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Opinion | Jon Santiago

All hands on deck to clean up a troubled corner

Lexi Pappas panhandled in 2016 along a stretch of Massachusetts Avenue.
Lexi Pappas panhandled in 2016 along a stretch of Massachusetts Avenue.(Keith Bedford/Globe Staff, file 2016)

The beating of a correctional officer on Atkinson Street in Boston last week is appalling and tragic. Not only was it a senseless act of violence, it served as a stark reminder of the homelessness, substance use, and mental health issues that plague the area near the intersection of Massachusetts Avenue and Melnea Cass Boulevard.

I have come to know the area quite well over the years. Living less than a mile from where the incident occurred, and as someone whose morning jog includes Atkinson and neighboring streets, I know the unfortunate sights, sounds, and smells of those blocks. I recognize familiar faces and have treated many of these folks in the emergency room at nearby Boston Medical Center. However, what transpired last week is merely a symptom of a much larger, systemic disease. The beating that took place was borne out of an evolving fentanyl epidemic, inadequate resources, and an over-concentration of services in the area.

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While the Legislature and Governor Baker have passed well-informed policies to address the opioid epidemic, many of which have saved countless lives, the area of Massachusetts Avenue and Melnea Cass Boulevard has become challenging. More than 50 overdoses took place on Atkinson Street during the first two weeks of July, largely driven by fentanyl, which is more potent than heroin. Hundreds of individuals swarm the area on a daily basis in search of services, shelter, or drugs. Lewd acts are witnessed during daylight hours as drug dealers prey on those in recovery. The City of Boston continues to provide more resources and attention to an area that is overburdened, swimming against a tsunami of used needles, fentanyl, and people — many from surrounding cities — in need of dire help. Ironically, the concentration of services in the area has only compounded the problem.

In order to combat this crisis, we need all hands on deck. Long-term strategies must be focused on the increased investment and expansion of housing, substance use, and mental health services across the Commonwealth. Additionally, the Long Island Bridge must be rebuilt to increase regional capacity. The area scheduled to be vacated by Shattuck Hospital must retain its public health purpose and be considered as an option to provide more services in the midst of a relentless epidemic. Expanding medication-assisted treatment, like buprenorphine, across the state will allow for treating people in their respective cities and decompressing overwhelmed urban centers and neighborhoods like Mass. Ave. and Melnea Cass. Creating “super-utilizer” programs — as we do in the ER — to provide intensive outpatient care for the most complex and high-cost patients must be explored. Addressing the stigma associated with addiction and providing mental health services as a cornerstone of recovery will also be critical.

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Short-term strategies must include the participation of public and private stakeholders to streamline and coordinate the myriad services in what has become the epicenter of the opioid epidemic in Massachusetts. Similarly, organizations providing services should better engage their surrounding neighborhoods. By having service providers step outside their traditional roles to assist with issues like public safety and cleanliness, these organizations can begin to ease the tense relationship between residents and providers that has been growing in that area. Establishing an improved dialogue with residents has the potential to foster trust, allay concerns, and create a shared vision for a community in crisis. And although we cannot arrest ourselves out of this situation, we must ensure public safety for all who use that space. The city’s decision to clean the area was important on a number of fronts for the residents, businesses, and schools reaching their breaking point.

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Mayor Walsh’s recent appointment of Buddy Christopher to manage the effort in the area shows promise. Further, a task force should be created to coordinate short- and long-term objectives of the public and private sectors. I have faith in our municipal leaders and my colleagues in state government to move quickly, and I look forward to partnering with them. However, now more than ever, urgency combined with bold and comprehensive interventions are what Mass. Ave. and Melnea Cass demand. Because if the response to last week’s attack on Atkinson Street is reduced to a single clean sweep, that will be the true tragedy.


Dr. Jon Santiago is state representative for the 9th Suffolk District, which includes Massachusetts Avenue and Melnea Cass Boulevard. He is also a practicing emergency room physician at Boston Medical Center.