“Narcan! Narcan!”
The shout came from down Bradston Street and no further explanation was needed. It was not a request, but rather a demand; a life hung in the balance. Someone had just overdosed and a man was yelling into a crowd for the medication used to reverse an opiate overdose.
Two outreach workers stationed nearby hustled over to a tattooed man who was lying flat on his back on the sidewalk. Onlookers were brusquely told to move out of the way as the pair worked to revive him.
All told, it’s another heartbreaking day in the neighborhood around the intersection of Massachusetts Avenue and Melnea Cass Boulevard, the epicenter of the city’s opioid and homelessness crises. The Wu administration cleared the area of ramshackle shelters in January, and connected scores of people to services, but the knotty problems of addiction and mental illness persist.
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Anecdotally, some in the area say there are fewer people milling about here on a day-to-day basis, but the scene looks much the same. The tents may be gone, but dozens of people are still using, selling, and seeking hard drugs on these streets everyday. A rash of violence has also plagued the area recently. Which leads to a pressing question for Mayor Michelle Wu: What’s next?
Wu’s team said they expect to roll out of the next phase of the city’s response soon.
Steve Fox, chairman of the South End Forum, an umbrella organization for neighborhood groups, said the city is making progress offering clinical programs to people on the streets, “but the housing is just not working, it’s not working fast enough.”
“We need more transitional supportive housing,” he said.
Authorities have used the nearby Roundhouse hotel as temporary housing and medical clinic for those living on the streets. Fox along with other area residents and business owners argue the Roundhouse operation is in the wrong place, with too many people using it “as their clubhouse for dealing drugs on a day-to-day basis.”
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He argued Boston has not done enough to spread the cluster of social services around Mass. and Cass throughout the city. He also wants more emphasis on public safety, specifically targeting the drug dealing.
For Wu’s part, she has said that decentralizing services remains a focus. But, her office declined to provide details of the new plan for Mass. and Cass to The Boston Globe earlier this week.
During an appearance on WBUR Monday, Wu acknowledged that removing the tents did not completely solve the humanitarian crisis at Mass. and Cass, although she noted that some 180 people who were living on the streets have been housed in some capacity and accessed treatment and care. (Wu’s administration added that 18 people who were placed into transitional housing citywide have found permanent housing.)
”We continue to see, with the warming weather, large crowds gathering, and that has been difficult for public safety,” Wu said.
Like Fox, Sue Sullivan, executive director of the Newmarket Business Association, praised the city for removing the tents in the area earlier this year and for preventing another tent city. Both acknowledge those developments are significant for the quality of life in the neighborhood.

But Fox and Sullivan question whether the benefits of having an engagement center that provides a daytime drop-in space for those struggling with addiction and homelessness outweigh the negatives. The center on Atkinson Street that opened in December offered food, shelter, clothing, treatment resources, and access to medical care, according to city authorities. The city recently shuttered the center — temporarily, officials said — following stabbings in the area.
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Sullivan said the center, whatever its aim, has become a “safe place for drug dealers during the day where they can ply their trade.”
“And that has to stop,” she said.
Janett Colombo, owner of New Market Pizza, believes the area has become more violent since the tents were removed. She is thinking about closing her pizzeria, given the effect the daily scenes of misery across Southampton Street has had on her business.
“No one wants to come here anymore,” said Colombo.
She said there are at least three disruptive incidents a week inside her pizza shop. Either people don’t want to leave, or an argument escalates into a screaming match, or someone tries to intimidate one of her four employees. This week she said someone flashed a knife to one of her workers.
“To tell you the truth, there’s no law here,” she said. “No law at all.”
Others had different criticisms of the city’s approach.
Leo Beletsky, a professor of law and health sciences at Northeastern University, is adamant “the problem isn’t the engagement center; it’s the lack of additional services.” He argued Boston should have more syringe exchange locations and establish a supervised drug consumption site near Mass. and Cass. He thought the removal of tents and the shuttering of the center were wrong-headed initiatives that leaned too heavily on law enforcement to simply sweep the problems of Mass. and Cass under the proverbial rug.
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And, pushing the problem to other areas of the city, he said, simply disrupts the fragile support networks people living on the street have built for themselves.
“You temporarily get rid of the visual signs of the problem without actually addressing it,” Beletsky said.
While neighbors and businesses remain frustrated, officials have launched other initiatives to combat the crisis. Suffolk District Attorney Kevin Hayden, for instance, recently announced the expansion of a program that allows defendants whose crimes are rooted in mental illness or substance use to have have the option of participating in a treatment program.
Some aspects of the city’s Mass. and Cass approach are in flux. For instance, mayoral adviser Dr. Monica Bharel, who has recently spearheaded the city’s Mass. and Cass efforts, plans to leave at the end of May. Boston plans to hire a liaison for the area.
On the streets, there is a mix of hope, apathy, and pessimism about what the future holds. Many scoff at the longer-term idea to reopen Long Island bridge and build a recovery campus on the island. Some say it’s an unrealistic pipe dream.
Recently, police and outreach workers have regularly herded people off Southampton Street, typically in the late morning, according to those who live there and advocates. In April, the city began weekday cleanings, and those in the area at the time are asked to leave for their safety, according to the city.
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“People like us, homeless people, we’ve been shifted around like cattle,” said Richard Cabral. With the engagement center closed, he added, “all these people have nowhere to go.”

“She’s got a real tough job ahead of her,” said Cabral of Wu. “Most of the focus should be spent on where to place these people.”
Jeanine Giordani, who is also down at Mass. and Cass, thought the city should open more engagement centers throughout Boston.
“She did a really good start,” she said of Wu. “Keep it up, keep the support going.”
On Bradston Street, outreach workers tended to the overdosed man with Narcan, oxygen, and sternum rubs. (The Boston Public Health Commission has distributed more than 26,000 doses of Narcan this fiscal year.)
“Come on, wake up buddy,” said one onlooker. Another man offered encouragement in Spanish, even as he was sticking a syringe into his own forearm. Others walking around the open-air drug market paid the scene no mind.

The man splayed out on the ground is big and tattoos cover his body, including a four letter-expletive scrawled across one of his knuckles. The police came just as he was coaxed back into consciousness, and almost as quickly, the officers left, the paramedics behind them. Leaning against the fence, the man returned to talking to people.
A few minutes later, one of the outreach workers was told he just saved a life.
“We’re doing our best,” the worker replied. “Some day there’ll be a solution, and our job is to make sure they’re alive for that solution.”
Danny McDonald can be reached at daniel.mcdonald@globe.com. Follow him @Danny__McDonald.