BALTIMORE — For Regina Brown, hope for a clean life is pink and comes at the bottom of a little plastic cup.
Each weekday, Brown rises early to stop at the Man Alive Lane Treatment Center before work. She takes a number and waits her turn before approaching a staffer sitting behind a plexiglass window. A small dose of methadone is passed through a hatch, and she gulps down the bitter liquid. Before she can leave, Brown must open her mouth to say “thank you” to the clinic worker — a practice to ensure patients won’t spit out the medication later to sell on the street.
A former heroin addict, Brown said that before coming to Man Alive, she was miserable — jobless, estranged from her son and out on the streets desperate to find her next high. After three years of treatment and counseling at the substance abuse clinic, Brown said, Man Alive transformed her life.
“It’s a good program,” Brown, 56, said. “It’s like a family out here.”
As the oldest methadone clinic in Maryland and the second oldest in the United States, Man Alive has consistently served hundreds like Brown for more than 50 years, but decades of service was abruptly halted July 15 when Ashanti Pinkney walked into the center armed with a silver handgun and opened fire.
Pinkney, who friends say had been complaining of weak dosages during his treatment, held one employee at gunpoint and fatally shot another as he demanded methadone, police and witnesses said. Pinkney seriously injured a Baltimore police sergeant responding to the scene before dying in a gunfight with police.
Though the shooting has been traumatic, those who rely on Man Alive said they refuse to let the violence upend the treatment center’s work. The clinic reopened Monday.
“Our hearts are broken over the lives lost and those staff who were injured and traumatized,” Man Alive Executive Director Karen Reese said in a statement on the organization’s website. “Over the past 52 years, our clinic has never experienced this kind of violence. While it has shaken us, it will never stop us from continuing our mission in the community we love.”
On Tuesday, Baltimore police released body-camera video from the sergeant who was shot, providing the first look at what clients and staff members experienced as officers responded to the scene.
Police and a woman inside the clinic are heard repeatedly commanding Pinkney to “put the gun down!” and “don’t do it!” as Pinkney takes cover behind a wall near a table with doses of methadone.
“I’m just waiting for someone!” Pinkney yells back at officers. The video then shows the glint of a silver revolver that Pinkney fires in the direction of the officers before police fire back.
“I’m hit in the stomach,” Sgt. Bill Shiflett says as the camera view shifts to the ceiling and another officer drags him out of the clinic. Shiflett, who was struck below his ballistic vest, was released from a hospital Sunday.
The revolver was not registered to Pinkney, who was later found to have additional rounds of ammunition with him, Baltimore Police Commissioner Michael Harrison said.
Outside the clinic on the day after the shooting, Man Alive regulars socialized along Maryland Avenue as they regularly do on the bustling street, where clinics are sandwiched between homes and law offices. Eating snowballs from an ice cream truck on the corner and sharing cigarettes, they recalled Pinkney — nicknamed “Ghost” — as a generous, chatty man. Still in shock that a fixture in the neighborhood would go on a rampage in the clinic, they worried that the shooting would add to biases against those in the recovery community.
“I hate to hear them say, ‘Look at these junkies,’ ” said Brown, who “started sniffing dope” at 25. “We go through the same thing alcoholics do.”
After three months at the clinic, Brown said, she noticed her life change through treatment, support groups and writing classes. The clinic helped cure her hepatitis C. She got a job and housing, and she has reconnected with her son.
“People think it’s all negative, but there are people here who have doctorates and are educated and they just had a problem,” said one man, who spoke on the condition of anonymity because he is undergoing treatment and fears that bias.
“Drugs don’t discriminate,” Velma Owens said in agreement.
Owens, who has been going to Man Alive for 12 years, said clinic employees are helpful and supportive. She specifically recalled David Caldwell, the clinic worker who was killed in the shooting.
Caldwell patiently listened when she came in and talked about support meetings she was attending and what she was doing to get clean.
“He supported our goals,” Owens said.
Paul Little, medical director at Laguna Treatment Hospital within the American Addiction Centers network, said methadone clinics are frequently disparaged but often lead to positive, lifesaving outcomes for patients.
Little said that in six years working full time at a methadone clinic, he has seen patients become agitated, shout and shove.
“Overall, I think methadone clinics are safe,” Little said, noting that employees commonly take part in safety training and disaster drills. “However, patients are often feeling miserable, terrible, and that can make people desperate.”
Reese’s statement did not specifically mention Pinkney, but she praised the “fearless response” of staffers on Monday, “evidence that preparedness, dedication and commitment to those we serve remains our highest priority.”
There are 87 drug treatment centers in Maryland, 35 of them in Baltimore. Man Alive is often held up as a trailblazer for its comprehensive programming that not only addresses substance abuse, but also offers mental-health treatment, art therapy and health-care guidance for those on Medicaid.
In 2016, the U.S. surgeon general at the time made it the first stop on a national tour of drug treatment facilities as the Obama administration sought to tackle the opioid crisis.
Man Alive has not had previous safety concerns, and the program is monitored annually for clinical and staffing compliance, according to the Maryland Department of Health. The department said that the clinic’s last compliance review was June 17 and that it was deemed compliant in all reviewed areas.
The nonprofit Behavioral Health System Baltimore works with the state to provide some funding and assessment to providers of mental-health services in the city, including Man Alive. Adrienne Breidenstine, vice president for policy and communications at Behavioral Health System, said the clinic has always been in good standing.
Man Alive, like all Behavioral Health System providers, goes through emergency-response planning and active-shooter drills, which include how to de-escalate a situation, she said.
“There is always an issue of people becoming agitated,” Breidenstine said.
Though many methadone patients go to clinics daily for treatment, the goal is to wean them off the opioid completely.
Cynthia Miles has been going to Man Alive for about eight years and is down to once-a-week visits. Man Alive stopped her addiction to cocaine and heroin.
“I was broke all the time,” said Miles, who was spending $80 to $100 a day on her addiction. “Now I have a bank account. I have my own place. I’ve been clean for six years. I had to get myself together.”
Owens shook her head, thinking about the July 15 shooting, saying the “people who got caught up in it didn’t deserve it.”
“Man Alive is not a bad place,” Owens said. “It’s a place that really wants to help people with recovering.”