When his body feels up to the task, Miguel Pagan grabs his backpack, gently ventures down three flights of stairs, and roams for miles around Boston with no destination in mind.
Most days, he walks to clear his mind and to silence an inner voice — what he calls his “addict voice” — that sometimes cries out for the heroin that has ruptured his relationships and brought him to the brink of death more than a dozen times.
The therapeutic walks, which sometimes take him from his apartment near downtown Boston to his childhood home in the Mission Hill housing projects, stem from a promise that Pagan made to his 84-year-old mother, Maria, who moved to Boston from Puerto Rico in 1965: “I promised her that I would get completely clean of drugs before she died,” Pagan said. “Nothing is more important to me.”
Pagan, who turned 64 two weeks ago, has never been closer to fulfilling that promise.
In late October, Pagan was among the first of 126 people living in the sprawling, crime-ridden encampment on the edge of Boston’s South End, known as Mass. and Cass, who accepted an offer of temporary housing from the city. Of these, nearly 100 have been placed in facilities such as sober homes, supportive housing complexes, and detoxification centers, where they have access to substance-use treatment and counseling, city officials estimate.
But, as Mayor Michelle Wu and other officials stressed last week, their job is far from complete. The dismantling of Mass. and Cass was only one step in a broader, multi-agency effort to address the overlapping crises of opioid addiction and homelessness. The long-term goal is to transition everyone who was staying at the encampments into permanent housing — a process that could take months, if not years, to complete, officials said.
The effort is a painstaking one for the Wu administration, and involves tracking the progress of every person who moved out of Mass. and Cass. Three times a day, representatives from a half-dozen agencies, including Wu’s office, the Police Department and the Public Health Commission, meet to discuss individual cases and to respond quickly to areas where homeless people are congregating.
“There is no one-size-fits-all magic wand, and that’s really why we are seeing so many people fall through the cracks,” Wu said. ”It’s complex because it is so individualized, and therefore the only way to truly help someone stabilize is to address their individual needs, person by person.”
For Pagan, the impact of that hands-on approach has been immediate. For the first time in nearly two decades, he is sleeping in a bed in a private room in Bowdoin Manor, a lodging house on Beacon Hill, with a locked door and access to a shower, and living without fear that someone will attack him at night or steal his belongings.
His apartment is tiny. He has a bed that’s too small for his 6-foot-3-inch frame and a desk where his television sits next to a pile of neatly folded laundry. He can walk from one end of the room to the next in three paces. On his first night, Pagan was jolted awake at 4 a.m. by a rat on his bedsheets. To keep the rodents out, he shoved a refrigerator in front of a hole in the corner.
It’s not much, but it’s luxurious compared to what Pagan had last summer, when his home was a tarp that stretched between the top of a fence to some shopping carts on Atkinson Street. Back then, he spent much of his waking hours drifting through the streets looking for a quick high, and was injecting heroin up to 10 times a day, he said. While living near Mass. and Cass, Pagan was shot through his arm and chest, stabbed twice, and witnessed dozens of people overdosing — some fatally, he said.
“I feel reborn,” said Pagan, as he drank a cup of coffee in his room. “To be honest, it’s a miracle I’m alive.”
Pagan traces his descent into addiction and homelessness to a hot, July afternoon at a baseball park in Mission Hill, when he was first introduced to heroin. A gang member handed Pagan, then 14, a bag of the drug and showed him how to inject it into his veins. “Right away, a warm feeling came rushing over me,” he said. “I felt invincible.”
The drugs offered Pagan an escape from the turmoil of his home life, which he said was marked by violence and neglect. He was born with a hearing impairment that was left untreated until he was 10, which caused him to fall behind academically and socially. Pagan repeated third grade three times before he was expelled for hitting a teacher, he said. Soon after, he joined a gang in Mission Hill.
Pagan spent much of his adult life bouncing from the streets to emergency shelters and to prison, and today his body is a living map of the violence he experienced along the way.
A jagged scar runs from his left hip to his knee from when he was stabbed from behind by someone at Mass. and Cass — an injury that required 57 stitches. He bears scars on his biceps and chest from when he was shot on Atkinson Street during a robbery attempt. And there are dark purple track marks that course down his legs.
At times, something as simple as a police siren will cause his mind to replay the trauma, frame by frame, of living near Mass. and Cass. In the final year there, Pagan landed work on a cleanup crew that discovered body parts, including a severed hand, on the streets. He recalls hearing the screams of women being assaulted at night in their tents and feeling powerless to help.
The physical and mental toll of living on the streets only reinforced his craving for opioids, as a way to numb the pain, he said.
And while Pagan is now miles removed from Atkinson Street, reminders of that life are never far away.
To avoid debilitating withdrawal symptoms, Pagan continues to inject heroin twice a day, and his primary supplier lives in the same building. To get a hit, Pagan needs only knock on his door. And he isn’t alone: Many of the residents in his complex are formerly homeless people who use illicit drugs, including people he recognizes from Mass. and Cass. On a recent morning, used drug syringes were visible in the building’s third-floor bathroom.
Managers at the apartment complex did not respond to repeated calls for comment.
Yet for the first time in years, Pagan has found stability. He wakes just before 8 most mornings to join a work crew for the Newmarket Business Improvement District, which pays him $20 an hour to clean city streets and sidewalks. He has space in his life for a girlfriend, Tina, who also struggles with addiction but shares his desire to get clean. The two plan to enter a drug-detoxication program once they find more permanent housing.
Pagan likened his situation to being tossed an emergency life raft on a stormy sea. The raft will keep him afloat for a time but, like all rafts, it’s not meant to be permanent. “I still need to find my way to shore,” he said.
On a recent Saturday evening, Pagan took another of his long, therapeutic walks.
He and his girlfriend strolled around Boston Common, watched the sun set over Beacon Hill, and eventually found their way to Chinatown.
Over dinner, he recalled, they discussed why they were grateful to be alive, and how it finally seemed within their power to face life without heroin.