A year ago, late on a Wednesday afternoon, Merri Cunniff had to transform herself from a nurse to an evacuation drill sergeant.
She and her colleagues at Andrew House had to get 60 detox patients off Long Island, pronto. They performed heroically, calming their patients as best they could, finding beds for those who were essentially refugees.
A handful of patients refused the new places and just walked away into the night, some of them looking for the only thing they wanted after the chaotic evacuation of Long Island, and that was a needle.
The 60 patients at Andrew House lost their beds, and some later lost their lives after the sudden disruption of services for the addicted and the homeless on Long Island. Merri Cunniff and her colleagues lost their jobs.
Not long after, there was a community meeting in Quincy about opening a treatment facility that could replace some of the lost treatment beds. There was considerable opposition from residents in the neighborhood not far from the Wollaston T station.
But something unusual happened. The mayor, Tom Koch, and Quincy’s state senator, John Keenan, defended the new treatment facility, saying it was needed. So did Merri Cunniff, who stood up at that meeting and talked about the reality on the streets around them.
“It was like a Bruins game, people screaming,” she said. “Some people were saying, ‘They’re junkies. Let them die.’ I was waiting for people to throw tomatoes at me.”
But cooler heads prevailed, and people listened to Merri Cunniff’s impassioned plea to help the addicted because they’re our children, our neighbors, our friends. And when the meeting was over, a guy named Neil Gaer, an executive at an addiction treatment organization called Phoenix House, walked up to Merri Cunniff and said, “What are you doing for the rest of your life?”
Phoenix House got its permits, Merri Cunniff got a job, and then got busy. She started calling her laid-off colleagues from the closed island. Nearly all of the laid-off nurses, case managers, and recovery specialists from Andrew House are now working at Phoenix House, the aptly named facility that rose from the ashes of the disaster that was the closing of Long Island.
The rise of Phoenix House, a 64-bed detox facility for those with drug or alcohol addictions, is one of the few bright spots in a year that saw so much instability and uncertainty for the homeless and addicted who lost their beds on Long Island.
But it’s also a cautionary tale about the difficulties and limits to addressing the opiate crisis, providing some uncomfortable truths about the effort to replace services that were lost when the decrepit bridge to Long Island was finally closed.
Expecting the city of Boston to shoulder so much of the responsibility for the opiate crisis is unrealistic. There were many people on Long Island who weren’t from Boston.
“We’ll never have enough beds,” said John McGahan, the president and chief executive of the Gavin Foundation, the South Boston-based group whose staff runs the clinical side of Phoenix House.
Bay Cove Human Services, which ran Andrew House, is trying to relocate the beds it had on Long Island, as is Victory Programs, which ran Joelyn’s House before its staff and clients were bundled off the island a year ago.
“I think all of us would like to expand, because the need is so great, but neighborhoods don’t want us,” McGahan said. “We couldn’t meet the demand before Long Island closed. We’ve got to do more than just create more beds. We’ve got to be creative in cutting down the supply and demand of drugs.”
For example, a new approach to decreasing the amount of prescription pills on the streets that fuel part of the opiate epidemic includes a program to educate realtors to instruct those selling their homes to lock up their medications before an open house. It’s not unusual for someone to steal medications during an open house.
McGahan understands the NIMBYism that blocks the creation of more treatment beds, but thinks it’s based on unfounded fear and ignorance, not the real world.
“If somebody picks up and starts using again, they’re not hanging around Gavin House or any place where people are in recovery,” he said. “The last people they want to be around are sober people. They just leave.”
Five miles away, Bobby Gallagher, the clinical director at Phoenix House, was sitting in his office, trying to find a bed for a guy who had been accepted in a step-down program only to find out that the program was full. Releasing someone to the streets, right after detox, with no support, is a prescription for relapse.
As disastrous as the Long Island closure was, Gallagher says it brought the problems hidden away in Boston Harbor to open view. More politicians are more supportive of treatment programs, even in the face of neighborhood opposition.
“Five, ten years ago, we were in the closet,” Gallagher said. “But we have a governor in Charlie Baker, a Boston mayor in Marty Walsh, and politicians like Tom Koch and John Keenan who are confronting this head on. That’s a real cultural change.”
As of Oct. 1, insurance companies are supposed to cover 14 days of treatment, instead of the previous 4 to 7.
“Blue Cross and Blue Shield have signed on, but there are still private companies that won’t do it,” Gallagher said. “We have to push on this, so they all obey the law.”
A couple of weeks ago, a 27-year-old man was walking down the sidewalk opposite Phoenix House when he collapsed. Rescue workers tried to save him with Narcan, the drug that counteracts heroin overdoses. But the man died. The heroin he injected was probably cut with Fentanyl, the synthetic opioid that renders Narcan useless.
The man wasn’t a patient at Phoenix House. If he was, he’d probably still be alive.
On the bottom floor at Phoenix House, Merri Cunniff put a file in a cabinet next to the desk where she works as the in-take nurse. It was another application for a bed that doesn’t exist. Over her shoulder, a Red Line train rumbled by, behind the back parking lot, where men and women are discharged and driven to step-down programs. It’s a concession to the neighbors, to secret the patients out the back.
Merri Cunniff believes that one of the best things about Long Island was that those seeking treatment couldn’t leave unless they swam off, and no one did.
But now she reluctantly sees the value of not having one of society’s biggest problems hidden away, out of sight, out of mind.
“We either deal with this,” she said, “or people die.”
Kevin Cullen is a Globe columnist. He can be reached at firstname.lastname@example.org. Follow him on Twitter @GlobeCullen.