The Junkie Legend of Philly's Pill Hill

By Jeff Deeney 11/25/12

Philly's open-air market for Oxy was about as safe as street dealing gets. Then the cops shut Pill Hill down. Now opiate addicts are in a lot more danger.

Philly's Pill Hill photo

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.

The roiling chaos and danger of Saturday night in the Badlands may have been thrilling when I was 20 but was less so as I was looking at 30. I didn’t want anything to do with those old dope corners when I picked up OC; I wanted a low-risk, low-drama, reliable way to get high. I was willing to pay a premium for pharmaceutical-grade drugs whose contents were regulated, as opposed to street bags of unpredictable potency that every five years or so lay waste to local addicts. I remembered all the beat bags I ever bought, bags that looked like dope during a rushed hand-to-hand street transaction but when I got home proved to be fake, gelling up into a semi-solid mess in the cooker. I wanted to know exactly what I was getting for my money. I wanted to use it with the confidence that, as an experienced addict who knew his tolerance and respected the drug’s overdose-inducing potential, there was little risk I would wind up blue faced and stiff as a board lying on my bathroom floor after getting off.

The easy times didn’t last, of course. Eventually my habit got so bad that I couldn’t put enough pills together by working the phone and had to hit the streets.

In those years prescription drugs had their own dedicated black market known as Pill Hill, at the intersection of Seventeenth and Jefferson streets in North Philly. The neighborhood was poor and blighted but had nowhere near the violence of the heroin corners of the Badlands.

Pill Hill had long been where off-duty corner hustlers went to get their “water,” as codeine cough syrup is known on the streets. Combining the benzo Xanax with codeine syrup became popular—a combination branded “pancakes and syrup”—and the area’s reputation as the pharm-dope hot spot was secure. Since it was often dealers buying off of other dealers, it was also known as an orderly, even businesslike, scene. From 1995 to 2001 only 19 of the city’s 2,518 homicides occurred at Pill Hill. There were 20 times as many murders near heroin corners during the same period. The ratio of nonfatal shootings was similarly skewed, with the Badlands enduring a veritable bloodbath. Pill Hill might not have been as safe as copping off a dirty doctor, but it beat the alternative of maybe taking a bullet to get a bundle.

When OxyContin arrived on the scene luring a skyrocketing population of new, young prescription-drug abusers to Seventeenth and Jefferson, the neighborhood surprisingly became no more violent. Violence on the Hill remained roughly the same as before even as drug sales boomed; from 2001 to 2004, when the neighborhood was doing heavy trade in OC, only seven of the city’s 1,277 homicides took place near what was a hopping, around-the-clock open-air market for painkillers. Meanwhile, heroin corners remained drenched in carnage, with gun violence becoming an intractable disease that spread to the entire surrounding North Philly community.

Ex-hustlers who sold OxyContin on Pill Hill attribute its relative nonviolence, not surprisingly, to their own professionalism. They ran their corners like businesses selling pricey niche products to consumers with access to money. Demand was high; supply was controlled by a small number of players making way too many profits to let unnecessary violence draw negative attention to the scene. They also say that they intentionally kept their corners quiet so inexperienced pill addicts new to copping wouldn’t be scared off. Their analysis rings true to me. I sometimes went to Pill Hill with huge sums of money to buy 80 mg pills at $40 a pop. I never got robbed or jumped, despite being a ripe target for a stickup.

On a typical Friday night, the atmosphere of Pill Hill was fairly relaxed, even as the busy corner buzzed with black-market commerce. The block was lined with tall brownstones; many were abandoned and, according to hustlers who worked the corner, served as stash houses, holding more painkillers than a pharmacy. Hustlers lined the stoops along the street and shouted out to drivers who looked interested: "Oxys, Percs, Endos, Vikes, syrup." Whatever your twist was, they had it. My coke dealer had introduced me to a girl who lived at the nearby Norris Apartment high-rise housing project, knew all the Pill Hill hustlers working the corner and would negotiate deals for me. Every transaction was comparatively safe, even if my dope-sick nerves had me on edge.

Tamper-resistant Oxy puts greater pressure on users to switch to heroin, and the message around increased harm for doing so has gained new urgency.

A confluence of forces has largely killed off Philly’s Pill Hill. When news of the “Oxy epidemic” spread, the police department’s narcotics unit targeted the neighborhood. Around that time developers began buying up abandoned properties to rehab and rent to students attending nearby Temple University. More recently, with the new tamper-resistant OC that requires a complicated "cold water extraction” process to break down into snortable or injectable dope, many Oxy users are switching to heroin—and have to relocate their daily routines across town to the still brutally violent Badlands, where they take bigger risks.

That opiate addicts will drop pricey pills for cheaper heroin if there’s a black market for it nearby is not a new discovery. As early as 2005 the Brown University Child and Adolescent Behavior Letter published their findings that OxyContin was a gateway drug to heroin among young users. But tamper-resistant Oxy puts new and greater pressure on users to switch, and the message around increased harm for doing so has gained new urgency in the media.

This was the dilemma I faced the day I dialed a phone number to see if I could get a detox bed. As my addiction grew, my ability to keep a job disappeared. With no income and a $200 or more per day habit raging, my savings quickly dwindled. I didn’t want to get back into injecting drugs and risking disease, violence and arrest, but I knew that for $10 I could get a bag of dope that would hit me as hard as an 80 mg Oxy that cost $40. Market forces were pressuring me to assume greater risks—or enter rehab. That decision would have been made even harder had my beloved crush-and-snort OCs been replaced with the tamper-proof version.

I got a detox bed and got clean rather than pick up the needle again. But not every Oxy addict is capable of getting clean. Some don’t want to. I suspect that many younger users who are on the front end of their addictions—as opposed to winding down as I was—will embrace the chaos and danger of the heroin scene the same way I did when I was their age. As a social worker who still visits my old copping grounds on a daily basis, I see fresh young faces popping up on Kensington Avenue all the time. I wish them luck in avoiding the diseases, violence and prisons where injection drug use often leads.

I look back with a conflicted sense of gratitude that OxyContin was easy to get on the streets during the time I was abusing it. This isn’t to exonerate OC manufacturer Purdue Pharma for engaging in epic acts of corporate malfeasance by minimizing the risks, especially the fierce addictiveness, of their opiate-pure pill even as they incentivized America’s doctors to prescribe it as widely as possible. A smoother-running, more effective drug-dealing operation can hardly be imagined, raking in maximum profits regardless of the havoc it wreaked on poor communities. And when Purdue got busted, no one spent a day in jail; the 10-figure fine was just the cost of doing business.

But in my case, as someone who probably would have been abusing heroin if I hadn’t had a safer alternative, in some perverse way OxyContin may have saved my life.

Jeff Deeney is a Philadelphia social worker and a writer who is in recovery. His column, "Street Beat," runs regularly in the The Fix. He is also a contributing writer at The Daily Beast.

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Jeff Deeney is a social worker, freelance writer and recovering addict in Philadelphia. He is a contributor to the Atlantic and has written for the Daily Beast, The Nation, and The Marshall Project. Follow Jeff on Twitter.