For years the streets around the intersection of Melnea Cass Boulevard and Massachusetts Avenue in Boston have been an unsafe homeless encampment and open-air drug market, populated by people struggling with homelessness and substance use disorder and those who prey on them.
Boston Mayor Michelle Wu has taken a compassionate, public health approach to Mass. and Cass, focusing on connecting people with housing and substance use treatment. This housing-first approach is valuable and needs to be expanded. But it is not sufficient.
Any approach to Mass. and Cass needs to start with health and housing but must also address public safety and quality of life.
Wu has acknowledged an increase in violence and drug and human trafficking, an uptick that has led some outreach organizations, which offer services like health care, to pull teams out of the area. Boston Police Department spokesperson Mariellen Burns said the police have seen a change the last couple of months. “The population has gone from one looking for help and resources, to folks looking for drugs and an increased number of dealers and others looking to prey upon the individuals in the area who are struggling with substance use and or mental health challenges,” Burns said.
City officials are considering changing the city’s policy regarding tent removal, possibly by eliminating a requirement that police give 48 hours notice before removing a tent. City coordinated response team director Tania Del Rio said tents are “shielding dangerous activity including drug trafficking and violent acts.”
The best way to address chronic homelessness is through low-threshold housing, where people are offered housing even if they are using drugs or alcohol and can access support services like mental health treatment. As Dr. Sarah Wakeman, medical director for substance use disorder at Mass General Brigham, said, it is a tall order to ask someone to stop using substances before addressing the factors that drive people to use — often a lack of housing, community, and financial stability.
The city and state have invested in six low-threshold housing sites in Boston with about 200 beds. (One, Roundhouse, is winding down operations.) Since January 2022, 486 people have moved into these transitional sites and of those 149 have moved to permanent housing. More than 4,100 people have been connected with substance use treatment, according to city officials. In fiscal 2024, the state Department of Public Health plans to spend $22 million to expand permanent low-threshold housing and services statewide, including 150 units in Boston. The state is planning a large supportive housing development at Lemuel Shattuck Hospital.
Experts say harm reduction strategies should be built into housing — strategies like training staff and residents to administer the anti-overdose drug naloxone, providing drug test strips to identify fentanyl or xylazine, and letting residents use drugs together. Housing should also be appealing. “When you offer someone a dignified space with a locking door, their own bathroom, and security that they can be there more than a day, people will take that offer 9 times out of 10,” said Eric Tars, legal director for the National Law Center on Homelessness and Poverty.
A study led by Ranjani Paradise of the Malden-based Institute for Community Health involving interviews with homeless opioid-overdose survivors at Mass. and Cass found that while many feared chaotic street life, interviewees said they had few affordable housing options and felt shelters were unsafe or dirty. (Interviewees did use resources like the city’s Engagement Center, which offers a place during the day to shower, sleep, eat, or do laundry.) “People are saying they need safety and they need stability to be able to think about longer term goals for their health or substance use recovery,” Paradise said.
Providing substance use treatment is also vital. The current system is fragmented, and patients have trouble moving between crisis stabilization, detoxification, and recovery. “It should be easier to access treatment than it is to access drugs, and right now that’s not the case,” Wakeman said.
Simultaneously, there is also a need for policies that crack down on dangerous behavior. This does not necessarily mean warrant sweeps, which often catch people convicted of minor infractions, or tent sweeps, which can lead to residents losing medication or documents. It does mean having the police arrest large-scale drug dealers, human traffickers, people carrying guns illegally, and anyone committing sexual or physical assault. Removing tents in a targeted, humane way may be warranted if tents are shielding dangerous activity.
Some of this work is ongoing. Boston police officers are in the area daily, making arrests and also connecting people to services and helping families find loved ones. Since July 1, the police have made 30 warrant arrests, 38 arrests for drug dealing, and nine involuntary commitments of people who pose a danger to themselves or others due to alcohol or substance use. Officers have made 238 arrests so far this year, according to numbers provided by the Boston Police Department.
There is also a need to address quality of life, through policies like cleaning streets, which Boston does daily, and providing bathroom access.
A study of five European cities that eradicated open-air drug markets, led by a researcher from the Norwegian Centre for Addiction Research, found that successful policies paired harm reduction and treatment with restrictive measures. “Prevention, harm reduction and treatment should be combined with law enforcement based on cooperation between police, health care and social services,” the study concluded.
In Amsterdam, for example, drug use is treated as a disease and the city makes methadone and clean needles available. But professional drug dealing is treated criminally, and public gatherings of drug users are broken up. Zurich made housing, shelters, and treatment readily available, but had zero tolerance for drug dealing and large gatherings of users. Portugal decriminalized drug use but created an administrative system where someone caught possessing drugs is given resources and education and can be fined or required to do community service.
Wu recently announced that planning is underway to create a modern recovery campus when the Long Island Bridge is rebuilt. But that is four years away. People living at Mass. and Cass need help now.
Trevor T., 48, lived in a tent at Mass. and Cass. He lost his rental apartment near the New Hampshire border due to renovations then stayed at shelters in Cambridge and Boston. Through city initiatives, Trevor, who asked that his last name not be used to protect his privacy, found an apartment. “Being able to have your own place to lay your head down, not have to worry about things being gone, not being out in the cold, cooking, I am all about that,” Trevor said.
But many people in recovery are still living in shelters and seeking stable housing. “The city made it a priority to bring on more transitional housing, but there’s not enough,” said Sue Sullivan, executive director of the Newmarket Business Association, a business owners’ association that employs around 20 men and women like Trevor in its street cleaning program. “There’s not enough in the city, there’s not enough in the county or in the state right now.”
That’s the core of the problem.
Editorials represent the views of the Boston Globe Editorial Board. Follow us @GlobeOpinion.