On an August 25 Sunday afternoon, the discarded bright orange safety caps of hypodermic needles littered a tucked away corner between the Frances Appleton and Longfellow Bridges. There are no needles to be found here today, but just a week earlier on the other side of Storrow Drive, a Beacon Hill resident photographed a dozen needles clustered haphazardly with other litter on a cement platform under the Frances Appleton Bridge on the Charles River Esplanade.

The photo prompted an immediate clean-up effort from the Department of Conservation and Recreation (DCR) and resources for the unhoused population inhabiting the space under the Appleton Bridge, provided by Mayor Michelle Wu’s Coordinated Response Team.

In an emailed statement, a spokesperson said, "[The] DCR is seeing a rise in individuals using harmful substances at our properties across the state, creating public safety concerns for them and those visiting our properties for recreation.”

The DCR has committed to weekly clean-ups of the Appleton Bridge area and the Coordinated Response Team advises that anyone who sees loose needles submit a ticket through the 311 app or by calling 311 directly. For emergencies, always dial 911.

As of the deadline of this story, there have already been 138 requests this year for needle pickup made to Boston’s 311 services for the 02114 zip code, which includes the northern portion of the Esplanade, Beacon Hill and the North End. This is up from 98 requests for the entirety of last year and 105 requests in 2022.

For the first time since April 2022, the City’s Access, Harm Reduction, Overdose Prevention and Education program, which gives out clean syringes to reduce rates of HIV/AIDS and other infectious diseases, reported a syringe return rate below 1.0.

A return rate is a measurement of how many syringes are distributed compared to how many syringes are collected. A number higher than 1.0 means the city is collecting more than it’s giving out. Lower than 1.0 implies the inverse. In July, the first month after the city ended a program that paid up to $10 a person for returned syringes and the last month with complete data available, the return rate fell to 0.8, far lower than the average of 2.1 for the previous 24 months.

The Beacon Hill resident who took the Appleton Bridge photo has lived in the neighborhood for 24 years, and says that within the last year, they’ve called in a 311 request for needle pickup nearly every day they walk their dog on the Esplanade.

“I walk there maybe once or twice a day,” said the concerned resident, who gave an interview on the condition of anonymity. “That was the first time I'd seen a handful of needles. That was odd and not typical. I would say, typically, I would see two or three.”

Substance abuse disorders have risen across the city in recent years by many measurements. According to the 2024 Substance Use and Disorders Report, drug use related hospital patient encounters rose sharply in the first year of the pandemic, by 32% between 2019 and 2020, and have stayed high.

Fentanyl, a highly potent synthetic opioid often used to increase the potency of illegal narcotics without a buyer's knowledge, was present in 92% of all opioid overdose-related deaths and 81% of all drug overdose deaths in 2022, the most recent year with data available.

To combat the increasing opioid-related overdose mortality rates, Worcester recently Ok'd the opening of Massachusetts's first overdose prevention center (OPC), sometimes referred to as supervised injection facilities, pending the approval of the state Department of Public Health (DPH). Both state and federal law currently prohibit the possession and facilitation of drug use, even for harm reduction purposes. But, a state bill (S.1242) proposed by Sen. Julian Cyr of the Cape and Island district would establish state legal protections and a licensure process for authorization of a 10-year OPC pilot program.

Such programs in other jurisdictions have seen success with reducing overdose mortality and public health risks associated with public drug use. The 2023 Overdose Prevention Center Feasibility Report by the DPH says no overdose death has ever been reported in 30 years of OPC operations in Canada, Australia and much of Europe.

In the U.S., since the opening of two pilot facilities in New York City, staff have intervened successfully in 1,131 non-fatal overdoses and have collected over 2 million units of hazardous waste, while studies show no increase in crime in the surrounding areas and decreases in calls to the local 311 hotline regarding drug use, syringes, noise, homelessness and sanitary conditions.