At 65, this African-American born in Washington has used heroin for most of his adult life.

But the arrival of fentanyl, an ultra-potent and addictive synthetic opiate, changed everything.

"Fentanyl killed a lot of my friends," he told AFP under a picture of black vice-president Kamala Harris that he hung in his apartment in Anacostia, one of the most poor of the American capital.

"Almost every two weeks I hear from someone I know who overdosed on fentanyl."

Today, this skinny man with whitening hair dreads being next.

"I have to stop, because in the end I will end up killing myself. And I know it".

From 2014, this drug sold in powder form has gradually flooded the market, due to its low manufacturing cost, which does not require cultures but a simple laboratory.

In 2021, the city experienced 426 fatal opiate overdoses, five times more than in 2014 -- and far more than gun deaths.

That year, 95% of those deaths were fentanyl-related, and 85% were black people.

Like Lorando, the majority were between 50 and 69 years old.

Regular heroin users have found themselves at the forefront of this "poisoning" of the supply, as experts call it.

Lorando Duncan's arms bear the scars of heroin injections in April 2022 in Washington Agnes BUN AFP Photo

"One day I bought drugs from a guy I knew, not knowing it was fentanyl, and I blacked out," says Lorando, a former prisoner now living on disability benefits.

"When I fell it was day and when I woke up it was night. God woke me up that time."

Fallen on one hip, he now walks with a cane.

And has no other choice than to consume the fentanyl sold, sometimes up to three times a day, to feel "normal" and not to experience withdrawal making him sick, until he vomits.

Today, "everyone uses fentanyl to cut the drug, to make it potent," he explains.

The problem is, "you never know what you're going to get. It's like playing Russian roulette."

Narcan cards

In Washington, long nicknamed "Chocolate City" because of its large African-American population, black people were already dying of overdoses twice as many as white people in 2010, according to a study.

In 2019, it was ten times more.

For both periods, this disparity was higher than in all the states of the country.

A few associations in the field are trying somehow to fight the ravages of fentanyl.

Tyrone Pinkney, 33, has worked for one of them, Family and Medical Counseling Service, for ten years.

Tyrone Pinkney crisscrosses Washington in a motorhome to distribute clean syringes, April 21, 2022 Agnes BUN AFP Photo

He crisscrosses the city, especially the "hot" neighborhoods, aboard a motorhome.

On the ground, a crate containing dirty syringes, collected from visitors to provide them with clean ones.

And on the benches, cartons of Narcan, the brand name of naloxone, an antidote capable of blocking the effect of opiates – and thus saving a person in the process of overdosing.

Tablet in hand, Tyrone Pinkney questions the few dozen people who come every day, checking, for example, if they have been tested for the AIDS virus.

These distributions "do not prevent them from doing what they do but at least they can do it safely", explains this imposing fellow.

"Emergency situation"

The association helped more than 2,500 people in 2021 and distributed more than 200,000 syringes, according to Mark Robinson, regional coordinator.

"This is an emergency situation," he told AFP.

"An epidemic of opiates", which adds "to a medical emergency that already existed among people of color" and to the Covid-19 pandemic, having further isolated fragile populations.

For many, the steps necessary to access treatment (such as methadone or buprenorphine, opiates acting as substitutes), remain too complex.

And it's often easier to get drugs than help.

Used syringes, used for drug injections, and collected by the Family and Medical Counseling Service association, on April 21, 2022 in Washington Agnes BUN AFP Photo

“We have really worked on access issues,” Barbara Bazron, in charge of this crisis at the town hall of Washington, told AFP.

No need to go through a dispatch center for these prescriptions, she explains.

The 70 approved entities can directly accept new patients.

More than 5,000 people are currently enrolled in these care programs.

The town hall has also focused on the free distribution of naloxone (56,000 kits in 2021) and tests to detect whether the purchased drug contains fentanyl.

What about an injection room, as recently set up in New York, to consume in a safe place?

According to Barbara Bazron, the question is under consideration: "Nothing is ruled out".

© 2022 AFP