A Tale of Two Crises: Homelessness and Opioid Addiction
As I walk down the streets of Boston, I can’t help but feel a sense of unease. The once-vibrant neighborhoods have become tinged with a palpable sense of desperation. Tents line the sidewalks, and the air is heavy with the scent of hopelessness. This is the intersection of two of our nation’s most pressing public health crises: the opioid epidemic and the affordable housing shortage.
The story begins in 2014, when the City of Boston suddenly shuttered the Long Island Bridge, a crucial lifeline connecting the mainland to hundreds of emergency shelter and recovery beds. With just a three-hour window to evacuate over a thousand people, the hastily relocated services were concentrated in the South End, near Boston Medical Center. This area, now known as the “Mass and Cass” district, has since become a flashpoint for the intersection of substance use, homelessness, and mental illness.
The COVID-19 pandemic has only exacerbated these interlocking challenges. Opioid-related overdose deaths in Massachusetts increased by 20% in 2020, with the highest increases among Black men. The loss of affordable housing, social isolation, and financial precarity have deepened the crisis, leaving vulnerable residents with few options for recovery and stability.
Addressing the Root Causes: Coordinated Leadership and Transparency
As a community, we must acknowledge the systemic failures that have brought us to this point. Responsibility for these overlapping crises has been fragmented across various city departments and agencies, leaving residents without a clear path to the support they desperately need.
To tackle this issue head-on, we must elevate these concerns within City Hall and establish direct accountability to the Mayor’s office. A centralized, coordinated strategy is essential, one that aligns community organizations, service providers, and government agencies around a common vision for addressing the root causes of homelessness and addiction.
Transparent community engagement is equally vital. The Mass and Cass 20 Task Force has been inconsistent in its meetings, leaving residents in the dark about the city’s plans and resource allocation. We must commit to ongoing data transparency, regularly sharing information on overdoses, police responses, and the outcomes of housing and recovery efforts.
Building a Regional Recovery Infrastructure
The problems we face in Boston are not isolated; they are part of a broader regional challenge. The closure of the Long Island Bridge has shown us the consequences of siloed decision-making, with one city’s actions reverberating across the entire Greater Boston area.
Moving forward, Boston must proactively collaborate with our neighboring communities to develop a unified, public health-focused approach. This could include a multi-city partnership with the MBTA to connect unhoused individuals with the resources and services they need, similar to initiatives in Los Angeles.
Additionally, we must work as a region to plan for and invest in recovery infrastructure that operates at a larger scale. This could involve advocating for a new recovery campus, such as at the Arborway Yards or another publicly-owned parcel, that can serve as a centralized hub for treatment and support.
By leveraging the immense healthcare resources within our city, we can forge proactive and transparent partnerships with regional and state partners to expand access to life-saving treatment and services.
Changing the Narrative: From Criminalization to Public Health
For too long, our response to the opioid crisis and homelessness has been rooted in criminalization, with the Boston Police Department often serving as the first line of defense. This approach has proven ineffective and, at times, actively harmful, exacerbating trauma and destabilizing recovery efforts.
It’s time to shift the narrative and lead with a public health-focused lens. We must develop crisis response programs that involve community members from the outset, ensuring buy-in and appropriate staffing and training for service providers. These teams should be empowered to connect individuals with medical care, housing resources, legal aid, and other essential support services, serving as a compassionate first touchpoint on the path to recovery.
Furthermore, we must invest in basic city services that uphold the dignity and well-being of all residents. This includes expanding access to public restrooms, showers, and laundry facilities, as well as scaling up partnerships with food justice organizations to enhance residents’ food security.
Affordable Housing as a Cornerstone of Recovery
At the heart of this challenge lies the fundamental need for affordable, stable housing. As service providers and advocates emphasize, getting individuals into treatment is only the first step; everyone needs a safe, healthy, and affordable home to establish a foundation for long-term recovery.
To address this, we must conduct a comprehensive audit of all housing units and supportive services within the city, identifying gaps and opportunities to develop additional supportive housing through the city’s capital budget. By streamlining the zoning and permitting process, we can accelerate the construction of scattered-site supportive housing units across Boston’s neighborhoods.
Moreover, we must lower the barriers to entry for shelters, ensuring that these spaces are available to all genders and family configurations, with flexible hours and transparent enforcement of client-centered policies.
Integrating transportation services is also crucial, as the lack of infrastructure to move people safely to shelters and treatment locations has been a persistent challenge. By investing in fare-free public transit and expanding support for dedicated transportation services, we can better connect individuals with the care they need.
Holistic Support for Individuals, Families, and Communities
Addressing the intersection of homelessness and opioid addiction requires a holistic approach that extends beyond the individual. We must recognize the ripple effects these crises have on children, families, workers, businesses, and entire neighborhoods.
For families, the City should invest in dedicated trauma supports within our public schools, as well as public art, parks, and other initiatives that foster healthier, more connected communities. For workers, we must create an Office of Worker Empowerment to advance the rights and protections of those serving on the frontlines of these overlapping public health challenges.
Furthermore, we must hold property management companies accountable for the safety and upkeep of their buildings in hotspot neighborhoods, ensuring that no resident lives in fear of violence or neglect. And for businesses, the City should provide one-on-one outreach and resources to support workers, while also directing resources to community organizations that can serve as anchors of stability and resilience.
A Pathway Forward: Investing in Health, Housing, and Hope
The challenges we face are daunting, but I firmly believe that with coordinated, transparent leadership and a commitment to a public health-focused approach, we can begin to address the intersection of homelessness and opioid addiction in Boston.
By investing in affordable housing, strengthening our regional recovery infrastructure, and shifting the narrative from criminalization to compassion, we can lay the foundation for long-term, sustainable change. And by supporting individuals, families, and communities holistically, we can empower those most affected by these crises to reclaim their health, their housing, and their hope.
The road ahead is not an easy one, but I am confident that by working together as a city, a region, and a community, we can create a future where no one has to choose between a roof over their head and access to life-saving recovery services. It’s time to break the cycle and build the just, equitable, and healthy city that all Bostonians deserve.
If you’re interested in learning more about the work being done to address affordable housing and the opioid crisis in Boston, I encourage you to visit HACC-Housing.org, an organization dedicated to providing innovative solutions and advocating for those in need.