Whose Problem is The Drug and Homelessness Issue to Solve? Taunton, MA
The commonwealth’s substance abuse and homelessness crises
BOSTON—Mass. and Cass, the Boston intersection that serves as the core of the commonwealth’s substance abuse and homelessness crises, is only the most obvious illustration of a state-wide problem requiring a state-wide solution, according to community mobilizers, public health specialists, and politicians.
To date, the tent city located at the junction of Massachusetts Avenue and Melnea Cass Boulevard has created many headlines but few meaningful answers. Until recently, Boston neighbors and neighboring municipalities were divided on who should address the issue.
“The commonwealth looks at Boston as its own sort of entity [that can] handle its own issues, and so the governor doesn’t want to maybe trample on the mayor or the mayor doesn’t want to ask the governor for help, but I think we’re beyond that level of political jockeying. People are dying, “said Marla Murphy-Smith, a resident local to the Mass. and Cass neighborhood and an organizer for the South End-Roxbury Community Partnership.
“The impact on the community has just been horrific, and the governor has been too hands-off for this critical humanitarian crisis that’s occurring. That needs to stop.
A “humanitarian and health emergency”
Governor Charlie Baker has dispatched the Department of Public Health to engage with the city to determine how the state can assist with the “humanitarian and public health crisis” at the intersection of Massachusetts Avenue and Cass Street, but he has ultimately stated that Boston “has jurisdiction over this stuff.”
Community members, such as Murphy-Smith, and state lawmakers contend that, although the state’s opioid and homelessness crises are most obvious at the intersection of Massachusetts and Cass, they represent a scourge of addiction and homelessness that threatens to spread to every part of the state.
“The state definitely has to play a role because not everybody who’s at [Mass. and Cass] is from Boston or the Greater Boston area,” said Sen. John Keenan, D-Quincy, Senate Chair of the Legislature’s Committee on Housing.
“They come from all over the commonwealth for a variety of reasons, so every community in the commonwealth and the commonwealth itself has an obligation to address [its] homelessness and substance abuse issues.”
Drug abuse and homelessness pandemic case-study
According to a DPH study published in November, there were 1,613 verified and projected opioid-related overdose deaths in the state during the first nine months of 2021, a 1% increase over the previous year.
The increase in opioid-related overdose deaths in the commonwealth corresponds with a countrywide crisis that was recently blamed for more than 100,000 deaths in 2020–2021. Massachusetts’ opioid-related mortality rate has stayed persistently above the national norm since 2008, hitting more than twice the national average in 2016.
Experts in public health, such as Bertha Madras of McLean Hospital, who has participated in a number of presidential drug committees, commend Baker for introducing policies that have assisted the state in reversing its escalating opioid epidemic trend.
“In the past year, when the U.S. was traumatized by over 100,000 deaths, the rate of increase in Massachusetts was only 5.8%, whereas it was almost 50% in California, 70% in Vermont, and 18% in Rhode Island,” said Madras. “While the rates were increasing steadily in the country, the rates in Massachusetts were either remaining stable or going down, except for very recently.”
But constituents and legislators are asking that the Baker administration do more, arguing that the problem in Boston requires more attention from the executive branch since it has gone beyond the city’s authority and does not involve only Boston or Greater Boston residents.
The mayor’s plans
The most current proposals of newly elected Mayor Michelle Wu involve transforming the Roundhouse Hotel at the junction of Massachusetts and Cass into a location for low-threshold housing to be managed by the Boston Medical Center. This idea has been met with strong opposition from community members, who argue that it conflicts with their demands for the decentralization of services.
“We’ve been demanding that they decentralize services throughout the commonwealth,” said Yahaira López, another organizer from the South End-Roxbury Community Partnership. “We don’t mean move it from Mass. and Cass to another Black and Brown, urban or low-income, low voter turnout community… we mean decentralize [services] across the entire Commonwealth of Massachusetts.
“How can we help stabilize people if we’re not giving them the opportunity to [recover]? By not removing them from the same spaces that trigger them, Madras elaborates on requests for the decentralization of services, stating that enabling individuals to remain in an environment that nourishes their addiction, or in close proximity to it, binds them in an eternal loop.
“The drug dealers are permanent residents of the area, meaning that they know exactly where the customers are, and that’s where they go,” said Madras. “There is almost no attention paid to reducing the supply or changing the environment in order to help these folks.”
Madras supports the reconstruction of the Long Island Bridge and the island’s facilities, which were formerly a campus of drug misuse treatment centers. It is not an instant answer, however, because the rehabilitation would take years and cost millions of dollars.
While López sees positives in reconstructing the Long Island Bridge and its amenities, she does not want it to become a vehicle for the state to hide its addiction and homelessness problems, allowing individuals to adopt an “out of sight, out of mind” attitude.
However, Madras believes, from a public health standpoint, that Long Island should be rebuilt because it provides a space for individuals to fully recuperate, free from the temptation to return to the hazardous environment they fled.
“It wasn’t perfect, but it was idyllic because it was inaccessible to the people who perpetuate the problem, and that’s a critical part of the solution,” said Madras. “It was isolated from drug dealers [and] from every possible environmental issue that could feed into a person’s problems.”
Not only the duty of Boston
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Multiple legislators have agreed that the state must have a role in tackling the opioid and homelessness problems in Massachusetts and Cass County and in implementing statewide programs to combat and avoid similar crises in other counties.
“It is absolutely not just Boston’s responsibility; there needs to be a commitment that every region of the state has not only substance abuse clinics but support services for people that have a predilection to addiction,” said Sen. Jamie Eldridge, D-Acton. “It’s about strengthening the social safety net… everything from affordable housing to better re-entry services for [formerly] incarcerated people.”
“It’s a crisis with many different facets; it’s a public health crisis, it’s a mental health crisis, it’s a housing crisis, and it’s a major problem that has impacted countless lives,” Rep. Bruce Ayers, D-Quincy, wrote in a statement. “A multi-faceted problem deserves multi-faceted solutions. We need to continue to invest in addiction treatment and recovery services, but we also need to look beyond that at how we can support a sustained recovery through comprehensive housing, nutritional, and educational initiatives.
According to Madras, transitional housing choices must be linked with appropriate treatment and rehabilitation programs to provide people with substance misuse disorders an opportunity to reintegrate into society.
“The most important resources are mental and physical health evaluations; these people absolutely require to be assessed,” said Madras. And there has to be a little bit of an effort [toward] also imposing a level of responsibility on the individual to take their medications, if they need them, to try to show up for treatments, appointments, group therapy or what have you… And if there is a sense of recovery, there should be job training. ”
And while Madras feels that the decentralization of services has more positives than problems, she reiterates that the government must be very deliberate in how it distributes them.
“If we decentralize the Mass. and Cass [facilities], we have to figure out what the positives of being in that location were and make sure that we can replicate them, not eliminate them,” said Madras. Are dry shelters a hindrance to the resolution of the crisis?
The opioid and homelessness pandemics in the Commonwealth, according to Keenan, demand a concerted effort from all levels of government and a more flexible approach to meeting people’s housing requirements.
“A lot of shelters are dry shelters, meaning people who go there cannot use drugs, and if you are addicted to heroin or fentanyl, you need drugs constantly.” so people can’t access homeless shelters because of their addiction, “said Keenan.
“[They need] a structure that acknowledges their addiction… And in those types of shelters, [there has to be] access to services so that when people are there, [they] have people that are ready to move them into treatment and recovery, and make sure that they’re aware of the various programs that are available.
Rep. Lindsay Sabadosa, D-Northampton, who has been outspoken about homelessness in western Massachusetts, agrees that dry shelters impede efforts to resolve the housing situation. She feels that individualized assistance for transitional housing would be more effective.
“The issue is hard because every individual is extremely different and needs a really personalized pathway,” said Sabadosa. “I’m a huge proponent of moving away from the traditional shelter model to[to] something that is more personalized for people because I think we have spent a lot of time just kind of putting band-aids on things and not really addressing the underlying issues.”
Sabadosa agrees with her colleagues that the state should be accountable for addressing its drug and homelessness crises, particularly given the associated expenses.
“The state absolutely needs to play a role because the citizens can’t pay for it on their own, there’s no way,” said Sabadosa. “Services need to be spread out all over the commonwealth because there are homeless people everywhere.”
Could ARPA funding be utilized?
Murphy-Smith has stated that the community is also concerned about prices.
“In order to provide housing, we need money to acquire housing,” said Murphy-Smith. “You need money to run programs, and I think having the state involved would provide more access to things that are available out there if only we had somebody at that level to make the ask.”
Following Baker’s approval of the first half of the commitments in the Legislature’s proposed spending plan that Baker signed on December 13, which allocates $964 million for health care and $624 million for housing, Keenan says the Legislature will look to further address these funding needs in the second half of the ARPA distributions.
As of December, the Baker administration has also committed funds for 38 syringe service programs and the development of 33 overdose education and naloxone-distribution locations, and it aims to create a temporary housing “cottage community” on the Lemuel Shattuck Hospital campus that would provide the individualized housing described by Sabadosa.
It is quite clear that this is not only a Boston problem; it is, at least, a statewide problem, if not a regional problem…
“The state, unfortunately, has been very slow to get involved with addressing the issues centered around Mass. and Cass,” said Murphy-Smith. “There is no excuse, in a resource-rich area like Massachusetts, where we have so many hospitals and schools and colleges and highly educated people, [for the state] not to be addressing this issue.”
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