Public health, addiction, and housing experts today responded to mass displacements in the area of Massachusetts Avenue and Melnea Cass Boulevard. 

Public health experts, addiction medicine doctors,  and advocates sent a letter to elected leaders earlier this month, urging officials to take a health-centered approach to the intersecting crises people are experiencing in the area of “Mass. and Cass” and the overdose epidemic throughout Massachusetts. Such an approach includes promoting harm reduction, expanding low threshold treatment, and eliminating systemic barriers to housing and treatment options. The experts and advocates oppose the inhumane and ineffective plan to establish involuntary detention in the South Bay jail for unhoused people in the area.

Instead of removing tents and forcing people to disperse, which separates unhoused people from medical providers and harm reduction services to manage illness and receive treatment, public health experts and housing advocates say the City should meet basic needs—such as trash receptacles and trash removal, bathrooms and sanitation, and access to clean water and showers through mobile units—for people living in encampments until people have access to housing.

Dr. Todd Kerensky, President of the Massachusetts Society of Addiction Medicine, released the following statement in response:

“Substance use disorder is a serious medical illness that can result in destructive and overwhelming consequences such as homelessness, infections, overdose, and death. We know that evidence-based, medical treatments for substance use disorders work. Specifically, treatment reduces the risk of infections, incarceration, and overdose, and helps prevent premature death. At this moment, we should invest in a sustained public health response to the developments in and around Massachusetts Avenue and Melnea Cass Boulevard. The solutions should include expanded access to low-barrier treatment options and more robust harm reduction services flanked by access to shelter. Having a substance use disorder is not a crime. Criminalization or coercive ‘therapy’ increases harm and will not provide the results our community desperately needs.”

Dr. Sarah Wakeman, Medical Director for Substance Use Disorder at Mass General Brigham, released the following statement in response:

“Addiction, houselessness, mental illness, poverty, structural barriers, and policies have resulted in the humanitarian crisis in the Mass. and Cass area of Boston. Effective interventions for these issues exist, but they do not include compulsory detention in a jail-based facility or ultimatums that offer solutions that have not yet been helpful to our community members staying there. We have evidence from other countries that compulsory addiction treatment is less effective than voluntary treatment and concerning data from Massachusetts showing higher rates of fatal overdose after involuntary treatment. What is effective and desperately needed is access to voluntary, welcoming, and evidence-based addiction treatment, proven harm reduction strategies, immediate access to non-congregate shelter for example in hotels or motels, and longer-term access to low threshold housing without the systemic barriers that currently exist, like those posed by criminal records. We demonstrated as a Commonwealth during COVID that we are more than capable of mobilizing quickly to shelter people and provide life-saving care. There is no reason the same couldn't and should be done here and now for this public health crisis, which has been exacerbated by the pandemic. Our state has always been a leader in health care and public health; why would we invest money, political capital, and energy into interventions shown to be ineffective and harmful when we could instead fund, collaborate, and innovate in humane and helpful interventions that would actually save lives?”

Cassie Hurd, executive director of Material Aid and Advocacy Program, released the following statement in response:

“Unhoused community members want and deserve to live in safer, more stable spaces than tents on Topeka, Atkinson, or Southampton Streets. However, people created this small encampment community to keep themselves and each other safe in the absence of available shelter or housing that meets their self-identified needs. People are practicing community care—responding to overdoses and crisis, and are connected to trusted providers where they access life-saving harm reduction services and health care. Many encampment residents receive daily medications for the prevention and treatment of HIV, medication for chronic illness and opioid use disorder, and antibiotics. At least five to 15 overdoses are reversed each day by peers and providers. Unhoused people who use drugs in the area are experiencing an escalating HIV outbreak. Sweeps and the forced removal of unhoused community members out of the Mass. and Cass area will remove much of the stability, safety, and access to support—peer and professional, as well as medical care and life-saving medication people have. In being pushed to less safe places, people experience an increased risk of fatal overdose. In short, sweeps only serve to increase harm, and potentially death. Unhoused community members at Mass. and Cass need and deserve evidence-based solutions that meet their needs: low threshold housing decoupled from abstinence, expanded harm reduction services including supervised consumption sites, voluntary treatment on demand, and to not be swept or criminalized for surviving poverty in public.”

Dr. Danna Mauch, President and CEO of the Massachusetts Association for Mental Health, released the following statement in response:

“The Commonwealth of Massachusetts is on a path to correcting the discriminatory inequity of criminalizing substance use conditions in treating some men committed under Section 35 to treatment in correctional facilities. It is illegal to treat women committed under Section 35 or any person committed under Section 12 in a correctional facility. The proposal to respond to the needs of people with substance use and mental health conditions now found at Mass. and Cass with involuntary treatment in a retrofitted jail facility is regressive and contradicts our current state policy direction and the preference even in the state’s commitment law, Chapter 123, for first offering voluntary treatment. If our administration and/or the legislature contemplates investment in solving the needs of people at Mass and Cass, let these be made in therapeutic services delivered in public health settings.”