Two years ago, on a gray January afternoon, I visited the Ridge Avenue homeless shelter in Philadelphia.
I was looking for poor people who had been paid to test experimental drugs. The streets outside the shelter were lined with ruined buildings and razor wire, and a pit bull barked behind a chain-link fence. A young guy was slumped on the curb, glassy-eyed and shaky. My guide, a local mental health activist named Connie Schuster, asked the guy if he was okay, but he didn’t answer. “My guess is heroin,” she said.
We arrived at the shelter, where a security guard was patting down residents for weapons. It didn’t take long for the shelter employees to confirm that some of the people living there were taking part in research studies.
They said that the studies are advertised in local newspapers, and that recruiters visit the shelter. “They’ll give you a sheet this big filled with pills,” a resident in the shelter’s day room told me the next day, holding up a large notebook. He had volunteered for two studies. He pointed out a stack of business cards on a desk next to us; they had been left by a local study recruiter. As we spoke, I noticed that an ad for a study of a new ADHD drug was running on a television across the room.
If you’re looking for poor people who have been paid to test experimental drugs, Philadelphia is a good place to start. The city is home to five medical schools, and pharmaceutical and drug-testing companies line a corridor that stretches northeast into New Jersey. It also has one of the most visible homeless populations in the country.
In Philly, homeless people seem to be everywhere: sleeping in Love Park, slumped on benches in Suburban Station, or gathered along the Benjamin Franklin Parkway, waiting for the free meals that a local church gives out on Saturdays.
On another occasion, I met former subjects at Chosen 300, a storefront church that serves meals to homeless people. The service had already started by the time I arrived, and raucous gospel music filled the bleak room. The congregation consisted of several dozen black men sitting on folding chairs. Many stared at the floor.
After the service I spoke to a thin young man in a dirty T-shirt who told me he had done an outpatient study for an anxiety drug. “Some kind of new benzo,” he said, as he devoured a bowl of Cheerios. (Benzodiazepines like Valium, Xanax, and Ativan are often prescribed for anxiety.)
Outside, an older man named Steve told me he was trying to get into a depression study. “They ask you a lot of questions and see if you’re approved for it,” he said. “If you’re approved for it they’ll pick you up wherever you’re at.”
Later I walked round the corner to a shelter, where I talked to an elderly white man. “I’d say the majority of guys here take advantage of that,” he told me, “because they get a lot of money and they’re broke as hell.”
Addiction treatment studies are one popular option. Last November, I visited the Sunday Breakfast Association shelter, where I met a man named George. He had a wispy goatee and a Letterman-like gap between his front teeth. George talked with such familiar, ironic congeniality that I was taken aback when he told me he had spent time in prison and once tried to commit suicide.
“This city is fucking tough, and it is getting worse,” he said. I mentioned a recruitment flyer I’d seen outside the shelter asking for subjects with “cocaine dependency.” George nodded. He told me that a lot of people start taking drugs just so they can qualify for those studies. “You take that shit two days before to get it into your blood.”
He mentioned that he had recently screened for a trial at a research site running addiction studies. “There were people in the waiting room high as a kite,” he said. “They were incoherent.”
But the studies I heard about most often were for psychiatric drugs: antipsychotics, antidepressants, anxiety drugs, and stimulants. George used to take Risperdal, an antipsychotic. “That drug will turn you into a zombie,” he said. He mimed falling over sideways in his chair. “I couldn’t sit up without falling asleep.” He gestured toward the other shelter residents: “Ninety-five percent of the population here has some kind of mental problem.”
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