says.

But within minutes the phone rings. It’s Higgins. She says Al “really wants to go to the emergency room.”

A frustrated Burrell turns the car around and heads back to Powell Recovery, where he picks up Al and heads for a hospital.

“Be cool, man,” Al begs as he climbs in the car.

“You gotta stop making excuses,” Burrell fumes. “You might not make it to Monday.”

“I promise I’m gonna do it man,” Al says. “I have to do this man.”

As they drive away, they start chatting about the people they recognized.

“You see Vanessa in there,” Burrell asks. “And Rhonda’s husband? Whole bunch of people.”

“Ricky in there too,” says Al.

After a pause Burrell points out, those folks are “shining now.”

“You could be the same way,” he says.

A few days later Burrell confirms Al did, indeed, break his arm. He wasn’t playing.

But several weeks later, Burrell says, Al is “still out there,” still fighting.

But then, Al never went that far toward treatment before.