BBC: As an open-air heroin camp is close, options narrow
At the top end of Gurney Street in Fairhill, Philadelphia, there's a dirt path that forks through some trees and winds behind an old car repair shop, down to the rail tracks below.
Follow the path and you'll find a makeshift shooting gallery under a bridge, where heroin addicts gather out of sight and the ground is a sea of used syringes, cookers and needle caps. People stand around a wooden table to fix, tying on tourniquets and tapping in the crooks of their arms to bring up their veins. One man leans into a mirror to find a spot on his neck, carefully pushing a needle through the skin and rolling back into a chair, his eyes glazing over. Others line up along a long steel beam that forms part of the bridge, unwrapping fresh syringes and preparing to inject. For anyone too nervous, or too far gone, to find a vein, there's a man in a wooden shack a few metres away known as "the doctor", who will stick you for a dollar.