The real dangers of self-medicating with Xanax

Mental Health: Beyond Awareness is a five-day campaign asking what we can do for mental health issues beyond "raising awareness". Young people are more aware of mental health issues than ever, but our services are broken, the internet is stressing us out, and self-medication is on the rise. Who is campaigning for change? And how can we help ourselves? This week, Dazed is aiming to find out. 

In the last couple of years, British youths have been experiencing higher rates of anxiety, with some research suggesting that 15-21 year olds have the second worst mental wellbeing in the world. It is against this backdrop that Xanax has become a staple drug in the UK.

As with other tranquilizers in the benzo family, like Valium, Xanax makes users feel relaxed, sleepy and calm – the latter being a major selling point for anxious youth. While The Guardian reports that the UK now accounts for over 20 per cent of global sales of the drug on the darknet, Xanax has become embedded in pop culture via music and memes. It gets constant shout outs on Soundcloud rapper tracks from Lil Xan, or XXXTentacion on his aptly named “XXXANAX”. Meanwhile, public figures like Lil Peep have died from overdosing on a cocktail of the anti-anxiety drug mixed with Fentanyl.

Harry Shapiro, the director of DrugWise, says that use of the drug is rising far quicker than an understanding of how to take it safely. That’s because this DIY quick fix is leading to reports that doctors are seeing a dramatic increase in young people being admitted to A&E after taking Xanax.

“Xanax is not available on the NHS, so you can’t use it legitimately easily in the UK,” Shapiro explains. “It takes all the peaks and troughs out of life, which can be good if you’re experiencing considerable lows, but they sort of zombie you out. But, if you are going to school, university, or work zonked out, everything is going to suffer, including your relationships. They’re not for long term use. You wouldn’t be prescribed these drugs for more than four to six weeks.”

Sultan ‘SID’ Dajani works on the frontline of the issue as an independent community pharmacist. We asked him about the dangers of using Xanax as a DIY anxiety fix.

“Everything from tremors, shakes, mood swings, aggression, hunger or weight changes. You go hot and cold, you can become socially withdrawn. So, it pretty much will affect your whole life” – Sultan Dajani

What are the positives that someone might see to taking Xanax?

Sultan Dajani: For people with anxiety and insomnia, it can relax you and make you feel more confident. It relaxes muscles and it helps sleep. They're effective when generally used in the short-term – if you use them for long-term, that's when you develop a tolerance, a dependence, and you develop other side-effects, especially with alcohol. They can be fatal in that respect. If you mix it with alcohol you could end up conking out a lot quicker; your time and space gets altered quite a lot, because it affects different neuro-transmissions in your brain. You might initially feel euphoric, and then you basically go down into the usual vomiting mess.

What have you been seeing over the past couple of years in your line of work?

Sultan Dajani: In terms of Xanax, we're seeing a rising trend in online purchases; some are homemade fakes (with ingredients bought overseas) and some are genuine.

Why now?

Sultan Dajani: I don’t think the rise has (just) started happening, it's always been there. It increased greatly once internet purchases started happening. Now illegal medicines can be ordered through a more legitimate supply chain, because organised crime got in involved and set up bogus pharmacy sites. We’re also seeing more pharma-crime, there’s a lot of fakes. I've had instance where one of my patients was admitted to hospital because they took Xanax, when actually it wasn't Xanax at all but a Warfarin-based medication. They ended up having a massive internal bleed, they were anaemic and became jaundiced and were rushed into hospital. 

Part of the reason that (young people are) self-medicating is because of the stress of modern life, online trolling, for example. Having the austerity cuts, we need people to work harder, for longer. The struggle to maintain payment, not being able to buy a house. There's also the issue around cuts to mental health services, putting more people in the community that might be ill-prepared because there's not enough social care services. Then, by cutting services, you're encouraging more people to end up in hospital.

What are the impacts of using Xanax as a DIY cure for anxiety?

Sultan Dajani: If it’s chronic use, it can become addictive. Chronic use is taking it every day – anything from a week to two weeks. It can become addictive, no matter how small a quantity you take. Not only does it cause a physical addiction, it causes a psychological one; it becomes a vicious cycle. You go from a tablet to two tablets, because you build up a tolerance to it. That will then result in short-term memory loss, erratic sleep habits.

And then you feel like you need Xanax to get to sleep?

Sultan Dajani: Absolutely right. That’s a part of that vicious cycle again, so you become more and more dependent on it.

“If you take it without professional support, it will wreck your life” – Sultan Dajani

What are the withdrawal symptoms you might experience after a while?

Sultan Dajani: Everything from tremors, shakes, mood swings, aggression, hunger or weight changes. You go hot and cold, you can become socially withdrawn. So, it pretty much will affect your whole life in terms of your work, relationships.

What can you do to get more information if you are thinking about taking it?

Sultan Dajani: Pharmacists are not policemen in white coats, we are people's advocates, so people can talk to us confidentially, privately, anonymously, in a consultation that is out of earshot. I provide so many substance-misuse services, blood-borne virus disease testing, and one of the (services) I provide is benzo addiction advice.

You can get referred to self-help groups, we can refer you to a doctor, give hope and motivational support, and treatment options for withdrawal. If you take it without professional support, it will wreck your life. Don’t take it unless it has been prescribed and you have the support of a pharmacist and a team behind you who will help you gradually come off it.

Do you think because it’s prescribed privately in the US and the UK, people think it’s okay?

Sultan Dajani: Yes, but on the NHS we have other short-acting-benzos, that are just as good. Hospital admissions for benzodiazepine use, including Xanax, have tripled in the last ten years. People have taken something safe and useful and have given it a sinister purpose; that’s when people start distrusting benzos, when actually they are quite safe when taken appropriately. The danger is not the benzos, it is the overuse of benzos by people who are ill-informed or are addicted, and they need psychological support from pharmacies or doctors to address the issue. Denying the problem is implausible now.