Over the last year there has been a rise in media coverage of alprazolam (typically known by its trademark name Xanax) and highlighting what’s seen as an increase in amount of teenagers who are taking the drug. The majority of the reports contain individual stories or accounts from treatment centers however there is very little discussion of the research findings or actual evidence.
Like all coverage of potential developments in the drug industry There is a possibility there is a chance that evidence for the change in trend doesn’t get properly provided or even accessible, and that highlighting the benefits of a particular drug may accidentally increase the interest of some users of the drug.
PHE has been studying the available evidence and this blog provides the information we have learned and what’s currently being investigated and what needs to be planned for the future.
What exactly is alprazolam?
Alprazolam belongs to the benzodiazepine class of drugs. The most frequently prescribed benzodiazepines are to treat insomnia and anxiety, and they also are used to treat epilepsy-related seizures.
The most commonly prescribed benzodiazepine medication in the UK is diazepam, which is known under the trade name Valium. Comparatively, alprazolam is a faster acting drug that is around 10 times more powerful, which means that it is able to quickly create a feeling of sedation.
As with other benzodiazepines like alprazolam, it could cause problems if used in the absence of medical advice. In the short-term the misuse of alprazolam can lead to excessive sedation, collapse and overdose. Longer-term use could lead to physical dependence and withdrawal after stopping or reducing usage.
In addition, using any benzodiazepine along with alcohol or other substances increases the chance of harm. This is especially the case when benzodiazepines mix with other sedatives.
Alprazolam is not accessible through the NHS However, it is bought with a private prescription from the UK. Illicit alprazolam is usually available as counterfeit Xanax tablets are available for purchase in street drug stores and can also be purchased buy from websites that are illegal and social media platforms.
What do people think concerning Alprazolam (Xanax)?
There’s been a rising number of personal stories that have been reported by the press, mainly concerning young people who are suffering from alprazolam (Xanax) and also as reports that anecdotally suggest they use Xanax as a self-medication for anxiety.
There have been discussions regarding alprazolam among political circles. In January an MP Bambos Charalambous led the first discussion at the House of Commons to discuss the use of alprazolam.
Sometimes the use of alcohol (Xanax) is presented by the press as an problem among teenagers. There is no evidence currently for this, however as we will explain further down, there’s some evidence to suggest that the rate of use is rising. It is crucial to recognize that the patterns of use of drugs alter with time. Certain drugs are discovered quickly, however, their use rapidly diminishes. However, other drugs continue to be used and cause lasting harm. It’s still too early to determine which category Alprazolam would fall into.
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What are we aware of about the use of alprazolam?
In the wake of the coverage in the media of alprazolam is continuing, PHE is being asked to make a statement, especially on current trends. There are some indications that suggests that it is on the rise especially among youth or young adults. But the information that we have do not offer an exact picture of extent of alprazolam usage, since certain of the data are for all benzodiazepines, but do not cover alprazolam specifically, which makes it harder to identify shifts in the use.
Hospital admissions data from England for 2017 shows that there was an upsurge in the numbers of patients who are younger than 20 years old admitted to hospitals with poisoning from benzodiazepine. The same time frame inquiries made to the National Poisons Information Service about the treatment for alprazolam poisoning have increased significantly. PHE has reviewed UK police seizures for the drugs submitted to forensic analysis. This revealed that the number of seizures involving alprazolam was significantly more than previous years, rising from fewer than 10 seizures in 2016 to nearly 800 in 2017.
The majority of Xanax tablets that are sold on illicit marketplaces aren’t quality pharmaceutical and are actually counterfeit. This is a serious problem because these fake products could contain varying quantities of alprazolam, making it difficult for users to determine how much they should take. Counterfeit Xanax has also been proven to contain other substances or potentially harmful adulterants.
The information we’ve received from TICTAC an analysis of drugs lab confirms that samples that were made to look like authentic Xanax tablets in fact contained additional drugs , such as etizolam which is a different benzodiazepine associated to numerous fatalities in Scotland. TICTAC has also confirmed that fake tablets that contained alprazolam differed in their strength and some tablets had greater than the usual dosage of a genuine Xanax tablet.
The uncertainty of doses could be extremely dangerous for drug users , who may not be able determine the amount of alprazolam (or other substituted drugs) the tablet contains until they’ve consumed it and experienced adverse consequences.
What’s happening and what needs to be done?
What is PHE doing? PHE is doing?
At PHE we’ve been looking over all national data as well as other data to gain a better understanding of alprazolam usage in England. We’ve also been talking with experts and other experts to get an even more precise picture.
Locally based PHE Centre teams are working closely with local authorities to provide the authorities with information, guidance and other tailored support to help them determine the need for local treatment and to commission services that fulfill those needs. This might include assistance for people who are using alprazolam dependent on the severity of the issue in their local area.
We are currently piloting Report Illicit Drug Reactions (RIDR) An online reporting system that tracks the harms caused by illicit drugs especially New psychoactive substances (NPS). The system also identifies negative effects of using drugs that are not properly such as alprazolam.
When new substances or patterns of use become apparent new patterns of use, the health risks of them might not be comprehended initially. For instance, bladder issues that are caused by ketamine weren’t first recognized until various treatment providers began to connect the dots and identify the connection with the bladder problems. RIDR is designed to speed up the recognition of any harms to ensure that healthcare and treatment providers can swiftly provide the most effective interventions. PHE recommends that frontline personnel utilize RIDR to report any clinical issues they observe in their communities. This will help build more understanding of new issues and their geographic distribution.
PHE organizes the quarterly meeting of the clinical network featuring experts on the latest developments in drugs and emerging trends in drug use and trends. This gives us the chance to discuss the latest data from RIDR and the most recent NPS-related research, as well as other sources. Following every meeting, we review our RIDR dashboard to track the latest issues and issues. Alprazolam is featured on the dashboard since September 2017.
We also keep updating FRANK with current information. This includes an article on alprazolam.
Local authorities, treatment facilities are required to do?
Certain treatment facilities respond to the growing trend by learning about it, training their staff, preparing materials for youth and educating them about the issue locally, and offering support, advice and assistance to children who are struggling.
Drug Watch, an information network, has put together an overview of alprazolam for professionals as well as the general public.
Local authorities should try to identify their personal patterns of using drugs and be aware of emerging trends; ensure that employees working in areas that work for vulnerable people, like child referral services and social careare aware and are able to assist in the development of appropriate strategies.
It is vitally important for any local messages to young and professional people are in proportion to improve awareness and education without increasing interest or seeking out drugs.