With a black plastic bag in hand, Gerald Young ducked into the needle exchange van parked across the street from Baltimore’s Saint Paul Freewill Baptist Church. A cold January rain drizzled outside.

Young shuffled to a small table and sat down, untying and overturning his half-knotted bag. Three bundles of used needles tumbled into a red medical waste bin.

Across from Young, John Harris opened a new box of clean hypodermic needles and restored Young’s supply. Harris, a Baltimore public health worker, also gave him a new kit of naloxone, an opioid antidote that stops a potentially fatal overdose in moments. Young, a 61-year-old homeless Baltimore native, rose to leave the van and wander around his hometown.

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