SILVER SPRING, MD, USA - JUNE 13, 2016 :
Alex sits between her friends and cringes in embarrassment as waiters sing "Happy Birthday" to her. Alex is celebrating her three year sobriety anniversary with a big group dinner, but since "there isn't really a happy sobriety song," as her friends pointed out, they had the restaurant sing "Happy Birthday" to her instead.
Heroin is a huge industry in Baltimore, as it is in many post-industrial towns and cities in the United States. It has seen a huge resurgence in popularity over the last decade, due in great measure to the availability of prescription opioids like oxycontin, which is often a gateway drug.
According to the Centers for Disease Control, in 2002, 100 people per 100,000 were addicted to heroin but that number had doubled by 2013. Rates of addiction in the Northeastern United States have increased dramatically, only slightly outpaced by addiction rates in the Midwest, with the highest addiction increases being reported amongst 18-25-year-olds. The rate of heroin-related overdose deaths increased 286 percent between 2002 and 2013.
This photograph was unposed and undirected by the photographer and shot on assignment for Stern Magazine.