KENSINGTON, PA- DECEMBER 13, 2022:  Brooke Peder, 38, changes the wrappings around her "Tranq Wound" in an office at Prevention Point after posing for a portrait. She changes the wrappings twice a day, she used to think she had to change them everyday but

KENSINGTON, PA- DECEMBER 13, 2022: Brooke Peder, 38, changes the wrappings around her "Tranq Wound" in an office at Prevention Point after posing for a portrait. She changes the wrappings twice a day, she used to think she had to change them everyday but learned that two times a day is sufficient, "it needs wound juice, it' doesn't get better without it," she says. Fearful of any new wounds appearing, Peder injects directly into the wound. She wants to get a skin graf so she can insure that they flesh will not become necrotic but that would involve staying in the hospital for six weeks of sobriety. Peder says the wound is painful, her tendon is sticking out but it's not enough to stop her from using yet. 

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PHILADELPHIA, PA- DECEMBER 6, 2022:   Carlos Del Valle, left and Shawn Westfahl work for prevention point doing outreach work in the Kensington community. They hand out NARCAN, help direct people to prevention point for wound care and needle exchanges. Th

PHILADELPHIA, PA- DECEMBER 6, 2022: Carlos Del Valle, left and Shawn Westfahl work for prevention point doing outreach work in the Kensington community. They hand out NARCAN, help direct people to prevention point for wound care and needle exchanges. The two often perform first aid, trauma care and NARCAN to people they come across on their walks. 

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PHILADELPHIA, PA- DECEMBER 6, 2022:  Carlos Del Valle leaves Narcan next to a window at a 24 hour corner store across from McPherson Park. He walks around the neighborhood several times a week handing out the opioid reversing drug and leaving it in places

PHILADELPHIA, PA- DECEMBER 6, 2022: Carlos Del Valle leaves Narcan next to a window at a 24 hour corner store across from McPherson Park. He walks around the neighborhood several times a week handing out the opioid reversing drug and leaving it in places where people are known to use more frequently.

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KENSINGTON, PA- DECEMBER 12, 2022:  Shawn Westfah and a colleague attempt to assist a man who just injected what Westfah presumed was Tranq on Kensington Ave. The man was in a considerable amount of pain and was falling out his wheelchair. Everytime Westf

KENSINGTON, PA- DECEMBER 12, 2022: Shawn Westfah and a colleague attempt to assist a man who just injected what Westfah presumed was Tranq on Kensington Ave. The man was in a considerable amount of pain and was falling out his wheelchair. Everytime Westfah and his colleague tried to move back into a more comfortable position in his chair, he cried out in pain. Eventually a friend of the gentleman came by, showing concern for his saftey and wellbeing she asked Westfah to call him an ambulance. The EMTs and Prevention Point workers were able to manuver him into his chair but he ultimately refused to go to the hospital. 

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KENSINGTON, PA- DECEMBER 12, 2022:  Shawn Westfah and his colleague Sascha walk through Kensington handing out NARCAN and performing wellness checks on anyone who looks as though they may need help.

KENSINGTON, PA- DECEMBER 12, 2022: Shawn Westfah and his colleague Sascha walk through Kensington handing out NARCAN and performing wellness checks on anyone who looks as though they may need help. 

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PHILADELPHIA, PA- DECEMBER 6, 2022:   Kim Barauskas, 53, poses for a portrait at Prevention Point Philadelphia. Baraukas has been a using opioids since she was 26, a habit that began as a form of pain management from an accident she was in years before. S

PHILADELPHIA, PA- DECEMBER 6, 2022: Kim Barauskas, 53, poses for a portrait at Prevention Point Philadelphia. Baraukas has been a using opioids since she was 26, a habit that began as a form of pain management from an accident she was in years before. She will have to have the finger tips on her left hand amputated as they flesh has become necrotic from an injection of Tranq two months ago. She accidentily injected into an artery instead of a vein and said it immediately felt like her hands were in acid, her whole left hand "blew up and got real swollen." Barauskas says "why are we shooting it, falling out and then waking up and we're all sick again and need to get another shot because we're so sick." She expressed frustration at the way doctors handled her wound but ultimately said "it's my own fault, I'm the one doing this to myself." 

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PHILADELPHIA, PA- DECEMBER 6, 2022:   Kim Barauskas, 53, poses for a portrait at Prevention Point Philadelphia. Baraukas has been a using opioids since she was 26, a habit that began as a form of pain management from an accident she was in years before. S

PHILADELPHIA, PA- DECEMBER 6, 2022: Kim Barauskas, 53, poses for a portrait at Prevention Point Philadelphia. Baraukas has been a using opioids since she was 26, a habit that began as a form of pain management from an accident she was in years before. She will have to have the finger tips on her left hand amputated as they flesh has become necrotic from an injection of Tranq two months ago. She accidentily injected into an artery instead of a vein and said it immediately felt like her hands were in acid, her whole left hand "blew up and got real swollen." Barauskas says "why are we shooting it, falling out and then waking up and we're all sick again and need to get another shot because we're so sick." She expressed frustration at the way doctors handled her wound but ultimately said "it's my own fault, I'm the one doing this to myself." 

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PHILADELPHIA, PA- DECEMBER 6, 2022:   Clients bring in used syringes in exchange for clean ones at Prevention Point Philadelphia. They often collect or save their needles in coffee cups, juice bottles and any plastic container they can come across

PHILADELPHIA, PA- DECEMBER 6, 2022: Clients bring in used syringes in exchange for clean ones at Prevention Point Philadelphia. They often collect or save their needles in coffee cups, juice bottles and any plastic container they can come across 

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KENSINGTON, PA- DECEMBER 12, 2022:  Needle Drop Boxes are places at intermitten locations around the Kensington neighborhood.

KENSINGTON, PA- DECEMBER 12, 2022: Needle Drop Boxes are places at intermitten locations around the Kensington neighborhood.

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PHILADELPHIA, PA- DECEMBER 5, 2022:  Devin Pearson makes two cups of sugar filled coffee in the shared living room of Beacon House, the shelter where he currently lives.

PHILADELPHIA, PA- DECEMBER 5, 2022: Devin Pearson makes two cups of sugar filled coffee in the shared living room of Beacon House, the shelter where he currently lives. 

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PHILADELPHIA, PA- DECEMBER 6, 2022:  Makeshift fire pits like this one on the sidewalk next to McPherson Park can be found all around Kensington

PHILADELPHIA, PA- DECEMBER 6, 2022: Makeshift fire pits like this one on the sidewalk next to McPherson Park can be found all around Kensington 

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PHILADELPHIA, PA- DECEMBER 6, 2022:   A kit with NARCAN is attached to a telephone pole outside of McPherson Park with a sign for a missing person. The kits and the signs are common sights for people who walk about Kensington

PHILADELPHIA, PA- DECEMBER 6, 2022: A kit with NARCAN is attached to a telephone pole outside of McPherson Park with a sign for a missing person. The kits and the signs are common sights for people who walk about Kensington 

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KENSINGTON, PA- DECEMBER 13, 2022:  Brooke Peder, 38, prepares a shot of cocaine that she says is mixed with Xylazine or "Tranq." She says any drug bought in Kensington has some amount of Tranq in it. She bought two $3 capsules of cocaine that she prepare

KENSINGTON, PA- DECEMBER 13, 2022: Brooke Peder, 38, prepares a shot of cocaine that she says is mixed with Xylazine or "Tranq." She says any drug bought in Kensington has some amount of Tranq in it. She bought two $3 capsules of cocaine that she prepares for an injection into her wound. She knows that the cocaine contains Tranq becuse it will make her "well,"-- stop her from having withdrawls. 

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KENSINGTON, PA- DECEMBER 13, 2022:  Brooke Peder, 38, changes the wrappings around her "Tranq Wound" in an office at Prevention Point after posing for a portrait. She changes the wrappings twice a day, she used to think she had to change them everyday but

KENSINGTON, PA- DECEMBER 13, 2022: Brooke Peder, 38, changes the wrappings around her "Tranq Wound" in an office at Prevention Point after posing for a portrait. She changes the wrappings twice a day, she used to think she had to change them everyday but learned that two times a day is sufficient, "it needs wound juice, it' doesn't get better without it," she says. Fearful of any new wounds appearing, Peder injects directly into the wound. She wants to get a skin graf so she can insure that they flesh will not become necrotic but that would involve staying in the hospital for six weeks of sobriety. Peder says the wound is painful, her tendon is sticking out but it's not enough to stop her from using yet. yet.

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KENSINGTON, PA- DECEMBER 13, 2022:  Brooke Peder, 38, wheels herself up Kensington Avenue to the nearest subway station. She will panhandle on the train until she gets enough money to support her through the next day. Many people with substance use disord

KENSINGTON, PA- DECEMBER 13, 2022: Brooke Peder, 38, wheels herself up Kensington Avenue to the nearest subway station. She will panhandle on the train until she gets enough money to support her through the next day. Many people with substance use disorder cite having this specific goal everyday as being a component of their addiction that gives them purpose. They'll often say that the biggest excitement is knowing you have the money to get the drug of choice for the day so you don't have to worry about getting sick or anything else. 

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KENSINGTON, PA- DECEMBER 12, 2022:  Used needles, Narcan sprays and abandoned belongings cover much of the street on Kensington Ave

KENSINGTON, PA- DECEMBER 12, 2022: Used needles, Narcan sprays and abandoned belongings cover much of the street on Kensington Ave 

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KENSINGTON, PA- DECEMBER 13, 2022: Brooke Peder, 38, wheels herself up Kensington Avenue to the nearest subway station. She will panhandle on the train until she gets enough money to support her through the next day. Many people with substance use disorder cite having this specific goal everyday as being a component of their addiction that gives them purpose. They'll often say that the biggest excitement is knowing you have the money to get the drug of choice for the day so you don't have to worry about getting sick or anything else. 

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KENSINGTON, PA- DECEMBER 12, 2022:  The road from McPherson Park to Kensington and Allegheny Ave are particularly popular places for folks to pick up or use drugs

KENSINGTON, PA- DECEMBER 12, 2022: The road from McPherson Park to Kensington and Allegheny Ave are particularly popular places for folks to pick up or use drugs 

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PHILADELPHIA, PA- MARCH 9, 2023: McPherson Park in the Kensington neighborhood of Philadelphia. Kensington is known to be the largest open air drug market in the United States.

PHILADELPHIA, PA- MARCH 9, 2023: McPherson Park in the Kensington neighborhood of Philadelphia. Kensington is known to be the largest open air drug market in the United States.

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