Boston officials are moving forward with a plan to increase both law enforcement presence and access to addiction treatment in the area around Massachusetts Avenue and Melnea Cass Boulevard, known as “Mass. And Cass,” despite concerns from some medical professionals that the approach prioritizes punishment over public health.
The recommendations, unveiled Wednesday by a city working group on addiction, recovery, and homelessness, include expanded case management, partnerships with designated addiction treatment providers, and increased supportive housing options. A key component of the plan is the establishment of a “recovery court” to handle drug-related arrests, a proposal that has drawn criticism from those who argue it could violate patient privacy and civil rights.
Stephen Fox, co-chair of the working group and a leader with the South End Forum, described the plan as a “magic sauce,” integrating public safety, public health, and judicial initiatives with comprehensive case management. “The idea of being able to employ public safety, public health and judicial initiatives together in an integrated fashion, coupled with a seamless case management architecture over it, Here’s really the secret sauce we have,” he said.
However, Dr. Miriam Komaromy, executive director of Boston Medical Center’s Grayken Center for Addiction, expressed concerns about the process and the resulting recommendations. A member of the working group, Komaromy said she felt excluded from the drafting process and that the final proposals do not reflect an evidence-based approach to addiction treatment. She specifically objected to the potential for collaboration between treatment providers and law enforcement, citing potential violations of patient privacy and civil rights.
“I feel like the process was not optimal for gathering clinical input or review from the committee members,” Komaromy said. “Requiring treatment providers to collaborate with police and the judiciary as part of the treatment of patients is likely a violation of patient privacy protections and even civil rights.”
The recommendations have been submitted to Boston Mayor Michelle Wu and state officials. Some initiatives are already underway, building on a strategy outlined by the city in September, which followed complaints from residents about drug use and public safety in the area. Kellie Young, director of Boston’s Coordinated Response Team, stated the new recommendations would strengthen the city’s existing efforts. Her team has already placed over 480 individuals in addiction treatment since September, according to Young.
“My team is out there every day doing this function and the city is aligned with these suggestions,” Young said. “These are to bolster our providers, judicial system and law enforcement. We want to be a tool for law enforcement, since this is a public safety and public health concern.”
Mayor Wu expressed support for the recommendations and the Boston Police Department’s work in the area. “The city is focused on active preparations for warmer weather and continuing to engage with all stakeholders on our coordinated approach,” she said in a statement, referencing anticipated increases in activity as winter subsides.
Critics argue the plan represents a shift toward a more punitive approach. They also question whether sufficient resources will be available for implementation. Komaromy and other providers point to research indicating an increased risk of overdose death when individuals are forced into treatment. She expressed concern that the proposed “preferred provider” network would only include those willing to collaborate with law enforcement to detain individuals against their will.
Cassie Hurd, executive director of the Material Aid and Advocacy Program, questioned the practicality and philosophical underpinnings of the recommendations. She highlighted the limited availability of long-term treatment beds and the likelihood that individuals will cycle through short-term detox programs without achieving lasting recovery. “The disappearing of unhoused people and poor people who use drugs from the street should not be how the city of Boston measures success,” Hurd said. “Actual experts, people who use drugs, public health professionals, providers should be leading this planning process.”
The working group maintains its approach is not coercive, but rather aims to offer “immediate placement into a recovery program or entry into the justice system” to those using drugs in public spaces. Young emphasized the team’s focus on supporting individuals on their path to recovery and utilizing diversion programs. Oliver D’Agostino, who credited the city’s Coordinated Response Team with helping him achieve sobriety, shared his experience, stating the support he received was crucial to his recovery.
The working group did not release cost estimates for the proposed initiatives. Members indicated they will collaborate with the city and state to secure funding and establish a centralized special court dedicated to cases originating near Mass. And Cass. A previous attempt to establish a similar court in the area, opened by the Suffolk County sheriff more than four years ago, was short-lived, closing after just nine days due to “low case volume.” The state Trial Court is currently reviewing the working group’s recommendations, although the Department of Public Health declined to comment.
Boston City Councilor John FitzGerald, who chairs the council’s Public Health, Homelessness and Recovery Committee, acknowledged the ongoing work and the need for continued dialogue. “There is still work to be done,” FitzGerald said. “We note that and we are committed to continue to having those conversations and working to bolster this framework.”
