As darkness begins to fall, lampposts flicker to life across the New Haven Green, illuminating the crisscrossing pathways and park benches. The place is almost completely deserted, save for a few people emerging from Center Church. Ray Greene, who is currently experiencing homelessness and receiving treatment for substance use disorder, stands on the corner waiting for the bus back to the town of Hamden, Connecticut. He’s bundled in a thick winter coat, and wears several pairs of thin cotton gloves. On his back he carries a large, worn-out backpack, which he says contains most of his belongings.
The New Haven Green, the city’s most central public park, came to national attention in August 2018, when 116 people were hospitalized after ingesting K2 there. K2 is a drug often described as a form of synthetic marijuana, but in reality, the two drugs have vastly different compositions, and K2 is significantly more dangerous.
Greene says he has noticed a greater police presence since the mass K2 overdose in 2018. “They’re definitely around here more since then, just making their faces known,” he says of the police officers. “It’s probably for the tourists and the families that want to come here, I guess. That’s their priority.”
The police aren’t the only people who have been frequenting the public park lately. Phil Costello, an advanced practice registered nurse and the clinical director for Homeless Care at the Cornell Scott Hill Health Center, spends much of his time on the New Haven Green, stopping at each park bench to chat with people and checking the vital signs of anyone who appears to be unconscious or at risk of an overdose. Greene says he often sees Costello making his rounds on the Green. “It’s good to know there’s somebody who’s looking out,” he says.
It’s around dinnertime on a cold night in February, and Phil Costello is standing by the entrance of the Downtown Evening Soup Kitchen on Temple Street. He’s leaning against the door of his black pick-up truck, wearing black scrubs. He carries two heavy backpacks, one slung over each of his broad shoulders. Patrons of the soup kitchen are shuffling towards the entrance for dinner. Many are coming from the New Haven Green, less than a block away. Most greet Costello by name as they pass, and he does the same. “Hey,” he says to a man standing by the entrance and smoking a cigarette. “How’re you feeling this week? How’s your breathing?” They chat amiably for a few minutes, cracking jokes and discussing the man’s various health issues.
Costello describes his specialty as “street medicine,” which primarily involves checking up on members of the New Haven community who are experiencing homelessness. Much of his work centers around the intersection of homelessness and addiction. “The people I usually work with spend most of their time just trying to figure out how to survive,” he says. “That makes finding windows of sobriety and stability in which to provide consistent and actually effective treatment for addiction or anything else particularly difficult.” As Costello sees it, his work both prevents unnecessary and expensive emergency room visits and ensures that people who do need emergency treatment at a hospital get it.
Costello was making his rounds on the Green when the 2018 overdoses began, and he was one of the first responders to treat the overdose victims. Though he describes the amount of K2 present on the Green that day as an anomaly, he believes the event was consistent with the rise in substance use disorder he had observed on the Green in years prior. Connecticut currently has the ninth highest rate of opioid-related deaths per capita in the country; New Haven County consistently ranks among the highest in the state for per-capita rates of overdoses, according to the Connecticut Department of Public Health. “The biggest thing that came out of this whole K2 thing is that it made the city more aware of what we all already knew, which is that our people desperately need help,” Costello says.
Shortly after the K2 poisoning, then-Mayor Toni Harp outlined a number of initiatives intended to address the problems presented by substance use disorder in New Haven. Through his work on the Green, Costello witnessed the implementation and effects of these projects firsthand. Among the initiatives was the New Haven Police Department’s adoption of hot spot technology, which allows officers to track drug overdoses throughout the Northeast and anticipate spikes in overdoses in New Haven before they occur. In the past year, the New Haven Fire Department has also partnered with local treatment centers to print cards with information about New Haven-based services.
Fire Chief John Alston argues that much of the solution has to do with simply providing people with the information they need to seek treatment. “We knew we wouldn’t be able to just arrest or legislate our way out of this problem,” he says. Alston believes the card program has been successful at directing people towards seeking treatment. “Eighty-three percent of the calls we get at the Fire Department are medical, and a significant number of those are going to be drug related,” he says. “If we believe that to be the case, we either give someone a card or we place it on their person so they find it later. We’ve had treatment centers reporting that lots of people are coming in seeking treatment because they found the information on these cards.”
Mayor Justin Elicker, who was inaugurated in January, supports the emergency responders’ emphasis on treatment rather than policing. “City Hall’s philosophy on how to address substance use disorder is about not criminalizing drug use but treating it as a medical issue,” he says. “Nonprofits in the city like the APT Foundation treat people regardless of whether they’re currently using or not. Research shows that you’ll get better results that way.” (The APT Foundation is a treatment center in New Haven that offers a range of services, including several methadone clinics in the area.)
Mayor Elicker does note, though, that police presence on the Green has increased since the K2 overdose. Phil Costello has noticed this in his work as well. “There are a lot of people trying to help out,” he says. “But has the increased police presence changed the drug issue? Probably not. Police presence is a band-aid, not a solution to the problem.”
Former Mayor Harp also created a task force with representatives from law enforcement, City Hall, treatment centers, non-governmental organizations, the Green’s Committee of Proprietors, the churches on the Green, and local residents. According to Costello, who was involved with the task force, the most important thing to come out of the group’s work was a proposed plan for a drop-in center and clinic near the Green, where people struggling with addiction could get treatment. Costello believes that establishing such a center would be a critical step towards addressing the problems of substance use disorder in New Haven. In Vancouver, he said, opioid treatment centers that feature supervised consumption or injection facilities have been shown to reduce the likelihood of overdose-related deaths.
According to Costello, there are currently two ongoing efforts to raise money for a drop-in center near the Green, but funding remains a significant hurdle. “It would make a big difference in the community if Yale would help out with that,” Costello says. Yale has historically been involved with providing access to treatment services in New Haven: the Hill Health Center, where Costello works, was founded in 1968 as a collaboration between the local community and doctors at the Yale School of Medicine.
As Costello envisions it, the drop-in center would include a clinic and a sobering room where people could rest and recover in a safe and monitored environment, reducing the risk of arrest or hospitalization. “One of the biggest problems is that there just isn’t a place for these people to be able to go,” he says. “A lot of them just need a safe, warm space, where they can be consistently addressed by the same people.” The center would also have mailboxes where people experiencing homelessness could receive mail and staff members who could help with scheduling medical appointments. “Many people don’t think about this, but for people who don’t have regular phone service, scheduling medical appointments and getting treatment can be extremely difficult,” Costello says. “Even if an appointment is made, if nobody ever answers the phone to confirm the appointment, it’ll just get cancelled.”
But other recent efforts to open treatment centers in New Haven have been met with backlash from a group of residents of the Hill, including Ward 3 Alder Ron Hurt and Ward 4 Alder Evelyn Rodriguez, who claim that the city is already saturated with social services. Last fall, the New Haven Independent reported that community members resisted the Hill Health Center’s plan to build a new, $20 million, fifty-two-bed inpatient treatment center. Opponents argued that further increasing the relatively high concentration of treatment centers runs counter to efforts to make lower-income neighborhoods safer, pointing out that the area around the APT Foundation’s methadone clinic in the Hill has been the site of a disproportionate amount of crime. The plan for the treatment center was ultimately approved by the Board of Alders.
Part of the resistance to the opening of new treatment centers in New Haven stems from the perception that this initiative would attract people from outside New Haven, who might create a drain on the city’s social services and contribute to higher crime rates. “We need to make sure that the surrounding towns and cities are adequately providing programs for their residents, so they don’t feel forced to come to New Haven for treatment,” Mayor Elicker says. “This is part of why this issue centers on the Green, because it’s right next to the bus stops, so it’s where these people spend their time.”
But according to Costello, though many people do travel to New Haven to receive treatment, they usually return to their own communities at night and are unlikely to stay in New Haven. “They’re typically not the ones spending time on the Green,” he says. “Plus, the K2 incident had nothing to do with opiates, so blaming opiate treatment centers that are actually helping people get better just confuses things.”
Costello believes that building public support for the drop-in center near the Green is the most important factor in making the center a reality. In his view, increasing police presence on the Green without expanding access to treatment services nearby serves primarily to appease local business owners who feel that the prevalence of substance abuse on the Green is bad for business. “What we need to do is educate local businesses and community members,” he says. “We need to let everyone know that if people are inside getting help and staying safe, they’re not out in front of the storefronts, and they’re not having these issues on the Green.” When asked if he thinks the center will become a reality soon, Costello grimaces a little. “It’s a slow process,” he says, chuckling and shaking his head.
Ray Greene says he has noticed the fire department’s card program, and believes it’s making a difference. “People got to get this information somehow,” he says. But he believes a drop-in treatment center near the Green would be transformative. “You’ve always got to be moving around from place to place to get the services in New Haven, so if it was right here I bet a lot of the people here on the Green would be doing a lot better,” he says.
He sees the Green as the best possible place to spend his time, but he says he wishes he felt more welcome there. “A lot of folks think of people hanging out on the Green as a nuisance, but I’m not trying to be a nuisance,” he says. “I just need a place to be.”
After spending the night in Hamden, he says, he’ll return to the New Haven Green the next morning.