NASHVILLE, Tenn. (WKRN) – Opioid overdose deaths have been called deaths of despair.

“When we think about the conditions under which people experiencing homelessness live, they have more reason to have despair,” said Bobby Watts the CEO of the National Health Care for the Homeless Council.

“Here in Nashville, the zip codes with the largest opioid deaths are those that are poorer Madison, Antioch, South Nashville, North Nashville,” Watts explained.

Courtney Pladsen, a nurse practitioner who serves as the Director of Clinical and Quality Improvement and is working alongside Watts, explained the cycle of drug use. “Even though heroin use or fentanyl use might be used at the same rate across different populations, homelessness exacerbates chronic illness, and chronic illness might be a driver of homelessness,” said Pladson.

Treatment is limited for several reasons.

“One of them is stigma,” said Watts. “We don’t view it as a medical problem. We view it as a deficiency of the person instead of looking at it as a deficiency of our system that we don’t have enough treatment.”

In Middle Tennessee, Street Works is the only location designated as a Syringe Service Program where free sterile injection equipment is available.

Currently, there are no safe consumption sites where people can use pre-obtained drugs under the supervision of trained personnel who also explain treatment and housing options.

“I think a big fear that people have with programs that are serving people experiencing homelessness, or people with mental illness, or people with substance use disorders, is they believe that that is going to attract people who will be a threat to the neighborhood,” Watts said. “The fact is, most of these programs are placed in areas that are already suffering greatly.”

Contrary to common belief, Pladsen said these sites do not increase drug use or crime but instead can save millions of dollars. “Emergency departments, jails, mental health hospitals are the most expensive types of housing we have. If we’re going to continue to pay millions of dollars for people experiencing homelessness to have to cycle through these systems, we’re not leveraging the money that we have in an effective way.”

And as long as dealers have easy access to people struggling, the fentanyl fight will continue.

“We call it an epidemic,” Watts said, “and an epidemic implies contagion, that things can spread. And we see that when we have a cluster of people using drugs, it makes it easier for others nearby to use drugs.”

Overdose deaths have nearly doubled in Tennessee in recent years. News 2 digs deeper into the impact on families and community in a series of special reports – Deadly Deal.