On the corner of Mass. Ave and Melnea Cass Boulevard, groups of people huddle under makeshift umbrella tents, while others wander aimlessly down the street, stepping over used needles, discarded blankets, food wrappers and human excrement. Outsiders swim through the scene like sharks, peddling their illegal wares: Klonopin, Xanax, Newport cigarettes.
Just around the corner, John, who asked GBH News not to use his last name, sits in the shade behind a dumpster and injects a needle into his thin, scarred arm. The shirtless, baby-faced 23-year-old looks like he could be a teenager, roaming the neighborhood with a broken city bike and a backpack that contains everything he owns.
For John and many others struggling with substance use, a Boston Medical Center site at the busy intersection provides services with a "harm-reduction" approach to sustain them until they're ready to get help. The number of unhoused people in the area swelled after a shelter on Boston Harbor's Long Island was closed in 2014; a connecting bridge had been declared unsafe. Residents and business owners around Mass and Cass say the concentration of services has overwhelmed the neighborhood to the point where it has become dangerous.
The situation's visibility — because of the high volume of drivers who pass through the area — has attracted the attention of the mayoral candidates, who have reached a general consensus on decentralizing the health-related resources there and spreading them around to other communities. Many area residents have been calling for that strategy for years.
At-large City Councilor Annissa Essaibi George has proposed a city-level board made up of individuals who are in long-term recovery or accessing harm reduction services. The advisory board would review plans and resources related to substance use.
At a candidates forum in May, Councilor Andrea Campbell, who represents Mattapan and Dorchester, has called for a “Mass and Cass chief” to coordinate the efforts of public health, law enforcement, and recovery and mental health specialists.
"Right now, you have folks who are going out helping folks get into supportive housing, helping folks get a recovery, working on maybe decentralizing services," Campbell said. "It's all disjointed. Everyone's in a silo, no one's sharing information with each other. So I'm saying put together a unit where it's the same folks showing up that include mental health clinicians, recovery specialists, those who work in supportive housing to help those who are homeless."
John Barros, the city's former chief of economic development, has advocated for a special advisor to oversee the situation and lead a special team to work on it.
“We need to hit the streets now,” Barros said at the debate. “We have to triple the team on the streets now and get services on the streets right now. We need to do it like not in some meeting or some new group, we need to do it by doing it now.”
Acting Mayor Kim Janey has floated the idea of ferrying people to Long Island to access the closed shelter, but Janey doesn't yet have an estimate of the costs or a plan on how to cover them.
“While a bridge still remains the clearest option for reopening the campus, the city continues to explore costs for a ferry that could at least serve as a transportation complement,” Janey wrote in a statement to GBH News. “This also includes expenses for emergency response on the island, such as medical staffing, trauma life support equipment, and first responder training.”
At-large Councilor Michelle Wu is the only candidate opposed to reopening the campus on Long Island. Between the estimated $92 million bill to repair the bridge and a contentious legal battle over reconstruction that has cost the city thousands, Wu says the proposal would take too long and cost too much.
"Even if we were able to get permits tomorrow, it would still be a three- to five-year process to rebuild the bridge,” Wu said at a City Council forum in 2019. "Not to mention the funding for new buildings. ... I have deep concerns about whether this is the most effective and immediate way to address the opiate crisis.”
During a news conference in May led by Barros’ campaign, Suffolk County Sheriff Steven Tompkins emphasized the need for all the mayoral candidates to act with urgency on Mass and Cass. The House of Correction he supervises is nearby. The sheriff says he won't endorse anyone in the mayoral race until after the Sept. 14 primary.
“What this community needs to see is the next mayor coming down here with some regularity,” Tompkins told Barros. “You can have your designee down here, but we need to see whoever is the next mayor, either you or one of your opponents, down here to give people the sense that the city does care. This was just dropped on us with no plan. You've just inherited 450 people that need shelter.”
Doris Wong, who owns Food-Pak Express, a wholesale grocer on Southampton Street, says her patience for new plans and strategies has worn thin.
“My employees are getting robbed, my customer’s cars are getting broken into. Of course, we all have empathy for them, but I just keep hearing the same old speech,” Wong said. “I keep hearing the same speech over and over, and everybody says they can commit — but no action. All talk, no action.”
Last November, the city added an advisory task force that meets monthly and a new Boston Police street outreach unit in the area to connect street dwellers with services, but business owners like Wong say they have seen little change.
Boston Medical Center did not provide anyone to comment on progress or updates. In an interview with GBH News last year, Kim Thai, the city’s Mass and Cass liaison, said that the pandemic has dramatically set back its strategic plan for the area.
“A lot of service providers had to close their doors,” Thai said, “and suddenly you just saw an influx of people on the street.”
Thai said she “understands the frustrations” of residents and business owners in the area. “I think that sometimes we feel the same frustrations because we're doing everything that we can to be able to offer as much access to treatment and services that we can,” he said.
Maria Adarmes, who has lived in the neighborhood since the early 1990s, said she, like Wong, is running out of patience.
“Every year, every day, it’s getting worse, and nothing has been done,” Adarmes said. “Every day, it’s more people shooting drugs outside your door, more people getting naked in the back of your house, more people trying to rob you. When are we going to see something change?”
Adarmes has videos and photos of people trying to break into her home, using drugs on her property and harassing her while she takes out the trash. Her back stoop was used as a bathroom so many times, she said, that the floor inside her home needed to be replaced to eliminate the stench of urine.
“These people are human beings, and I feel sorry for what they are going through, but it’s affecting our life, too,” she said. “It’s affecting my family and the way that I live my life. I feel like I am trapped in my house.”
Adarmes raised her daughter, Yahaira Lopez, in this apartment. Lopez, 42, leads the South End Roxbury Community Partnership — a group of concerned residents that has been calling for a solution for years.
“It just kind of feels like it's not going to happen,” Lopez said. “We're screaming for decentralizing, but what community is going to step up and take on this role if we haven't demonstrated that it has worked?”
A 2015 report from the state shows that individuals who seek acute treatment for one week report difficulty finding further support services that last more than two weeks, according to a 2015 report from the Massachusetts Center for Health Information and Analysis.
Lopez, a former crisis worker, says people need long-term solutions.
“No one recovers in two weeks,” Lopez said. “That doesn't include the mental health part, unpacking your traumas from being on Mass and Cass. I feel like we jump to a solution without tackling the middle part, and you can't stabilize people if you have not stabilized them mentally, spiritually and emotionally.”
Lopez’s older brother and Adarmes' son struggled with substance use and spent years living on Mass and Cass, where Lopez said he sought substances, not treatment.
“I've had a sibling down here and I know that's what's happening there has not worked,” Lopez said. “How can you expect someone to recover when everything that they are looking for is centralized in one location?”
Lopez says there needs to be a system of accountability — a way to figure out where people struggling with substance use are and whether they are safe.
“We're constantly asking, do we have a database of these individuals? Because in different Facebook groups, you're seeing people posting, have you seen my cousin, my sister, my mother?” Lopez said. “We weren’t a family that gave up on my brother. There’s all these families who are always out there looking for their loved ones.”
Creating such a database would be next to impossible to compile because federal privacy law protects the medical records of outpatients.
Back at the corner of Mass and Cass, John says his mother has been trying to find him for years, and checks in when she can.
“We spoke a few months ago, and she told me to go home,” John said. “I told her I don't want that, because it's going to be hard for me to stop.”
After living on the street in downtown Boston for two years, John heard about Mass and Cass, a place where people struggling with substance use can access not only detox programs but also free methadone, clean needles and a space to use drugs with impunity.
“I mean, obviously I'm down here to do my drugs,” John said. “Cops pass by, they see you shooting up, they don't do anything.”
John says he wants to go into recovery, but like many people living on Mass and Cass, he just isn't ready. He says having access to opioids here makes it safer to use but harder to quit.
“It makes it easier for people to get the drugs, the materials to do it, everything that they need,” John said. “So for me, it’s really not helping.”
As a high school student, John was enrolled in the Junior ROTC. He had dreams of a career in politics or business. Just five years later, he says he feels like he's trapped with no way out.
“I look around and I look at my life, and I'm like, I'm tired of this,” he said. “It changes people.”
This year, former Boston Mayor Marty Walsh was sworn in as President Joe Biden’s labor secretary, making history as the first cabinet member to be openly in 12-step recovery from addiction, in his case, to alcohol. In his 2016 State of the City address, Walsh offered advice to people like John, a young man with ambitions stifled by the grasp of addiction.
“Recovery begins with a simple plea for help,” Walsh said. “We are here to help. Don’t suffer alone.”
John sometimes feels like his life is hopeless... but his family hasn't given up on him, and he still holds out hope for his own recovery.
“One step is coming out of this,” John said. “And people have done it.”