Outreach worker Amy Santiago had not seen her homeless client, Tracy, in more than a week. Not since a woman in the encampment where Tracy was living died of a drug overdose.
“When you have emergency medical personnel and the police come into your encampment,’’ Santiago said, “it’s a frightening experience.”
Santiago and her co-workers at the nonprofit Better Lives Rhode Island, had received notice from the state chief of emergency medical services about a dangerous additive showing up in street drugs, and she wanted to warn Tracy. But she couldn’t find her.
More than a month after Providence ordered roughly 60 people out of the city’s two largest homeless encampments, in mid-May, citing safety concerns, drug overdoses among the unhoused are up. And outreach workers offering the life-saving overdose prevention medication naloxone, known as Narcan, said the crackdown was driving their clients farther out of reach.
“I don’t know where a lot of these clients are, still,’’ Nicole Cervantes, an outreach worker for the nonprofit Project Weber/Renew in Providence, said in late June. Of the 60 or more clients that were displaced, she said, “I maybe know where 10 of them are, 15. And it’s been like, well, a month.”
And when people like Cervantes can’t find their clients, they can’t make sure they have Narcan and aren’t using drugs alone. Because people who use drugs alone and overdose are more apt to die.
“So that’s always been a concern, right? If they move from here, where do they go?” said Zachariah Kenyon, chief of the Providence Fire Department’s emergency medical services.
Thirty of the 91 overdose calls his department responded to in May — one in three calls — were for people who identified themselves as homeless, according to data he compiled and shared with The Public’s Radio. That’s compared with about one-in-four overdoses among homeless people (24 of the 106 calls) in May of 2023, the data show. And those are just the ones he knows about.
“It wouldn’t be any surprise to me,’’ Kenyon said, if there were “hundreds, if not thousands” where nobody calls 9-1-1 or anyone else for help “whether it’s in a house or in a homeless encampment.”
Drug overdose deaths are among the safety concerns that Providence Mayor Brett Smiley cited for breaking up homeless encampments. Speaking to The Public’s Radio Morning Edition Host Luis Hernandez, Smiley said last week that many of the encampments are in secluded places that are difficult for fire and EMS workers to reach.
“Sadly, many of these encampments are terribly unsafe,’’ the mayor said, “and in my year and a half in office, we’ve had fires, we’ve had acts of violence, we’ve had overdoses in these encampments.”
But outreach workers say that homeless people are the ones most at risk – and they’re at greater risk when the encampments are broken up.
“Folks really, truly look out for one another when they’re in groups,’’ said Ward 6 City Councilor Miguel Sanchez, who also does outreach work with homeless communities. When the encampments are broken up, he said, “people start isolating themselves.”
And isolation among drug users is especially worrisome given the constant shift in the street drug supplies. In late May, one week after the breakup of the two largest homeless encampments, outreach workers received a notice from Kenyon, the city’s EMS head, about a synthetic benzodiazepine found in street fentanyl and other opioids. The additive, Bromazolam, depresses breathing and slows heart rate. And like the veterinary tranquilizer, xylazine, which also has been found in fentanyl, the deep sedation caused by Bromazolam won’t be reversed by the medication naloxone, known as Narcan. Five overdose deaths in 2023 were linked to Bromazolam, Joseph Wendelken, a state health department spokesman, said.
The outreach workers from Better Lives Rhode Island wanted to warn their clients.
So on a recent afternoon in late June, Santiago went out to look for Tracy. (The Public’s Radio is only using her first name because she uses illegal drugs.)
Santiago parked her 2018 Toyota Prius in a mini-mart plaza, grabbed a plastic shopping bag from her trunk, and set out on foot.
“It looks like we are going into a little wooded area off a very main, congested street,’’ she said. “But I know it as a place where my folks feel safe to tent.”
After trudging through the underbrush, she came to a clearing. A doctor stood near a homeless man with a nasty leg wound. A young woman handed out hygiene kits and socks. Santiago peaked over a tarp hanging between two trees.
“Does anyone need Narcan?” she asked.
A woman’s voice floated over the tarp. Santiago pulled a box of the nasal-spray medication from her bag and passed it over to her.
She found lots of people in need. But no sign of Tracy.
If Tracy wasn’t found soon, Santiatgo said, she also could lose her spot for a subsidized housing voucher. A worker at Crossroads, the homeless shelter in Providence, started searching social media posts for Tracy and found her. She messaged Tracy who then called Santiago.
On a recent afternoon, Tracy sat in Santiago’s cubicle at the offices of Better Lives Rhode Island, sipping black coffee and recounting her recent ordeal.
Tracy had been one of several homeless people sharing a tent with the woman who died of an overdose at the end of May.
That night, Tracy couldn’t sleep, so she left their tent before dawn to take a walk.
“I just got up to leave, like four, and she was fine,’’ Tracy said. “And she was snoring, like a full, deep, like breathing.”
A couple of hours later, EMS workers responded to a 9-1-1 call from the encampment.
According to city Fire Department records The Public’s Radio obtained through a public records request, the woman’s boyfriend told EMS workers that he’d given her Narcan and CPR. The EMS crew spent more than a half hour trying to revive her. But she never regained a pulse.
Tracy returned to find the tent cut open. And when she heard what had happened she fled.
“I know I sound crazy when I say this,’’ she said, “but like it feels like something bad is gonna happen when you’re over there.”
As of late June, about 450 people were waiting for shelter beds, according to the Rhode Island Coalition to End Homelessness. More than 180 of the people on shelter waiting lists were in Providence.
Health reporter Lynn Arditi can be reached at larditi@thepublicsradio.org
