The street worker with the Boston Public Health Commission’s outreach team arrived at Clifford Park just after 8 a.m. Friday to scan for discarded needles, just as she does every weekday. She found two by the playground and four in the shaded area by the fence and one by a stray baseball from the nearby field. A homeless man lay under blankets nearby.
She planned to return to the field in Roxbury later in the day. And again the next day, and thereafter, armed with her plastic gloves, small tongs, and a plastic bin.
Amid the opioid epidemic that has grasped the region, the city has been increasing efforts to address one of the crisis’ most potentially dangerous side effects: needles that have been improperly discarded in playgrounds and on side streets.
The city, by its own count, collects more than 14,000 needles each week across its parks and playgrounds, at 13 drop-off kiosks in different neighborhoods, and from the city’s needle exchange program, called AHOPE.
Since Boston’s 311 line fully went into effect four years ago, the number of calls each year for discarded needles has ballooned, from 1,991 in 2016 to 4,332 in just the first half of 2019. The data do not account for the number of needles reported during each call. But the increase can largely be attributed to the changing addiction landscape in the city, officials said, as more addicts come here to seek services.
Many have turned to fentanyl, a stronger and more addictive drug that requires more frequent doses: A heroin addict who shot up once or twice a day with a needle is now getting high 15 times a day.
The dirty needles pose significant health risks, and not only to those who use them. Anyone encountering a needle could get stuck and be at risk of contracting an infection. The concerns were put into stark relief when schoolchildren in Roxbury staged a demonstration to protest the abundance of needles in their community.
The worsening crisis has forced the city to look at new ways to address the balance of providing addiction recovery services against the need to ensure public safety for residents and businesses, specifically at the intersection of Melnea Cass Boulevard and Massachusetts Avenue, where many of the programs are concentrated. The retrieval of improperly discarded needles, from the playground in Roxbury where young football players practice each day, to the public squares in the South End, has become a focal point of that effort.
“Our priority is getting syringes off of the street,” said Devin Larkin, director of the Recovery Services Bureau at the Boston Public Health Commission. While some have been used for ailments such as diabetes, most can be attributed to the opioid epidemic, she said.
And as the city looks for new strategies to provide services — what is unofficially being called Mass. and Cass 2.0 by officials — part of that effort has been to better track where authorities are finding needles and who is using them. In many ways, Larkin said, the Mobile Sharps Team has become the front line in gauging what kind of services are needed.
“They are our eyes and ears on the ground,” Larkin said. “It’s not just about picking up syringes. It’s about getting out to the area, seeing what services we can provide in the area.”
Four members of the city’s Mobile Sharps Team are focused on responding to complaints of improperly discarded needles, largely made through the city’s 311 call service. In addition, the city has eight outreach workers assigned to the Mass. and Cass area who connect people to recovery services and also pick up discarded syringes.
The city has also trained 400 school custodians as well as members of the Parks and Recreation Department on how to properly handle needles — an effort to expand the number of city employees equipped to help the effort.
“We are in one of the worst public health crises of our time, and I think it’s fair to ask public employees to do what they can,” Larkin said.
The city plans to install five additional kiosks where needles can be dropped off throughout the city, bringing the total to 18. While officials continue to look at demand and communicate plans with residents, Larkin said the city has so far considered placing new kiosks in East Boston, the Back Bay, Dorchester Avenue, Dudley Square, and the Fenway.
William “Buddy” Christopher, who was appointed this spring as the city’s first-ever czar overseeing the Mass. and Cass area, said the effort will require a multipronged approach to provide services for those in need, while at the same time keeping parks and playgrounds safe.
“Our children should not be exposed to these issues,” he said, saying the effort means having outreach workers deployed alongside police officers, so that “the message police are giving to people is one of support and help.” That requires community input as well, he said.
“The teams will get there and pick things up,” he said. But, he added, “All of the city’s resources are working, and I mean daily, we’re working to make sure our assessments are right, that the resources we’re allocating are right. The biggest part of this is everybody at the table working this out.”
City Councilor Annissa Essaibi-George, who heads the committee on homelessness and recovery, said last week that the spike in discarded needles represents “the crisis of this addiction, and the very dramatic shift in the type of drugs on our streets.”
Essaibi-George said the total package of services that is needed to help those with addiction requires the exchange of clean needles, to limit the spread of infectious diseases. But, she added, more can be done to keep needles off streets. She has called for a city ordinance that requires pharmacies that sell needles to take them back, saying, “They are part of the ecosystem of a needle.”
“We know we are unable to keep up with the number of needles on our streets, and we continue to work to create systems that can manage that volume,” she said. “It’s important for us to think about how to create capacity to do this work, and awareness to educate around disposal.”
Domingos DaRosa, who coaches youth football at the Clifford Park in Roxbury, questioned, though, whether the city, as well as businesses, are doing enough. He agreed that people in recovery need help and are entitled to housing and health programs, but he also noted the impact on city youth who arrive at the park to see a large red needle kiosk by the tennis courts or homeless people sleeping in the corner of the fields.
DaRosa said he and coaches have removed needles from the field themselves.
“The first thing you’re seeing is a disposable needle box,” he said. “That’s unattractive, not just to the community but to the people who no longer want to come to the community.”