The Junkie Legend of Philly's Pill Hill
The Junkie Legend of Philly's Pill Hill
In August 2010, Purdue Pharma released a tamper-resistant version of its powerful painkiller, OxyContin. When abusers crack the time-release coating on the new formulation, the pill’s contents gel up in a sticky mess, unlike the original Oxy that yielded a little football-shaped white pellet of pure oxycodone that was easily crushed, snorted or injected. The push for "abuse-proof" OxyContin was championed by families of those who had died from overdoses; their hope was that lives would be saved by preventing overdoses and decreasing abuse.
In fact, Oxy abuse has fallen, and deaths are down. But now researchers have uncovered an unintended outcome of the reform; Oxy addicts are instead turning to heroin, which poses an even greater risk to their lives. As someone who has been both a heroin injector and an OC snorter I can tell you why, despite everything you’ve read about OxyContin being a ferociously addictive and deadly medicine, having a ready supply of it kept me away from heroin, and may have saved my life.
Prescription drug abuse prevention advocates were likely caught unaware by this inadvertent development partly because over the past decade broad generalities have prevailed about who OxyContin addicts really are. The sudden influx of "Hillbilly heroin" in the late 1990s definitely did a number on the mountain regions of West Virginia with a particular swiftness because drug abusers there had never before had access to such a supply of powerful dope. Perhaps for Oxy addicts far from the heroin hubs of major cities, a tamper-resistant pill is the answer to the abuse problem. But Oxy’s attractions were broader than this; in suburbs and in major cities that have heroin supplies, OxyContin has appealed to a broad base of users who didn’t want to be a part of the heroin scene.
I was one of those users. Back in 2004, I went to detox with a 350 mg per day OxyContin habit. Unlike many painkiller addicts in Appalachia, it wasn't a lack of heroin that made Oxy my drug of choice; I live in Philadelphia, which has for decades been saturated in extremely potent, cheap heroin. Nor was I an inexperienced addict who didn’t know how to get my hands on street drugs; I had been an injection drug user in the early 1990s before going to rehab and getting some clean years together. When I started using Oxy in the early 2000s, I had relapsed on cocaine for a while and knew plenty of drug dealers. I knew where the heroin corners were because I used to cop on them. I knew where to get needles and I knew how to cook and shoot dope had I wanted to do that. I knew that the price of OxyContin, then 50 cents per milligram, was approximately four times greater than heroin. Yet I chose to use it, anyway, despite the hefty price tag.
Why? Because it was safer.
Crush-and-snort Oxy was an affordable luxury, until it wasn’t. Coming off a period when I had my addiction fairly under control, I still had an income and some savings when I started using it, so initially there was no financial pressure to switch back to cheaper heroin.
Pill Hill might not have been as safe as copping off a dirty doctor, but it beat taking a bullet to get a bundle of heroin.
At first, I didn’t even need to hit the streets to buy Oxy. My coke dealer had a black book with the names of hustler dudes all over North Philly who could get whatever I needed. It usually didn’t take more than a phone call or two to line up a couple days’ supply of pills that were discreetly delivered and exchanged without any drama. I didn’t bother to doctor shop; black-market Oxy was plentiful.
Buying heroin a decade earlier had been vastly different. I rode with other addicts, usually a North Philly oldhead called Crackhead Joe and occasionally his running buddy, Chino, a Korean coke smoker whose family owned a corner store down the block. Joe and Chino knew the dense honeycomb of dope corners off Philly’s Lehigh Avenue like the back of their hand and always had an ear to the ground for who had the bomb bags. When I rolled into the neighborhood they jumped in my car and we made off for long nights of dipping and dodging from one corner to the next to cop, periodically falling back to less hectic corners south of Lehigh where we could get high before returning to the zone for another run.
Syringe-exchange services were still young in Philly in 1994; the public health measure to protect users from HIV had been legalized by then-Mayor Ed Rendell only two years earlier. But I wasn’t aware of it and instead purchased sharps on the street. My needle dealer was hardly a model of public health and safety. A friend of Crackhead Joe named Jamaica, he lived in an abandoned house near Fifth and York streets. Buying syringes from him was a tricky business because the house had no stairs and Jamaica, lived on the second floor. What once had been the stairs was a pile of rubble in the living room.
So you had to find a rock, wrap a dollar bill around it and throw it through an upstairs window. Usually this took a couple tries because you either missed or the dollar came unwrapped before the rock went through the window and floated back down in your face. But eventually you would get the rock and the dollar through the window. After a moment, a plastic-wrapped syringe would arc out the window and land at your feet. I never saw Jamaica. He never said a word. I still sometimes wonder how he got in and out of the house without any stairs.
Obtaining clean syringes—a challenge that persists to this day, with funding cuts curtailing access to the service—was only one problem solved by intranasal use of a prescription drug.
Some corners where Crackhead Joe would lead me were guarded by sentries openly wielding automatic weapons.
In Philly in 1994 there were 400 murders, more than 10% on or near corners where heroin was traded. For addicts, these were the days of dancing through gunfire in high-rise public housing courtyards to get to the dope man. Some corners where Crackhead Joe would lead me were guarded by sentries openly wielding automatic weapons. Joe always sternly advised me each time he got out of the car to go cop, leaving me inside, “Lock the doors. Don’t talk to nobody. Don’t make eye contact. Don’t get out of the car for nothin’.”
The danger was—and still is—palpable. Philadelphia is on course to have 15% fewer murders this year than in 1994, but this violence is still densely clustered around the city’s heroin corners and every day addicts face a high risk of assault, robbery, arrest and incarceration.