DDN April 2017 DDN April 2017 | Page 6

COVER STORY The celebrity craze for stress pills is even reaching schoolchildren – should we be concerned? Kevin Flemen looks at the risks and availability of alprazolam, branded as Xanax Under PressUre A friend of mine in Hackney was recounting a recent case involving the death of a child at her daughter’s school. While the inquest results were still awaited, it appeared the death may have involved alprazolam. When I voiced some surprise at this drug being a factor, my friend said: ‘All of my daughter’s friends are going on about Xanax. It’s really the thing at the moment.’ Xanax is the brand name of the benzodiazepine alprazolam. It is highly potent – some 20 times the strength of diazepam (Valium) – with a medium duration of effect and a half-life of around 12 hours. It is widely prescribed in America with claims that it is now the number one prescribed psychiatric medication. Most legal use in the UK is from private prescriptions as it is not prescribed on the NHS, but it is also available via the dark web. Over the past few years, most UK reports of alprazolam have referred to it as a cut in heroin rather than a significant drug in its own right. Norwich police warned of alprazolam in heroin back in 2004, and in the more recent heroin ‘drought’ around 2010, reports circulated of orange-tinted heroin linked to overdoses. Historically, the most popular benzodiazepine in the UK has been diazepam, which was frequently diverted from legitimate prescriptions. As prescribers were repeatedly reminded about the need to address widespread over-prescribing, people seeking sedation have had to resort to looking elsewhere. 6 | drinkanddrugsnews | April 2017 Some injectors turned to temazepam, albeit with disastrous health consequences following the intro - duction of Gelthix capsules intended to deter injecting. Pregabalin and gabapentin increasingly became the prescribed drugs of choice, and workers and peer educators reported an increase in ‘pregabs’ as a core drug of polydrug use – initially in custodial settings and then in community settings too. ‘It’s like sciatica is a catching condition,’ commented a prison drugs worker on a training course, noting ruefully how many prisoners presented to the medical team complaining of neuropathic pain in the hope that it would result in a pregabalin prescription. Further afield, online pharmacies represented a ready source of tablets sold as diazepam. Overseas suppliers sold it in the form of blue pills – some genuine, but others containing a range of compounds or none of the drug at all. Canny consumers became increasingly wary of purchasing diazepam from such sources. The explosion of novel psychoactives brought with it the advent of numerous novel benzodiazepines, includ ing phenazepam, etizolam and flubromazepam. These worked, and were cheap and widely available. Rather than seeking dwindling NHS prescriptions or chancing random blue pills from Asia, more of the depressant market turned to these NPS benzodiazepines. So back to Xanax. Is it becoming a ‘thing’ in the UK? If so, why – and to what extent is this likely to become a trend? The drug has gained profile significantly. It has been linked to a number of high-profile celebrity deaths and continues to be associated with the media, earning mentions in music and film as well as appearing in many internet memes. If diazepam is possibly a bit old and fusty, Xanax has become the sedating pill for those stressed by celebrity rather than mundanity. The school-age peers of the friend I mentioned at the start had come to Xanax via its associations with American celebrities. It was fashionable. In recent sessions with young people in a number of settings, I’ve been exploring awareness of Xanax. In one (albeit small) group of young people in Norwich, all had heard of it and they mentioned memes that they had seen. Although alprazolam isn’t significantly prescribed in the UK, there’s good availability via the dark web. A search filtered for European suppliers returned 297 entries on Dream Market. By comparison, diazepam returned 391 entries. Costs varied significantly, but The drug has gained profile significantly. It has been linked to a number of high-profile celebrity deaths and continues to be associated with the media, earning mentions in music and film as well as appearing in many internet memes. www.drinkanddrugsnews.com