“You’ll have blackouts. You’ll wake up on the other side of town not knowing where you are. Last Christmas, lots of young people were turning up at A&E not being able to walk. They’d been at a party, had a few beers, necked Xanax – and shut down. It leaves people very vulnerable.”
Nick Hickmott, an Early Intervention Lead for the UK drugs and alcohol charity Addaction, is telling NME about benzodiazepines, or benzos, a group of drugs often used to treat anxiety and which includes the drug Xanax. He’s spent 10 years working with young people with drug issues, but had little experience with youth benzodiazepine misuse until the last couple of years, during which time media reports of overdoses rocketed.
From his perspective, it looks like incidents of young people arriving at hospital after a misdose of benzos coincided with the rise of Soundcloud rap, a distinctly DIY music movement epitomised by rappers such as Lil Xan and Lil Peep, young artists who shared nihilistic visions of post-opiate America. Their open discussions about their anxiety, depression and reliance on Xanax resonated with British teens, who got hold of the drug themselves.
Media interest in Xanax as a health issue peaked when Lil Peep, aka Gustav Elijah Åhr, died from an overdose on Xanax and the prescription drug fentanyl, which he took alongside a cocktail of drugs that also included cocaine, marijuana and the painkiller Tramadol. Lil Pump, who once posed proudly on Instagram with a Xanax-shaped cake, vowed that 21-year-old Peep’s tragic death had shocked him into quitting Xanax, as did Smokepurrp.
American Xanax headlines spawned others, closer to home. In May 2017 around 20 young people were hospitalised in Wiltshire when they came into contact with benzodiazepines; NHS Grampian and Police Scotland issued a warning last January after 20 benzo-related deaths.
Benzos are particularly dangerous when mixed with other substances, so those hospitalised (or even killed) are most commonly drug users topping up crack or heroin, or – more relevant here – young people who have taken pills with cannabis or alcohol at the kind of party Hickmott described.
It’s uncommon for Xanax to be issued by the NHS, so people instead buy counterfeit pills online.
we leaving Xanax in 2017.
— smokemidd (@smokepurpp) January 1, 2018
That counterfeit market is the subject of a new BBC documentary, Britain’s Black Market: Who Is Selling Fake Stuff?, which will air a week on Monday (February 25). Host Livvy Haydock is an investigative reporter who previously operated behind the scenes, putting journalists in touch with criminals. The documentary is about counterfeit goods in general – think fake designer clothes – but her journey sent her to the fake drugs market.
“I got access to a UK manufacturer,” she tells NME. “He had enough product in front of him that, when he turns it into fake Xanax, will be worth a quarter of a million pounds.” The manufacturer spends three hours making 42,000 of these tablets, which are worth £100,000.
“I spoke to a dealer who was selling Xanax and she said her customers were getting younger and younger,’ Livvy explains. “I said, ‘How young?’ and she said, ‘Well, 14’. When I asked if she felt weird about selling to a 14-year-old, she said, ‘No, but i would cut off at about 10 years old’.”
According to a BBC Three report, more than 1.5m counterfeit Xanax pills entered Britain’s drugs market in the 21 months leading to 2017. Prescription-bought Xanax is between one-and-a-half to four milligrams per pill; counterfeits tend to begin at four milligrams.
“The tolerance builds really, really quickly,” says Nick Hickmott. “You can become dependent in five to 10 days – you can start feeling withdrawal when you’re in an anxious situation and you haven’t got that drug to help you out. And the withdrawal’s pretty awful. It’s up there with opiate withdrawal. You feel terrible; you can have pains; if you’re fully addicted you can have seizures and be fitting.”
“Come off benzos and tell me you’re going to go back on it. Jesus Christ, it’s awful. You feel like you’re dying.” – The 1975’s Matt Healy
Las year, when NME interviewed The 1975’s Matt Healy, who had struggled with opiate addiction and been through rehab, he explained that he would sometimes score benzos in the absence of his preferred drug, heroin – and that withdrawing from benzos is harder.
“I would come off heroin 10 times a year instead of coming off benzos once. It’s fucking massive over here [in America] and it’s fucking horrendous. Come off benzos and tell me you’re going to go back on it. Jesus Christ, it’s awful. You feel like you’re dying.”
Initially fake Xannies were mainly sold on the darkweb, but now some dealers sell them on social media. As a result, says Haydock, “a lot of youngsters don’t necessarily feel like it’s a dangerous thing because you can order it quite blasé online; it arrives at your door, so you don’t have to meet some shady dealer.” Haydock provided NME with screengrabs of open Instagram accounts claiming to offer benzos and Xanax for sale.
A representative of Instagram told NME: “Buying or selling illegal or prescription drugs is not allowed on Instagram. We encourage anyone who comes across content like this to report it using our in-app tools. We check these reports 24/7 and as soon as we’re made aware of violating content, we work quickly to remove it.” Instagram has since closed the accounts in question.
According to Hickmott, “Xanax has a close relationship with social media; I think that it’s almost the ideal place for it to be sold because of the social issues that represents or aids with.”
Last year, a survey from The Royal Society for Public Health and the Young Health Movement concluded what everybody already knows: that image-based apps adversely affect young people’s anxiety. Instagram scored the worst. As Haydock puts it: “We’re living in a brutal time to be a young person.”
The counterfeit Xanax market emerged from the counterfeit steroid market. In 2012 it became illegal to import steroids from overseas, so labs – such as one in Cheetham Hill, Manchester, which Haydock visits in the documentary and which has been dubbed ‘the counterfeit capital of the UK’, home to fake designer clothes and fake designer drugs – stepped in.
“Once underground labs started popping up,” says Haydock, “they realised the capabilities and thought, ‘OK, if we’re making steroids, why don’t we just make all the other meds we want?’”
Joe Casey, who directed Britain’s Black Market…, tells NME “it’s not as if [dealers and manufacturers] are overly worried about authorities becoming involved.” One manufacturer interviewed in the programme, who goes by the pseudonym Phil, reveals that he imports raw materials from China; customs intercept around one in 10 of these packages. “All he gets is a letter saying the package been seized,” says Joe. “There’s no other follow-up beyond that.”
“Police cuts are huge,” adds Haydock. “If you look at the cuts to the Border Force you can see [the problem].”
In response, the Home Office told NME: “It is an offence to possess, produce, supply, or import/export alprazolam without the appropriate authority and carries a maximum sentence of 14 years’ imprisonment on conviction. Law enforcement agencies continue to work with internet providers to shut down UK-based websites found to be selling these drugs illegally.
“We are increasing total police funding by up to £970m in 2019/20, including precept, and are increasing the headcount of Border Force by around 900 by the end of March 2019.”
Benzodiazepines are a Class C drug in the UK, which may be how manufacturers such as ‘Phil’ – who, says Casey, is “self-taught” and learned to create counterfeit Xanax from YouTube videos – operate relatively openly. Yet as Haydock points out: “If you buy raw products from China, they could easily be counterfeit as well. You’re just ordering bags of powders.”
Although there is, understandably, potential for panic around counterfeit Xanax, Addaction’s Nick Hickmott praises the way that the UK media has covered the problem.
“It’s been quite remarkable to me, honestly,” he says. “It’s been really pragmatic. Really good, strategic reporting from the media means people can get some decent idea of how to taper off. It’s not been a ‘zombie drug epidemic’; because it’s a prescription med, it feels like the narrative around it in the media and newspapers has been a lot more thoughtful and helpful.”
He compares this unfavourably to media coverage of Spice, which was indeed termed a ‘zombie drug’ when it coursed through city centres – Manchester in particular – in 2017. Spice, an umbrella word that encompasses synthetic cannabinoid drugs, ultra-potent substance with no resemblance to cannabis oil from which it is derived, was largely associated with homeless people. Catatonic users were nicknamed ‘The Walking Dead’ in local media.
Fake Xanax, on the other hand, has found its way to users in a totally different social sphere. According to Mark Hickmott, a counterfeit pill that costs about 30p on the darkweb could cost around £3 on social media.
“I spoke to a dealer who sells to 14-year-olds” – investigative reporter Livvy Haydock
“Even though Xanax has come from essentially the working class of America through mumble rap and Soundcloud rap,” says Hickmott, “it has translated into more of a potentially middle-class issue here. Certainly those that I’ve spoken to who have had issues around Xanax tend to be grammar school pupils in quite affluent areas. There seems to be something around pressure, stress and mental literacy that means that [benzo addiction] does tend to sit in those more affluent middle- to upper-class areas when it becomes problematic.”
Perhaps, then, Xanax has been better reported because journalists in newsrooms relate to young benzo users – who could easily be their own kids – where a homeless Spice addict may seem ‘other’. However, the ‘mental health literacy’ that Hickmott referenced, which implies a certain level of education – or emotional parental support – could be part of the problem.
“We know that his younger generation is often billed as the most anxious generation ever,” he explains, “but we’ve got really poor support for them. What we’ve done is put in loads and loads of good education around mental health and made them really emotionally literate and being able to talk about feelings – you know, big, strapping seven-foot lads talking about anxiety, paranoia and depression – and then there’s no support services for them.”
And that’s where self-medication with fake Xanax, likely inspired by Soundcloud rap, has come in.
“We’re in a pill popping generation, says Hickmott. “There’s supposedly a pill for everything – ‘We can sort ourselves out.’ I think that can easily lead to people going, ‘Well, this is a quick fix.’”
Addaction’s Head of Media Mark Byrne confirms that fake Xanax is “definitely a big issue and a growing issue”, but says that much of the evidence available is anecdotal. That’s because people harmed by knock-off Xanax tend to not to end up working with drugs services, perhaps because they fear the stigma that they feel such an admission would involve.
Of the 47,000 people Addaction helped across the country last year, approximately 250 were dealing with benzo addiction. It’s still an emerging issue – remember that Nick Hickmott, with a decade of experience, wasn’t aware of adolescent benzodiazepine problems two years ago – so case studies are rare.
“It would be far easier to speak to someone who’s been through a heroin recovery service,” says Byrne, “because there’s an established journey that people go through. It’s been around long enough that those people are out there volunteering at the services that we run; they’re the people that we go to for first-person stories.
“There are people in our services at the moment getting treated for issues around benzos, but we would never put them forward because they’re in the middle of the plan. Mostly they’re young, so we can’t do anything to jeopardise their recovery.”
All drug and alcohol services in the UK, including Addaction, feed information into the National Drug Treatment Monitoring System (NDTMS). In theory, this offers a clear perspective on the substance abuse issues in the country. The problem, says Hickmott, is that the numbers being collected are way behind what’s actually happening in the real world: “This information has been added to data sets within the last six months as it has emerged.
“As is kind of typical of the UK, they’re trying to play catch-up on it. So, to really get a true reflection and get some hard evidence about people turning up at treatments saying, ‘I need support around benzos’, or specifically Xanax, you’re probably looking at 18 months down the line.”
“Tolerance to benzos builds really, really quickly” – Addaction’s Nick Hickmott
There are, of course, people who have taken benzos and been absolutely fine. One anonymous person tells NME: “I’ve only ever taken [Xanax] as part of a cocktail of other drugs – sorry, mum. For example, it’s a good thing to take if you’ve been tripping on psychedelics for a long time and want everything to stop being weird and mellow out. In that situation it gives a sort of warm, drowsy, wrapped-in-cotton-wool sensation. Eventually it’ll help you sleep too.”
But the problem is the unpredictability of the often very potent pills, and the fact anxious people may be using counterfeit Xanax instead of engaging with mental health services. What advice would Addaction’s Nick Hickmott have for a young person struggling with benzos?
“It’s really important to stop gradually – known as ‘tapering’ – to avoid unpleasant or dangerous side effects,” he says. “If someone’s struggling with any drug, talking always helps. Excessive or problematic drug use is normally a symptom of a bigger problem in someone’s life, which hopefully a good listener could help to solve.”
For help and advice on drug and mental health issues
- Addaction – Leading UK drug & alcohol charity
- FRANK – Honest information about drugs
- The Samaritans – Confidential support 24 hours a day
- ‘Am I depressed?‘ – Help and advice on mental health and what to do next
– Britain’s Black Market: Who Is Selling Fake Stuff? is available to watch on BBC iPlayer from February 25