Health

The city reopened its ‘comfort station’ in the area of Mass. and Cass. What you should know. 

“It’s the most low-threshold space that there is in the city and the next stop is the street.” 

By Dialynn Dwyer

May 20, 2021

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Boston has seen the COVID-19 pandemic exacerbate the impacts of the opioid crisis in the city over the last year. 

With the state-wide lockdown, individuals living unsheltered found public restrooms closed to them and the services they relied on altered or shuttered. As a result, residents of the South End and Roxbury experienced an increase in incidents of human waste and refuse left on private and public property. As the pandemic surged, reports of improperly discarded needles flooded the city’s 3-1-1 system. 

Now, residents of the neighborhoods are bracing for seeing worsening impacts from the opioid epidemic with the arrival of warmer weather, which in recent years has seen more people navigating substance use disorder, mental health issues, and homelessness arriving in the area to seek help from service providers clustered around “Mass & Cass,” the stretch of city blocks known disparagingly for years as “Methadone Mile.”

The impacts related to the opioid crisis in the area surrounding Mass. Ave. and Melnea Cass Boulevard, where shelters and services offer support to those dealing with addiction and homelessness, are not new. But officials have conceded in the last year there is “no question” that more people have descended on Boston for services because of the coronavirus crisis, linking the increase to the fact that city resources remained open even as the pandemic forced support systems elsewhere in the state and New England to shut down. (Massachusetts, like the rest of the nation, saw an increase in fatal overdoses in 2020, which state health officials said coincided with “with the extraordinary public health challenges stemming from the COVID-19 pandemic.”)

To address the increased demand for services in 2020, the city opened what they called “comfort stations” — enclosed areas with tents, portable toilets, hand-washing stations, and outreach services. Since they opened, the comfort stations have emerged as the latest flashpoint in the debate over the city’s handling of the opioid crisis and its impacts on Mass and Cass. 

Acting Mayor Kim Janey’s administration closed the comfort station on Atkinson Street in late March in response to escalating violence in the area and concerns about overcrowding in the space. The site was reopened May 6 with changes city officials said aim to address the overcrowding and safety concerns.

But news of the station’s reopening has been met with a mixed response from members of the neighboring communities in recent weeks. Some have welcomed the return of the station, while other neighborhood groups and business leaders are continuing to argue the space should remain closed until the city presents a more detailed public safety plan to the community.

Here’s what the city is doing differently with the comfort station

To reopen the comfort station, the city’s Office of Recovery Services, Boston police, and other internal departments collaborated to develop improved safety measures, Kim Thai, a special assistant in the Mayor’s Office, told Boston.com. 

The changes made by the city include: 

• Limiting the station’s capacity to 100 people 
• Placing uniformed security at the entrance for monitoring and communicating the rules of the space 
• Implementing an ID system for anyone who wishes to enter the station 
• Ensuring that 911 calls from Atkinson Street are prioritized directly to police officers “on the street into the space”

In addition, the city said members of the police department’s Street Outreach Team will help close the station daily (it operates from 8 a.m. to 5 p.m., Monday through Friday). Officials are also promising increased communication between the city’s Office of Recovery Services and Boston police through a coordinated response team for street management. 

All of those changes are part of what Thai said is a temporary plan, “part of a larger reboot effort of the Mass Cass plan,” which former Mayor Marty Walsh released in 2019 to address public health and safety impacts of the opioid epidemic in Newmarket Square and the surrounding neighborhoods. The release of the plan included the launch of a task force dedicated to addressing the issues of “Mass. and Cass.”

Thai told Boston.com that during the time the Atkinson Street station was closed, the city saw a reduction in violence in the area, but it still saw “a number of individuals who were hanging around” without a space to go to during the day, which is why it was reopened.

“We’re still in the midst of COVID, there are still providers and service providers that have not fully reopened,” Thai said. “So we still feel like there is a need to keep it open to maintain that engagement and provide that access to bathrooms, which is a large problem in the area.”

Jennifer Tracey, director of the Mayor’s Office of Recovery Services, told Boston.com there was an initial concern about whether some of the updates, like the ID system and uniformed security, might serve as a deterrent to people using the space as they did before. But during the first few days of the station reopening, the city did not see any dropoff in the number of people connecting with care at the site. 

“I think that people really need the services and come in for a lot of care, so the folks who are looking for services have come back,” she said. “I will say that part of instituting the ID system was to get a better understanding of who was in the space, and, for those individuals who are on Atkinson that are not there for services, we would have a better understanding of what that picture looked like as part of the safety mitigation efforts.”

But she said the city will continue to monitor for how the new measures are being received and their potential impacts. 

In addition to bathrooms and handwashing stations, the comfort station has nursing staff on site who help administer HIV meds to individuals living outside, tend to cold weather injuries, make sure people have access to the overdose-reversal drug Narcan, and have also helped administer COVID-19 vaccines in partnership with the city’s nearby Engagement Center and Boston Health Care for the Homeless. 

“We’ve been able to locate people, working very closely with our state partners, Department of Mental Health, Department of Public Health and then all the area providers that have housing vouchers and outreach teams,” Tracey said. “During COVID a lot of services lost track of individuals — people fall off of housing lists or fall off of other case management cases. We’ve been able to work very closely with those entities, too, because we see a lot of those folks. So they’re not lost, they just are here getting services because everything else was closed in the state.” 

While the city says the use of substances is not permitted in the station, critics have said the space has become a de facto supervised injection site with people using drugs inside or just outside the space. 

When asked about the procedure for when an individual inside the comfort station is found to be using an illicit substance, Tracey said the city does not condone the use of drugs on its property and that such situations are dealt with on a case-by-case basis. She said the use of drugs is part of the disease that health care and recovery service providers are intervening with in their work. 

Tracey likened the care and level of service being provided at the comfort station to what street outreach teams provide; it just happens to be in an enclosed area.

“[We’re] there to engage with people in real time on the street,” she said. “We will continue to do that and try to work with people to get them the services and the treatment that they need.”

What neighbors, community members think about the station’s reopening

Desmond Murphy, who is vice president of the Worcester Square Area Neighborhood Association, lives a five-minute walk away from the Atkinson Street station. Within 24 hours of its temporary shutdown, he heard a man screaming in Spanish in his alleyway. 

When he went out to investigate, he found the man was trying to get help for his friend, who had overdosed, slumped against a fence between two cars in the alley.

Murphy told Boston.com he called 9-1-1, but he stressed that if the friend hadn’t been screaming, the man could have been there for hours before anyone discovered him.

The South End resident said that ultimately, he believes individuals need a place to go, which is why he and many of his neighbors support the presence of the comfort station. 

Before it opened last year, individuals were in alleys and on stoops, without access to restrooms or locations to dispose of sharps, he said. With the station open, it seems to him there are fewer people injecting and hanging out in alleys.

“On the one hand I acknowledge that there’s some violence down there, but on the other hand, if you’re going to close it and then not provide an alternative, is the alternative that people are injecting in alleyways?” Murphy said. “I would say that’s a pretty horrible outcome if we’re expecting residents who have no training to be able to figure out how to handle an overdose.” 

If and when the city decides to close the comfort station again, he said there needs to be another plan for how the services the site provides will be replaced. 

But rather than close it, Murphy said he’d like to see more low-threshold spaces for people to use in other parts of the city. 

“It gives people a place to go,” he said. “They are people. They deserve to have somewhere to go.”

David Stone, president of the Blackstone Franklin Square Neighborhood Association and a member of the Mass./Cass Taskforce, also supported the reopening of the comfort station and co-wrote a letter with other neighborhood association leaders urging the city to resume its operation. 

He said he believes the station has been a “net positive” for the community in a crisis where there are “no good choices,” he told Boston.com. 

It provides a better alternative for public health and the community’s quality of life than having nothing at all, he said.

“The choices start with bad and then worse, and then there’s worse,” he said. “Those are realistically the outcomes that exist, and I think the comfort station is a classic example of that.”

The comfort stations have become places where people congregate, gathering outside on the sidewalk in conditions that Stone acknowledged are difficult to witness. But he agreed with Murphy that one of the site’s virtues is that professional help is nearby when someone overdoses. 

When the site closed, the alternative for the hundreds of people who made use of it daily was just the city’s streets, parks, and alleys, he said. 

“Their conditions don’t allow them to be in any places that require any higher level of self-regulation, so losing the comfort station is basically, absent an alternative to the streets and the parks, it’s just throwing up your hands and giving up. It’s the most low-threshold space that there is in the city and the next stop is the street.” 

That said, Stone acknowledged that the impact of the site to those who live or work directly adjacent to it is significant.

“It’s very challenging to be next door to it, there’s no question about that,” he said. “But closing it isn’t going to cause the problem to go away, it’s just going to migrate into areas that are even more problematic.”

For community members who continue to oppose the comfort station, public safety is the concern they feel the city has not adequately addressed. 

Alarmed by the worsening conditions in the area last year, Yahaira Lopez founded the Facebook group South End – Roxbury Community Partnership. She and members of the group are asking the city to keep the comfort station closed until an “equitable public safety plan that does not exclude community safety” is put forward alongside the efforts to provide treatment and recovery services to people in need.

The group has been protesting weekly to demand a public safety plan.

“We haven’t received that,” Lopez said. “Everyone who lives in the area knows that the summer months are horrible. People feel imprisoned in their house, like they can’t even come outside. The kids can’t even play in the parks. People’s cars are being broken into, people are engaging in lewd acts on private and public property.” 

The partnership has held regular protests in the area demanding action by state and city officials since it was launched last year, and their efforts have garnered attention from the start. Members of the group regularly share photos on social media of the conditions on the street, reports of violence, and actions for members of the community to join in their advocacy. 

The partnership’s slogan is “a comfortable community for all,” and in addition to their now weekly demonstrations, Lopez works with other Facebook groups to organize food donations, visiting Mass. and Cass every Friday to hand out snacks, supplies, and necessities to those on the street.

Lopez, who now lives in Randolph, grew up in the South End and her mother still lives in the neighborhood. While her family is experiencing the impacts from Mass. and Cass, she said she also knows what it is like to have a loved one caught up in the drug crisis. Her brother spent time living “on the mile,” she told Boston.com. 

“Our family has never been the same,” she said. “Seeing someone you live go down the road of addiction takes an emotional toll on you.”

She rejected criticism her group has received from some who have accused the partnership of wanting to remove people struggling with addiction and homelessness from the area. She said the group just wants the broader Roxbury and South End communities to be considered and consulted as officials work to address the crisis. 

“The people who are actually demonstrating at Mass and Cass, who have been the most consistent in our group, are people who are in recovery, are people who live in low-income communities, and some people who have lost loved ones on Methadone Mile/Mass and Cass,” she said. “So… [we’re] asking for a public safety plan and the comfort station to remain closed to ensure that not only those that are navigating addiction are given a comfortable place … the community is also saying, what about us? Where is our comfortability? How can we feel comfortable and secure in our community, when you have a person like my mother who was robbed by someone with a needle full of blood coming out of her doctor’s appointment?”

With the added advocacy from the Roxbury – South End partnership over the last year, Murphy and Stone agreed a gap between the two neighborhoods is being addressed and more people are having their voices heard on the issues impacting residents. 

There’s no doubt the demonstrations and marches held by vocal community members have focused the city’s attention, Stone said. 

And despite the disagreements over the path forward for the comfort station, the three community leaders agreed that the demand for services continues to outstrip what the city can handle and that more leadership at the state and federal level is needed to address the ongoing crisis. Lopez and Murphy pointed out that with many coming to Boston for services from outside the city and even outside the state, other municipalities need to step up to help provide care for those in need. They also agreed that services should be decentralized from the Mass and Cass area to other parts of the city. 

It was clear to all three that even with the work being done by the city now, much more is needed to address the crisis on the ground — for the sake of both those experiencing addiction and homelessness and the residents of the surrounding neighborhoods. 

“I don’t think the situation we’re in right now is for a lack of people trying,” Stone said. “It’s true that nobody has a solution, but no one has found the solution anywhere. We have tools, we have things that move the needle a little bit. It’s an incredibly challenging issue … Once you actually try to make a difference, it defies all those slogans and rhetoric.” 

In the meantime, with a mayoral election on the horizon and the expectation of worsening conditions during the summer, community members are watching for how candidates respond to the concerns being raised. So far only two candidates, City Councilors Andrea Campbell and Annissa Essaibi George, have released plans targeting Mass. and Cass and the opioid epidemic. State Rep. Jon Santiago is holding a press conference on Thursday to announce his plan to tackle the crisis.

With community members like Lopez continuing to raise awareness about the issue, Murphy said it helps remind others who remain untouched by the opioid epidemic that it is still going on. 

“It’s just one of those topics that until it hits you, until it’s a family member, a friend who overdoses or until you live down here and you see it every day, it’s just not a top of mind issue,” he said. 

Before he moved to the neighborhood, he said he never imagined he would be learning so much about homelessness and substance use disorder. But for those in Roxbury and the South End, there is an expectation during the year’s warmer months that you’re likely to run into people experiencing an overdose on neighborhood streets.

“Every summer I’m just expecting that it’s going to happen,” he said. “I’m just mentally getting prepared for it. With that said, that’s also why I’m an advocate for the comfort station because if people are going to use drugs, I would much rather have them use drugs around people who are trained to handle it.”

The first few times he came across someone overdosing was a shocking experience, Murphy said. He’s now encountered enough people overdosing that he knows what to look for in order to provide an initial assessment to emergency dispatchers. 

“It’s unfortunate that it’s just such a common occurrence down here,” he said. “But unfortunately it’s the world we live in.”