One day another dealer waved him down on the street and invited him to have a seat in a mammoth SUV. Take a look at this, he said, pointing to a red-and-white Igloo lunch box resting in the space between the seats. He picked it up, pushed the button that held the lid in place and pulled it to the side. He tilted the box so that my dealer could see in. The lunch box was filled to the brim with gunmetal-green pills. Eighty-milligram Oxys. The biggest dose manufactured. The WMD. How many 80-milligram Oxys fit in a lunch box the size of a small cooler? Fuck if I know, but it's a lot.

SCORE NO MORE: Writer Jeff Deeney, photographed May 30, 2006, in North Philadelphia. Photo By: Michael T. Regan

You want any of these, the guy asked, I can't get rid of these things fast enough. You might want to consider moving some yourself. My dealer declined. Pills weren't his thing. At least the pills weren't his thing then. Now he was kicking himself in the ass knowing that he once had access to that kind of supply. Where did those pills come from? Where did they wind up? All I know is that this was before the government was really tipped off to this new epidemic sweeping the nation, like a hole had been blasted in the legitimate pharmaceutical pipelines, letting pills pour into the streets of North Philly like water from an uncapped fire hydrant at the height of summer.

If my dealer came up short on supply and couldn't hook me up, he sent me out to a place where there was enough Oxy going around to support the whole city's habit.

"Pill Hill" was the name of the infamous intersection of 17th and Jefferson streets. It's in an area just west and south of Temple's campus, across Broad Street and north of Girard Avenue, a stone's throw from Center City and then rapidly gentrifying Fairmount. Pill Hill was where you went to get Oxys, Percocets, Endocets and Vicodins: an open-air pharmaceuticals market that operated around the clock, seven days a week.

The houses in the area were tightly packed two-story red brick row homes that stretched for blocks in any direction. The corner was a portrait of North Philadelphia's faded former glory, giant sweeping homes with intricate arches built into facades that had largely gone to rot. The rest of the block comprised towering old brownstones, a smattering of them thoroughly blasted and deserted.

Most windows on 17th Street weren't boarded over, nor were most houses abandoned, but nonetheless, at night they were always dark. It was like a war zone between battles, the soldiers afraid to strike a match for fear of giving away their position. It seemed like the people who lived in those houses must always be holding their breath, waiting for guns to go off outside their doors. I assumed that the streetlights on these blocks were either shot out by drug dealers to provide more cover from the cops or maybe they were burnt out and neglected by the city. It made for an eerie and suffocating darkness that was broken only by the lights from corner bodegas, where dealers and buyers loosely congregated, drifting into the light and back into the dark, exchanging money and drugs with what looked like casual handshakes.

Pill Hill was no place for Center City yuppies, and the amount of money I was spending on a single transaction—OxyContin was expensive—made it even more dangerous to be out there than going into the Badlands to buy heroin. Your average junkie isn't toting around $400 to $600 at any given moment, but it was assumed that a young, well-dressed white kid up on Pill Hill was there to cop Oxys, and everyone knew how much those cost.

The going rate was 50 cents a milligram. Forty dollars for an 80-milligram pill. I was using four a day and preferred to buy in bulk.

The cops knew I was there to score, the dealers would rip me off if I gave them the chance and the other users would rob me in a heartbeat if I went strolling down Jefferson Street. So I didn't venture out to Pill Hill alone.

I parked the car and waited for Ditta longer than I wanted. A kid in a military green quilted down jacket and hugely oversized jeans that hung so low they were about to drop off his ass came over and knocked on the window. He had a giant Afro with a black pick sticking out of the back of it.

"What you need, man, who you here to see?" he asked. There was suspicion in his voice, but no hostility.

I didn't feel threatened, but I didn't like standing out and drawing attention. I rolled the window down.

"Ditta. I'm waiting for Ditta."

He looked surprised, like he didn't actually expect me to give him a name that he recognized.

I felt shitty and impatient; the leading edges of the flu-like symptoms that kick off full-blown withdrawal were creeping up on me like an approaching storm. My eyes were getting watery and my body started to ache.

After another minute, I heard the voice of the kid who had tapped on the window call out, "Hey Ditta, white boy lookin' for you."

"Yeah," she called back, "I'm expectin' him, y'all leave him be when you see him 'round here. He with me."

When she got in the car, a thick cloud of perfume that was unbearably sweet trailed. She had on shoes that, above the ankle, were like high-top canvas Chuck Taylors but, as they approached the heel, became white stilettos. She wore skin-tight jeans, and a loose belt hung askance around her waist; it was thick enough to have been won in boxer's title bout. Her black T-shirt was cut off just under her breasts; the sleeves were torn and intentionally shredded. On her arms she wore long gloves made out of neon-green mesh that cinched around her thumbs. Her nails were fake, long and glossy, and her lips were made up to match. The dealer who arranged to have her meet me told me that girls like Ditta never go out without being dressed for the club, regardless of whether they are actually going to one.

"I'm Ditta," she said, not extending a hand. "What's your name again?"

"Jeff," I said, "I'm Jeff."

"You know where we goin', Jeff?" she asked, slipping a pack of menthol cigarettes from the denim jacket she had slung over her arm that looked about big enough to fit a 4-year-old. She lit the cigarette without asking if she could.

"I have no idea where we're going, Ditta. You're going to have to lead the way. I've never been up here before."

"Don't worry, everything gonna be cool, don't sweat, I know these dudes we're goin' to see tonight. I know all them dudes up on Jay Street."

I put the car in drive, followed her directions and we were there before her cigarette was finished. It was only a short drive across Temple's campus and past the Broad Street boundary, where relative safety and security immediately disappeared into bleak and treacherous North Philadelphia.

"Drive on through here," she said when we arrived at 17th and Jefferson streets. "Don't slow down."

I could see why. Parked on each of the intersection's four corners was a cop car, a patrolman sitting behind the wheel doing paperwork or talking on his radio. I didn't like driving past four cops, and I ducked down a bit in my seat as I drove, trying to cover my face with my hand like I was blocking a bright light. The cops didn't look up.

"They do that," she said. "It gets real hot up here sometimes and they park and stay put until it cools off. Don't mean no thing, just means I gotta walk a bit and go see where them fools is at. Park down the next block."

I did what she told me. When I parked, she turned in her seat to look at me.

"So what you need? How much you want?"

I pulled out my wallet, which could barely close because it was stuffed so full with $20 bills. I pulled the wad of cash out and handed it to her.

"That's four hundred," I said. "I need as much as you can get with that. Eighties if they have them, but if they've only got 40s, I'll take those, too."

"Oh, they'll have the 80s," she said, rolling up the bills and sticking them down her shirt, securing them under the wire of her bra between her breasts. "Don't worry about that, they can get whatever you want up here. Be cool. I might have to walk a bit."

As she was getting out of the car, she called out a name and another young girl down the block turned and waved at her. They talked quietly for a moment and then walked off into the darkness of the unlit block together.

Ditta jumped back in after what seemed like an eternity, telling me to drive and apologizing for taking so long.

"The cops got everyone scattered," she said. "It took me a while to find him."

She had stopped to talk to a couple of people along the way, and I started to realize that runs like this were probably Ditta's only real social exposure. The rest of her time was spent caring for an extended network of little cousins and neighbor's kids in her tiny project apartment. She wasn't going to hurry up on my behalf; she was dressed up and looking good, out there talking to girlfriends she hadn't seen in a while, chatting up the neighborhood street-corner players.

"Hold your hand out," she said, as I started the car up, and when I did she dropped the pills into it, ten 80-milligram Oxys, just like I ordered.

I gingerly set them down on the seat between us and slid the bottom plastic wrapping from my cigarette box and dumped the pills into it, folding the wrapper over and then sticking it in a concealed pocket in my wallet. I left one pill on the seat that I desperately needed right now, that I would have to chew instead of snort and that really pissed me off. Better to have something now than nothing until later, I thought, and popped the pill in my mouth and started to chew.

You might expect to find only the worst cases of chronic addiction on a detox ward whose patients were mostly fed into the system by the city's welfare office, but this wasn't the case. Oxy's reach was so much broader than street drugs such as heroin or crack. Detox had its share of hardcore IV drug addicts, but there were also teenagers, housewives and family men who were all addicted to Oxy. These were sociological anomalies who wound up mixed in with the worst of the worst simply because it was close to home; they lived in the area of eastern Lower Bucks County that directly surrounded the rehab. This was the logical landing place for them even though there were much nicer places within a day's drive.

The rehab was in an asphalt-heavy suburb packed tight with strip malls. Small, unassuming single-family homes lined streets that were separated by patches of brush and scant woods. It wasn't exactly bucolic, but for the patients who had come crawling out of Kensington to get here, it was a vacation in the countryside. You could tell who was from Kensington and who wasn't. Kensington was written into the deep lines of their faces and the darkness in the flesh of their blackened gums from which rotted teeth protruded.

The local suburbanites were solidly middle-class until recently, when their Oxy habits had eroded their financial security. They came across Oxy by chance, some through car accidents or other painful short-term medical conditions that required painkillers. Even after the doctor discontinued prescriptions for the painkiller, these uninitiated addicts were able to produce a steady enough supply of the drug to form a bad enough habit to necessitate a detox, something that was to me a clear indication of Oxy's prevalence and availability in the region. It amazed me that such suburban homebodies with no prior history of drug use—let alone abuse—could wind up here on the detox unit with the rest of the gangster-idolizing young thugs and long-suffering junkies and drunks.

But all it took for a new initiate to get started was one trip around the circuit of local pain clinics faking or exaggerating symptoms to find out which doctor would write scrips without asking too many questions. If these novice addicts weren't bold enough to doctor shop, it wasn't hard to talk up the topic of pain pills in the local bars and see if anyone offered up a connection. Or maybe they turned to their more rugged neighbors to the south in Morrel Park or Pennypack, the ones who parked work vans and pickups laden with ladders and were familiar with the areas over the city line, where young dealers dwelled in the shadows of the refinery, waiting for new customers who were looking to hook up with black-market Oxys for the first time.

One of my roommates revealed himself to be one of these former-pain-patient-turned-dabbling-druggie-turned-full-blown-Oxy-addicts. We had a candid, whispered conversation about how he wound up here in one of the rare moments when our other two roommates were in the detox waiting room watching the 10-inch black-and-white television that was our only source of entertainment.

BOTTOM OF THE HILL: "Your average junkie isn't toting around $400 to $600 at any given moment. But it was assumed that a young, well-dressed white kid up on Pill Hill was there to cop Oxys." Photo By: Michael T. Regan

"Hey, did I hear you say you were originally from West Philly?" he asked.

We were both making our beds, a process that didn't take much effort considering we were issued only one thin blanket upon intake. I stretched the coarse brown fabric across the plastic-coated mattress and folded it back a bit, laying the rubber-encased pillow on top of the crease I made.

"My family has roots that go way back, there, yeah. My grandparents settled there when they first arrived in the States from Italy and never budged, not even after the neighborhood went south. When I was 6 we moved to Delaware County, out to the suburbs."

He looked tremendously relieved when I said this and walked around my bed like he had something important to tell me. He was quiet guy who kept to himself in the waiting room, like he didn't feel comfortable being around the people he had no choice but to be around in detox. He wasn't slight or bookish or in possession of any other outward quality that would make the detox roughnecks shun him. In fact, he had a thick, bushy mustache and wore the same style of boxy white basketball sneakers the rest of the patients wore. He looked every bit as Northeast Philadelphia to me as they did. Nonetheless, he obviously didn't like being here and wasn't connecting with the other patients, except for me, now that we were having our little moment of identification.

When he was close enough to do so, he spoke in a hushed voice while lightly holding on to my forearm. He told me that his family was also from West Philadelphia; in fact, our grandparents grew up only a block away from each other in the same section of Overbrook. He swore me to secrecy before telling me that his family controlled a Philadelphia restaurant dynasty; he didn't want word of it getting out for fear that the other patients might show up at his work begging.

He said he was sharing this because he could tell from the looks of me that I wasn't like the other patients. He was appalled to find himself sharing space with common junkies, hoods and street walkers. He knew he was hooked on Oxy but for him it was a medically related misstep that got a little out of control. He started abusing the pills after having them prescribed for a prolonged period after fucking up his back in a car accident.

Then, once the prescription was canceled, he turned to the kitchen staff in one of his restaurants, black guys from the old neighborhood he knew to be regular weed smokers, and asked them for a pill connection. They had pill connections. He freely admitted that Oxy was ruining his home life since then, putting him in financial jeopardy and dominating his thoughts whenever he went without it.

But he wasn't a drug addict. Not like these dirtbags in detox. All he needed was to get the shit flushed out of his system and he would be good to go. A four-day fix and back to work, like getting over the flu.

I asked him what would happen when he went back to work. He would always know that Oxy was a simple request away from being his again. Once you know how to get a drug, you can't willfully forget how to cop, which could be a major problem if your supplier works in the kitchen and you work the counter. What if he was having a hard time coping with the hectic pace at work? What if when he went back, he still felt like shit, being fresh from a detox unit? What was he going to do to keep himself from sliding back onto the pills and eventually winding up in a worse situation than the one he was in right now? It was like having taken a bite out of the proverbial apple, a taste of the forbidden fruit that stays with you forever.

The other unlikely Oxy addicts, the housewives and teenagers, good people from good backgrounds, all shared the same glibness when it came to their stay in detox and making any preparations for returning home. They each saw getting hooked on Oxy as a bump in the road, an accidental slip-up that they would be sure to avoid letting happen again. It's possible that that was the case; none of them was immersed in the same grinding environmental conditions that the other detox patients were. Maybe it's easy to put a drug down if you haven't been using it for too long and haven't shaped your life around it. Maybe having a quiet home in a safe neighborhood instead of living in a ghetto where other users were always calling to you to come back and kick it on the corner with them would help, too. Maybe my roommate was right, a couple of days in bed and then back to work, good as new.

Only time would tell, but it was a hell of a risk to take so lightly, considering that being wrong could mean going to jail, losing your kids, losing everything you own. Especially since the lure of Philadelphia's cheap heroin eventually sucks in an Oxy addict. Even the most wizened heroin junkies on the detox ward for the umpteenth time had been drug-free at one point. Then, they had been dabblers. As years drifted past and life ground down hard on them, they wound up here, the way they are now. I bet they said the same thing to themselves once upon a time. I don't steal. I don't beg. I don't hook. I'll bounce back. I'll catch a break. Eventually the only thing left to say is at least I'm not dead, but by that point, they probably wouldn't have minded if they were.

Philadelphia's a little big city, a small-town metropolis where you're bound to run into people you used to know even after the arcs of your lives have moved in completely different directions. I run into people from rehab all the time. There are success stories; I consider myself one of them, though a fledgling writing career that's stuck on the runway and has yet to take flight might not be considered by some as such a big win. I'm still clean. I have a simple and quiet life now, which is what I want. Most of the other winners I've encountered are the same way. They don't ask for much from life now that they've managed to get off of the rollercoaster they were on for decades, that they wanted off of more than they could ever want any job or piece of jewelry or other worldly accoutrement. It's all about the simple things now. We meet up for coffee sometimes and talk about it, about how different it is now than it used to be. We shake our heads and roll our eyes at the thought of how crazy it was. It's almost hard to believe that was us.

But like in any game, there are rehab losers, too. Lots of them. Some of them disappear immediately, even after seeming to have made miraculous strides in personal growth during the month you spent together. Some keep in touch and then slowly fade off of your life's radar, not returning your phone calls until the one time you try the number and find it disconnected and have to assume the worst. Then, months or years later, they pop up. And not surprisingly, the losers turn out to be ones you knew were going to lose right from the start. They put nothing in, fucked around all day, refused to do what the staff told them, tried to get laid and spent countless hours telling war stories about all the bags they shot and rocks they smoked like they were talking about ex-girlfriends they were still in love with.

Next thing you know, it's six months later, you're getting off work and here comes your old roommate who slept through every lecture, meeting and group session running up Market Street yelling out your name, begging you for five dollars in front of your appalled co-workers. Oh look, there's the glib young Oxy-addicted Italian kid from South Philly who dismissed the counselors as idiots, who felt he was just going through a phase, would be fine on his own and decided to leave early against medical advice, standing on the corner of 17th and Walnut streets scratching himself like he's covered in fleas and telling you with a face full of remorse that he fucked up. Back on the Oxys. Back to the unrelenting everyday grind of full-blown drug addiction.

I can't say I was surprised.

Jeff Deeney has written a memoir about his experience with OxyContin addiction called Pharmadelphia. The book also investigates black-market diversion of the drug and larger recent trends in the nationwide prescription drug problem.