Click photo to enlarge
ADVANCE FOR USE SATURDAY, FEB. 20, 2016, AND THEREAFTER- In this Jan. 20, 2016, photo, Pathfinder Director Jessica Perreault interviews Donald Hovasse at his homeless camp in Lowell, Mass., during the city's annual homeless count. (Alana Melanson/The Lowell Sun via AP) MANDATORY CREDIT

LOWELL >> Donald Hovasse makes his home in the wooded patch alongside River Meadow Brook, running adjacent to the Lowell Connector.

Hovasse, 48, lives in a tent bolstered by tarps. His wife normally lives with him, but on this early January morning, she's at a shelter in Boston. It's 15 degrees with a wind chill well below zero. Hovasse wears five layers of clothing and several blankets to get by.

Hovasse has been homeless for two years, and on and off for five years before that. He says he lost his job because of medical issues. Government benefits are barely enough to get by, Hovasse says.

He doesn't tolerate drugs and alcohol in his campsite. Two years sober, he doesn't want anything to lead him back to a heroin and cocaine addiction he battled for years.

"I have the same problems I had when I was using as I am clean, but using only makes it worse," Hovasse says.

His campsite is an anomaly.

In the woods on the other side of the Connector, three tents are abandoned in the cold of the night.

Cardboard boxes that once held syringes are torn apart inside one of the open tents.

Hovasse says he used alcohol and marijuana when he was young. Now, he says he sees more and more homeless people in their late teens to early 30s using harder drugs.

"Heroin seems to be the drug of choice in Lowell," he says.

Volunteers gather in a conference room at the city Department of Planning and Development.

Some are medical professionals and social workers with the Bedford VA and other organizations.


Some are church members who want to make a difference.

Community Development Specialist Linda King passes out clipboards and stacks of questionnaires, asking about drug use and past trauma.

King tells them to take the lead of the homeless they meet. Volunteers can ask them the questions, or the homeless can fill out the forms themselves.

She has everyone exchange phone numbers to keep in touch. Call me when you're done with your assignment, she says, so we can be sure you're safe.

The tightly bundled-up volunteers exit City Hall. It's 4 a.m., Jan. 20. The flag outside whips in the wind and the blustery cold bites at their cheeks.

The volunteers scatter to 18 known homeless camps throughout the city.

Their mission: Count the number of unsheltered homeless they find.

The annual exercise, known as the Point-in-Time count, is mandated by the U.S. Department of Housing and Urban Development. On a single night each January, cities like Lowell must counts homeless who are in shelters, or outside. Those numbers drive services.

Officer Kevin Garneau, homeless liaison for the Lowell Police Department, and Cheryl Sullivan, outreach coordinator for the Lowell Transitional Living Center, have already spent hours counting.

Accompanied by an ambulance from Trinity EMS, they began at midnight searching out the riskiest camps in the city.

Garneau, Pathfinder Director Jessica Perrault and Veterans Northeast Outreach Center Case Manager Alberto Gonzalez travel together for the second leg.

They stop at Gallagher Terminal. In a small alcove only feet away from where the commuter-rail trains whiz by, they find a sleeping man bundled in layers of blankets atop two stacked mattresses. He's not keen about being awakened at the early hour, and grumbles answers to the questions he's asked. He admits to being a drug user, but won't identify his poison.

Perreault knows him. She points out the graffiti on the walls, professing his love to his girlfriend who recently died.

While cancer ultimately claimed her life, she long struggled with heroin addiction.

As opioid use has turned epidemic in recent years, homelessness also has increased dramatically. The impact is being felt across all age groups, but most strongly among younger adults.

Last year, about 12 percent of the homeless served by the Rock Street drop-in center run by Bridgewell's Pathfinder program were ages 18 to 24, Perreault said. This year, they number nearly 40 percent, she said.

Nearly 60 percent of clients in that age group use opioids, based on data from self-reports and urine screens, Perreault said. Heroin use hovers at 50 to 60 percent across all age groups, she said.

Most younger users did not start shooting heroin, Perreault said.

They began with painkillers like Oxycontin and Percocet. Some drugs were legitimately prescribed for high school or college sports injuries, others as recreational use, she said.

Opioid painkillers quickly become an expensive habit. On the street, pills will sell for about $1 per milligram, Garneau said, making a 30-milligram Percocet $30. A bag of heroin can cost as little as $6 to $10, he said.

"If you're actively using heroin, it's very difficult to maintain a job and function in society, because your whole life revolves around acquiring funds so you can use," Perreault said. "It's a vicious cycle."

Families often will give younger addicts multiple chances, repeatedly trying rehab and detox, she said. As addicts relapse, they'll steal from family and friends, commit other crimes and need to be bailed out of jail, Perreault said.

"It often gets to the ultimatum, 'Stop, or leave,' " she said.

Young, often unskilled, many addicts find themselves on the streets. Many turn to theft, prostitution and selling drugs to support their habits.

Garneau is used to seeing homeless in their 20s and 30s. Now, he's seeing kids as young as 13 on the streets. Those 17 and younger are turned over to the custody of the state Department of Children and Families.

Sullivan said a few parents lead their children to disaster. Some parents are addicts who first injected their children. Some homeless have been physically and sexually abused by their parents, and turn to drugs to numb their pain.

LTLC Executive Director Joshua White said the shelter began to see the dramatic increase of homeless young adults about two years ago.

LTLC is primarily a dry shelter. But during the winter months, the center provides cots in a separate area for homeless who would otherwise not be welcome, White said.

The shelter engages with homeless drug users through the winter bed program and ongoing outreach efforts to help them find treatment and other services, he said.

The city offers many quality services that are usually longer term than those found in other communities, Sullivan said. Some homeless migrate to Lowell to take advantage of the services. Others are drawn to the strong drugs they find here.

Drug use and mental illness are often formidable barriers. Many programs require homeless to be sober or in treatment programs before they will be granted access to temporary or transitional shelter and other services.

Young adults in these situations are often afraid to speak about their experiences, because of the social stigma of drug use and homelessness. Pathfinder and LTLC hoped to introduce to The Sun to several homeless youth. Each one shied away.

Garneau said mental illness is an added challenge. Even when these homeless receive help, they often fail to get to appointments and stay on prescribed treatments. Some will simply reject assistance. Some have mental-health issues so severe that services are not available, White said.

Sullivan tells the story of a chronically homeless man with significant mental-health issues. She said he's a danger to himself.

White said the man was in a shelter, but had to leave because of his behavior. He also had an apartment, but could not stay because he destroyed property and didn't realize it.

"At what point can you force somebody to live in a group home so they're not out on the street?" Sullivan said.

Homeless youth face unique challenges.

Many don't have jobs, or have poor-paying jobs. They're undereducated. They have a hard time holding on to an apartment. Some have also come out of the state system, said Robyn Kennedy, the deputy assistant secretary for children, youth and families at the state Executive Office of Health and Human Services.

Kennedy said the Special Commission on Unaccompanied Homeless Youth has been working to better understand and address these challenges.

"A lot of these young people don't graduate. They don't have secondary degrees. They don't have higher-education degrees," Kennedy said. "So really, how do we provide them with these services and give them the best chance to succeed so they don't become part of the chronic homeless population?"

She said the state will provide $2 million to regional service providers this year for these efforts. Under the 2014 statute governing the commission, funding can be used for a number of services. Among them are technical assistance to serve special populations such as LGBT youth and youth under 18, family counseling and reunification, shelter and housing.

For many homeless youth, it's a race to obtain the services they need before they get in trouble with the law.

That's where UTEC's Streetworker program steps in, providing workforce development and educational services to young men and women ages 16 to 24 with proven risk factors. Before they can take advantage of these services, UTEC will work with community partners to help get them in stable housing and addiction treatment programs, said Streetworker Program Manager Jonathan Lunde.

He and Senior Streetworker Mao Kang know the stories. They've lived them.

In his gang life, Kang used cocaine and heroin and was homeless on and off for three years. Lunde, who called himself a former hippie, started with marijuana and psychedelics. Once introduced to painkillers, he quickly graduated to heroin.

LTLC's Sullivan was homeless and addicted to crack cocaine when she came to Lowell from Revere 16 years ago. She denied her addiction, the result of childhood emotional trauma.

All three use their firsthand experience with addiction to help others climb back into society.

Kang turned to Buddhism and became a monk. Lunde had family support and methadone. Sullivan had Alcoholics Anonymous and was introduced to recovery work.

Garneau said long-term recovery programs and intensive case management are necessary to ensure addicts change course. He hopes the city can find social-service partners to lead the way.

Short-term detox isn't enough, Garneau said, especially when a patient has no income, housing or family to count on afterward. Even when an addict has those pieces in place, a drug's pull can be irresistible.

He recalled a 22-year-old woman who was clean for six months, got an apartment and began a job at a local restaurant. One day last summer, he found her in a vacant Middlesex Street lot, popular with those who shoot heroin. She was still wearing her work apron, and had a syringe in her hand.

Garneau startled her. She emptied the contents of the syringe.

She hugged and thanked him for stopping her from relapsing.

He tried to get the woman more help. Three days later, she was found in her bed, dead from an overdose.

Garneau said he's willing to take addicts to treatment by the hand, if he has to.

"I'm sick and tired of burying people," he said.

As the sun rises after the Lowell count, Perreault reflects on the difficulty of capturing a true number of unsheltered homeless.

The count takes place in the dead of winter, so "you're not really seeing an accurate representation of the people who live outside, especially on a cold night," Perreault said.

White says the federal definition of homelessness also has changed repeatedly. Homeless numbers in recent years have appeared to decline, he said, but that's not true.

Under the federal definition, only those in an emergency shelter or situation "unfit for human habitation" are considered unsheltered homeless. Those with temporary shelter aren't included, even if they are only safe the night of the count, Perreault says.

Younger homeless are most likely to be "couch surfers," she says, spending nights with those who will allow them to stay. Women especially are undercounted because they are more likely than men to have sympathetic friends and family, she says.

The Executive Office of Health and Human Services has undertaken its own homeless census for two years now. It is informal, taking place over two weeks around the same time as the HUD count.

Inclement weather hampered the first two years, so the 2016 count will likely be held in the spring to ensure more opportunities to engage with homeless young adults, Kennedy says.

The volunteers' final counts are tallied. This year, they found about 25 unsheltered homeless.

Last year, Perreault said, there were only 15.

Information from: The (Lowell) Sun,