One man stood outside a storefront church on a recent morning and stuck a needle in his arm. Bystanders milling about didn’t give him a second glance. Another man sat on a curb, his shoes and socks off, and jabbed a needle in between his toes. Nearby, a woman in a wheelchair shot up.
For years, city officials have been fighting — and largely losing — the battle against the opioid epidemic at the intersection of Massachusetts Avenue and Melnea Cass Boulevard, known as Mass. and Cass. They have poured in money and resources but the complex problems in the neighborhood persist.
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Now it has emerged as a central issue in the mayoral race, with multiple major candidates releasing plans that would dedicate still more resources — along with other tactics — to resolving the opioid and homelessness crises that have only intensified during the pandemic.
“We have failed everyone down here,” said City Councilor Annissa Essaibi George, one of those six mayoral contenders, as she toured the area with a small group of business and community leaders one recent late morning.
For years, this area, near the border of Roxbury and the South End and sometimes referred to as Methadone Mile, has been the epicenter of those crises. Boston Medical Center stands nearby, and the area is home to a cluster of services, including multiple homeless shelters and outpatient centers for those struggling with addiction, as well as a pair of methadone clinics.
There are some overlaps among the approaches suggested by the mayoral contenders and many unanswered questions. Multiple candidates are pledging to create more city positions that will focus on the neighborhood. Several are calling for a regional discussion to solve the problems of opioid addiction and homelessness. Most candidates have not offered much in the way of a price tag for their proposed solutions, though. Likewise, some in the field have emphasized developing housing with supportive services, but do not pinpoint where such programs would be sited.
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Essaibi George, state Representative Jon Santiago, City Councilor Andrea Campbell, and John Barros, the city’s former economic development chief, have highlighted the need to decentralize services offered in the area. Campbell wants to appoint a Mass. and Cass chief who would focus on the area’s problems and establish a dedicated first responder unit for the neighborhood.
Santiago, who works as an emergency room doctor at Boston Medical Center, advocates shifting the homeless services model away from traditional, large shelters toward supportive housing that has wraparound services to address addiction. Santiago wants long-term supportive housing at Shattuck Hospital and a treatment and recovery campus on Long Island. Where other locations for services would be sited remains an open question.
He also is pushing for an immediate moratorium on the siting of new public homeless and addiction services within a 1-mile radius of Mass. and Cass, as well as the creation of a police subdistrict specifically for the area. Like Campbell’s Mass. and Cass chief, Santiago wants to appoint a director of services for the area.
Similarly, Barros has said that if elected mayor he would immediately appoint a special adviser for mental health and substance use. He is also calling for three new city liaisons to oversee constituent services in the neighborhoods affected by Mass. and Cass. Barros has proposed establishing an operations center in the area, although he does not say specifically where. His campaign added that there are city and Boston Public Health Commission assets already located in the immediate vicinity. Like Santiago, Barros is calling for the public health commission to declare Mass. and Cass a public health emergency.
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None of the detailed plans released by Barros, Santiago, and Campbell talks about how much their initiatives would likely cost. Campbell maintains that most of her ideas would not require additional funding to implement. She said that until there is a chief for the neighborhood and a responder unit in place, it will be hard to move services away.
Barros did say his plan would require more investment from the city, adding that he would seek to use federal stimulus money to bring in more resources and personnel.
Santiago’s campaign said his plan “is an investment that will pay for itself while providing better care,” while stating that his proposal will require “investment and partnership with neighboring cities, the Massachusetts Legislature, and the federal government.”
The rebuilding of the bridge to Long Island, where former mayor Martin J. Walsh had promised a rehabilitation campus, looms large in any conversation about Mass. and Cass.
The bridge was abruptly closed in 2014 because it was deemed unsafe, upending addiction treatment services long offered there. Residents were evacuated off the island. Residents and business owners in the Mass. and Cass area said conditions deteriorated after the bridge closed.
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As mayor, Walsh, who became US labor secretary in March, made rebuilding the bridge and reopening the treatment facility a signature issue. But his vision floundered, complicated by a protracted legal battle with neighboring Quincy, where officials and residents remain fiercely opposed to constructing a new bridge.
Most of the mayoral candidates are emphasizing rebuilding and reopening the bridge and having some sort of campus providing addiction treatment services there. Councilor Michelle Wu, who has a citywide plan to address homelessness, substance use, and mental health, stands as a notable exception: She believes reconstructing the Long Island Bridge is not a feasible short-term solution.
“I am focused on solutions that we will deliver in the four-year mayoral term that I am seeking,” she said in a statement.
Last month, Acting Mayor Kim Janey said her administration is reviewing plans to make an addiction treatment recovery campus on Long Island in Boston Harbor sustainable, including considering launching a ferry service to transport people to services there, something Campbell had already pitched as a short-term solution.
Last month, Janey suggested that treating the region’s opioid crisis as limited to one cluster of city blocks was an inaccurate oversimplification.
“Some of the challenges that individuals are facing are much more than a location,” she said.
Like Janey, Wu has said the city must act and plan beyond Mass. and Cass. She has pledged to perform an audit within her first 100 days as mayor to identify city-owned parcels of land or facilities on which to quickly build supportive housing to alleviate the housing crisis that is concentrating people in the area. Her campaign has yet to detail the cost of such an initiative, although a spokeswoman did say “part of the point is that savings achieved by not investing $100 million in Long Island Bridge could help fund those services.”
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In her vision, Wu described a “hub and spoke model” that would locate recovery services and supportive housing throughout Boston in a way that would ”avoid placing additional transportation burdens on people in need of multiple services.” She also said the city needs to hire more case managers and provide more funding for existing services.
The city is already investing tens of millions into dealing with the problems at Mass. and Cass. Boston’s office of recovery services is budgeted for $8.6 million next fiscal year, a figure that has doubled during the last four years, according to authorities. A separate city department includes $5 million for homelessness programs.
New federal funding will be used to add clinicians to a medical street team and expand outreach in the neighborhood. Boston’s capital plan includes $5.5 million worth of renovations to Woods Mullen Shelter, a women’s homeless shelter, $9.6 million plans for an “engagement center” for the area, and $24 million for a Long Island recovery center.
On the day Essaibi George toured the Newmarket Square area, an industrial expanse of warehouses near Mass. and Cass, the complaints were numerous and varied: defecation on the loading docks of establishments, public sex acts, employees afraid to cross the street because of ever-present concerns of street violence. Reports of stabbings are commonplace, Essaibi George said.
Essaibi George spoke of “more” when talking about Mass. and Cass — more state support and more help from other cities and towns, noting that many who are struggling with addiction in the area came from outside the city. There are needs for “more shelter space, more services, more support for businesses, more coordinated response.” Like other candidates, Essaibi George said federal funds, along with the city’s budget and capital plan, should be used to improve the area. Her campaign estimated it will take about $30 million worth of investment.
She also mentioned that sexual exploitation in the area is a rampant problem.
“The sexual violence down here and the regular everyday violence is out of control,” said Essaibi George.
On the day Essaibi George toured the area, violence was not far away. Shortly after her entourage dispersed before noon on Southampton Street, dozens of people hung around the sidewalk with no particular place to go. The sun was shining and one woman sat cross-legged on the sidewalk and took a hit from a narrow glass pipe.
From the crowd, one man emerged and became enraged at a news photographer, hurling misogynistic threats of violence at her before assaulting another journalist, tearing open his shirt.
“You going to let these people stay in your [expletive] basement?” he yelled. “Then get out of here.”
Danny McDonald can be reached at daniel.mcdonald@globe.com. Follow him on Twitter @Danny__McDonald.