Fentanyl has reshaped the drug supply in Baltimore over the past decade. Far more potent than heroin, it shows up unpredictably – in opioids, stimulants, and counterfeit pills – and even a small amount can be fatal. 

After years of sharp increases, overdose deaths have recently begun to decline. But the crisis is far from over. Deaths remain high, and the risk is still there every single time someone uses. 

That’s the reality behind Go Slow, a Baltimore harm reduction campaign built around a simple idea: people can’t stay safe if the message doesn’t match what they’re actually experiencing. 

Instead of telling people not to use drugs, the campaign focuses on how to reduce risk. Start with a small amount (in case it contains a deadly dose of fentanyl). Don’t use alone. Carry naloxone. 

What makes Go Slow different is how it was created. The messaging came out of a multi-day workshop in 2018, led by the Johns Hopkins Center for Communication Programs, that brought together peer outreach workers, harm reduction advocates, and public health professionals. The goal wasn’t just to design a campaign. It was to listen. 

“The process of creating the campaign was just as important as the final product,” said CCP’s Tina Suliman. “We believe that the lives of people who use drugs have value and are worth saving. What better way to show that than to support them and the people who love them to design a campaign to keep each other safe?” 

Participants talked about how fentanyl had changed the drug supply – making it more unpredictable and more dangerous. They also talked about what kinds of warnings people actually pay attention to, and which ones they ignore. 

That approach – often called human-centered design – puts people with lived experience at the center of the work. The result is messaging that feels direct and practical, not abstract or judgmental. 

“Building trust in Baltimore starts with listening, truly listening, to people with lived experience,” says CCP’s Apral Smith-Jefferson. “When we work alongside communities, center their voices, and meet them where they are, we create space for authentic messaging. That’s where messages stop feeling imposed and start resonating, because they are shaped by the people they’re meant to serve.” 

Trust plays a big role in whether those messages land. Many people who use drugs have had negative experiences with traditional health systems and may be less likely to respond to institutional messaging alone. 

That’s where peer outreach workers came in. Members of Bmore POWER – a harm reduction group staffed entirely by people with lived experience with drug use – helped CCP develop the early campaign. Their deep ties and vast experience in the community made them ideal partners. Their knowledge enriched every conversion. 

Behavioral Health Systems Baltimore, the non-profit organization that manages the public mental health and substance use disorder service system for Baltimore, also brought its on-the-ground perspective to the workshop (and funded the original Go Slow campaign). 

CCP’s approach to developing health messages is grounded in partnership with communities, with intended audiences actively engaged in shaping, pre-testing, and refining those messages so that they are co-owned by the people who will most benefit from them.  

In this case, Bmore POWER members wanted to bring the concepts into the community themselves, which they did with training and support from CCP staff. This led to truly honest feedback on the draft materials.  

William Miller, Jr., one of the founders of Bmore POWER, remembers how people in the community reacted at first when they brought the materials to the street. “Ain’t nobody going to stop using drugs,” Miller recalls. “We just wanted to keep more people alive.” 

The word was out about fentanyl, how deadly it could be, how one bad batch of heroin laced with the stuff could set up a string of overdoses in the neighborhood. And people were scared. 

Knowing the threat, some people had started to inject their opioids slower, to give a chance to stay safe if the drugs turned out to be bad. But no one had put a word to it like the CCP workshop did. Miller saw it clicked when he was talking to his neighbors. The added ideas of using alongside someone else and carrying Naloxone spoke to them. 

What Bmore POWER brought back enabled CCP and Mission Media to refine the campaign into what it became. 

Survey results from 2020 found that among respondents who recall seeing the “Go Slow” message, 48 percent got naloxone in the previous year compared to 15 percent of respondents who did not recall seeing the message.

More than 40 percent of respondents who recalled seeing the message had a conversation about overdose prevention with a friend or loved one compared to 21 percent who did not recall seeing the message.

To this day, nearly a decade on from the first workshop, Bmore POWER and other community members still hand out naloxone, talk through overdose responses, and share Go Slow materials in their communities. 

And because the message is coming from someone they trust, it’s more likely to stick. 

The campaign reached people across the city – on the street, on buses, online, and in community spaces. Its digital ads generated hundreds of thousands of impressions, and surveys suggest many Baltimore residents recognize overdose prevention messaging, including Go Slow. 

People report learning how to use naloxone, how to recognize an overdose, and how to reduce their risk. Just as important, they’re talking about it – with friends, family members, and outreach workers. 

No single campaign explains why overdose deaths have started to fall. But public health experts point to a combination of factors: wider access to naloxone, more outreach, and greater awareness of how dangerous the drug supply has become. Go Slow was part of that shift. By focusing on realistic, actionable steps – and delivering them through trusted voices – it helped more people understand how to stay safer in a high-risk environment. 

The work isn’t finished. Fentanyl still dominates the drug supply, often mixed with other substances, and its strength can vary widely. Structural challenges, like unstable housing and limited access to care, continue to shape who is most at risk.  

And not everyone heeds the message. Miller knows this firsthand.   

He had founded Bmore POWER along with his father, William Miller Sr., who used drugs for 40 years. In October 2020, with the concepts of Go Slow catching on, Miller Sr. died of an opioid overdose himself. 

He was using alone. 

Go Slow is still active, continuing from its origin in CCP’s conference room by community outreach workers like Miller Jr., nearly a decade after it launched.  

And as he and others  continue to distribute naloxone, they continue to adapt their messaging as conditions change, some with an eye to legalizing safe injection sites where the ideas in Go Slow would be implemented The campaign has also drawn interest from other communities looking for ways to respond to fentanyl in a more grounded, community-driven way. Miller says he has spoken at drug policy and addiction conferences around the U.S. about this harm reduction that works. 

Go Slow doesn’t promise to solve the overdose crisis. What it does is simpler, and just as important: it helps people stay alive.