Ambien for Coke Heads

Getty Images The latest pharmaceutical being sold on the street is a knock-you-out antipsychotic called Seroquel. Jeff Deeney talks to the dealers, users, and narcs in the “Suzie-Q” black market.

In one of Philadelphia’s many community substance-abuse treatment centers, Hector, a young Puerto Rican from the city’s heroin-swamped Badlands barrio, discusses with his outpatient counselor whether his medication is helping fight his insomnia.

"Are the ‘Quells workin'?" he asks rhetorically, using the drug’s street name. He laughs. "Man, I got to take them right before I hop in the shower and then run to make it to bed. Them shits knock me the fuck out, fast."

Seroquel’s action on dopamine in the brain makes it the perfect foil to a coke binge or meth tweak that’s overstayed its welcome.

If you want to know which prescription drugs are trading on the black market, take a ride up to 17th and Jefferson in North Philadelphia, aka “Pill Hill,” a corner dedicated to the sale of diverted pharmaceuticals. These days on Pill Hill, there’s a good chance you’ll get sold some Seroquels, also known on the street as ’Quells or Suzie-Qs. A powerful antipsychotic intended to treat schizophrenia and bipolar disorder, Seroquel can have serious side effects including diabetes, a permanent Parkinson’s-like palsy called tardive dyskinesia, and sudden cardiac death. Despite this, it’s increasingly prescribed off-label to substance abusers like Hector for less-serious illnesses, like insomnia and anxiety.

And Hector, like many of these Seroquel users, has prior arrests for drug dealing (in his case, crack cocaine). Which provides Seroquel the perfect middleman to usher it into the illicit drug trade. Drug dealers, mandated to treatment as a condition of their probation or parole, are given off-label prescriptions for Seroquel, then sent right back to the street, where the pills can be sold for cash to users and other dealers.

As a barometer for what pharmaceuticals are in demand, Pill Hill’s track record is well established. In the early ‘80s, the hot pill was a sedative-hypnotic called Doriden, a flat, white tablet often paired with codeine cough medicine, a combination known as “pancakes and syrup.” Pancakes and syrup became popular with nearby corner coke hustlers who were looking for a mellow high, and over the years Philly rappers from the Roots to Beanie Sigel have name-dropped the drug combo in their lyrics. After Doriden was discontinued in 1999, Xanax—the extra-potent bar-shaped 2mg doses, called “tombstones” on Pill Hill—took its place and has reigned supreme ever since. As for pain killers, Percocet was king until being unseated in the late ‘90s by OxyContin. Now Seroquel is swimming in the mix of medications trading on Pill Hill, though the drug is so new to the street scene that law-enforcement agents are still trying to pin down its target market.

But one thing is clear: It’s not just popular in Philly. Demand for the drug is based on the quick and powerful knockout punch it delivers to users whose coke binge or meth tweak has overstayed its welcome. Seroquel's action on dopamine in the brain makes it the perfect foil to the comedown from stimulants—there’s no euphoric high, it simply eases you to sleep when you’re “schizin’,” as the drug-induced psychosis commonly suffered by longtime users is known on the street. On Opiophile.org, a Web site where drug abusers talk about getting high, users from all over recommend Seroquel for coming off speed, and describe the lights-out experience of taking the drug. One poster’s experience echoes Hector's: "I took it for a while and I literally had to wait to take the pill until I was IN BED, under the covers, because otherwise I wouldn't even make it to bed without passing out first!" Another user corroborates: "I took one 50mg pill (chewed it a little) and I fell asleep with my glasses on and with my cellphone in my hand in the middle of a text."

A narcotics officer who worked undercover on Pill Hill says that in recent years Seroquel became a regular part of the mix of black-market pharmaceuticals they were taking off the streets. "I was seeing Seroquel a lot during raids on Pill Hill, and because it isn't [DEA] controlled didn’t think too much of it.” But although cokeheads and tweakers use it to come down from their highs, informants told him that Seroquel's real black-market value is to other dope dealers using it to cut heroin.