Tag Archives: teens

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

Clinic opens to help teens hooked on illegal pills bought online

Self-medication is on the rise – and troubled users finally have a place to turn

Box of Xanax in a pharmacy drawer


A growing number of teenagers are using anti-anxiety drug Xanax, which is a class C controlled substance in Britain. Photograph: BSIP/UIG via Getty Images

Inside the UK’s first clinic dedicated to tackling the consequences of the spiralling use for medicines bought illegally on the internet, Dr Owen Bowden-Jones is outlining his plans.

He is opening what is thought to be the country’s first facility aimed at people experiencing problems resulting from medication they have sourced online. The service launches on Monday amid growing concern about addiction to such drugs: last week the government ordered Public Health England to examine why one in 11 patients was prescribed an addictive medicine last year, including benzodiazepines and opiods.

The psychological impact of drugs like these, bought online, has prompted Bowden-Jones to open the Addiction to Online Medicine (Atom) service in London: a free, easy-to-access clinic run by Central and North West London NHS foundation trust.

“The internet has really transformed the patterns of people’s drug use. It sanitises the buying of drugs,” says Bowden-Jones, a consultant psychiatrist, as he settles into one of the chairs in the group therapy room. “There is something about the ability of the internet to deliver products to you in a timely, safe and predictable way that seems to have now extended to include prescription medicines.”

The growth of an online marketplace is changing the landscape of drug-taking in Britain. For many, getting hold of drugs no longer involves waiting for dealers on street corners or seeing a doctor for a prescription. Now people are buying them online in a matter of minutes. The phenomenon has seen a rapid increase over the past year, bringing with it new risks and obstacles to recovery.

“What we want to do is try to develop some expertise about this,” says Bowden-Jones. “There is a whole set of extra complications around online purchasing. The sort of age group that we see in the clinic spends a lot of time on their phones, so what you can’t do is tell them you can’t use the internet.”

A growing number of teenagers appear to be using the benzodiazepine Xanax, a potent anti-anxiety drug, for recreational use as well as a means to self-medicate. Earlier this month, the danger posed by the misuse of Xanax was raised in parliament after an MP’s constituent claimed her daughter was groomed through her need for the drug.

Experts say they are seeing people experiencing problems after taking other anti-anxiety drugs and painkillers, also bought online. Bowden-Jones says: “We’re beginning to see students taking cognitive enhancers, and people with anxiety disorders taking illicit benzodiazepines. There’s an issue with people in custodial settings taking [anti-anxiety drug] pregabalin, and people with chronic pain purchasing illicit analgesics.”

These groups often feel they cannot get help through existing addiction services. “They look at traditional drug and alcohol services and feel that those are for people using heroin or crack cocaine or alcohol,” Bowden-Jones says. “So they don’t really know where to go or where they fit in.”

Roz Gittins, director of pharmacy at drug charity Addaction, agrees: “They are difficult to engage. We need to be doing more to raise awareness of the addiction services that are out there that can help – just making a bit more noise about it.”

Dr Owen Bowden-Jones at the Atom clinic.


Dr Owen Bowden-Jones at the Atom clinic. Photograph: Sophia Evans for the Observer

Buying drugs on the net poses its own risks. Alongside the legal implications, buying medication online can be dangerous because, while some websites purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer.

Some medicines can be bought legally with a prescription from legitimate companies operating online, which are regulated by the General Pharmaceutical Council. Their websites bear a logo linking to the online register of regulated pharmacies.

By comparison, the illicit websites range hugely in their setup. Some are sophisticated pseudo-medical copycats, complete with stock photographs of doctors in white coats, claiming to sell pharmaceutical-grade medication. Other sites are more explicit, and sell everything from prescription medication to Colombian cocaine. Many feature a five-star review system, where buyers can leave comments and rate their drug purchases, which can create a further false sense of safety for those purchasing the drugs. Law enforcement agencies are working with internet providers to shut down UK-based websites, but many of the sites are hosted abroad.

Rick Bradley, who works with young people at Addaction, says that because what users are buying is something that might be taken as a medicine, “it tempers their perception of what risks might be involved in it”. Gittins adds that the websites are “very cleverly done”.

Although Xanax is not available on the NHS and is a class C controlled drug, it can be bought online for as little as 89p per pill. “People getting hold of Xanax are either buying it through a website usually from outside of the UK and it’s being shipped in; or on the dark web; or they are getting it on private prescriptions or from closed Facebook groups,” says Gittins.

In addition, she says Addaction is seeing many people reporting problems with pregabalin and gabapentin, which are licensed to treat pain, anxiety and epilepsy.

“Pregabalin is a real challenge for us,” she says. “We’re increasingly seeing both of those medicines, and particularly pregabalin, being implicated in drug-related deaths.” In September last year, the Home Office announced plans to make both drugs class C controlled substances, after 111 deaths were connected to pregabalin in 2016.

The government’s 2017 UK drugs strategy acknowledged the problem of online drug purchases, saying: “Access to medicines on the internet has led to increases in online purchasing, some of which is legitimate, but with some internet sites unlicensed and supplying fake or counterfeit medicines.”

The Home Office says: “Prescription-only medicines are, by their very nature, potent and should only be prescribed by a doctor or appropriate healthcare professional.”

Back in the clinic, just hours before opening, Bowden-Jones is urging people with addictions to come forward: “If you are buying medicines online and you think that you’re beginning to experience difficulties with that, seek help. Don’t wait and think it will sort itself out.”

Q&A: Buying drugs online

What is the problem and how widespread is it?
People are increasingly buying medications as well as illicit drugs online, amid reports of dependency, hospitalisations and even deaths around the UK. Experts are hearing more firsthand accounts of online drug purchases over the last year. The internet is a feature of daily life, and so cutting it out is almost impossible for those in recovery.

Why are people buying drugs online?
Buying drugs on the web is relatively straightforward. Often it is seen as easier than finding and meeting a dealer, and some people mistakenly think buying online is safer. There are also reports of teenagers clubbing together to buy drugs such as Xanax in bulk.

What kind of medications are people buying online?
The most common ones include anti-anxiety benzodiazepines such as Xanax (alprazolam) and Valium (diazepam); Ritalin (methylphenidate, a stimulant used to treat ADHD); pregabalin (used to treat epilepsy and anxiety); and gabapentin (also used to treat epilepsy and nerve pain).

Why are people buying these drugs?
The drugs are, quite simply, “in fashion” at the moment. The rise of Xanax use in the UK is thought to be influenced by trends in America, where it is widely prescribed and features in music, social media and online culture. Pregabalin was prescribed 5.5 million times in the UK in 2016 and is thought to be an effective alternative painkiller for people with opioid-use disorders.

What is the law?
Buying online is no different to buying in person: the law relates to the substance being bought, not the method of purchase. Xanax is listed as a class C controlled drug and the maximum sentence for possessing, supplying or importing a class C drug is 14 years’ imprisonment.

What needs to be done?
Addaction is calling for more information about the risks of taking unprescribed medications. Alongside better awareness for users, it wants healthcare professionals to educate people about the dangers. Speaking in parliament last Monday, Labour MP Bambos Charalambous called for the government to research the prevalence of Xanax use and respond to the growing mental health crisis among teenagers.

More US teens are vaping than smoking cigarettes, study finds

More US teenagers have tried vaping than smoking cigarettes, a new study shows, raising concerns among some researchers that vaping could become a new generation’s substance delivery system of choice.

The new nationally representative study showed that 35.8% of students in their final year of high school had tried vaping, versus 26.6% who had ever smoked a cigarette.


These findings emphasize that vaping has progressed well beyond a cigarette alternative

Richard Miech, principal investigator

Since vaping’s growth in popularity, debate has raged in public health circles about the role e-cigarettes should play. American researchers have largely taken a prohibitionist stance, arguing vaping does more harm than good, while British have researchers focused on the device’s potential benefits to current smokers.

“These findings emphasize that vaping has progressed well beyond a cigarette alternative,” said Richard Miech, the principal investigator on the annual Monitoring the Future survey, which involves tens of thousands of students. The government-funded research is now in its 43rd year, and considered the most authoritative national picture of teen drug use.

“Vaping has become a new delivery device for a number of substances, and this number will likely increase in the years to come,” said Miech.

Researchers only have three years of data on how many teens use the electronic devices, but the latest Monitoring the Future study found vaping is already widespread among high school students.

From its peak in the mid-1990s, the rate of all high school students who are smoking has dropped dramatically. For example in 1997, 65.4% of students in their final year of high school said they had ever smoked a cigarette. In 2017, 26.6% of the oldest high school students had smoked one.

However, in the last few years vaping has seen huge growth. Monitoring the Future did not measure teen vaping until 2015. By that time, 35.5% of 12th graders had used one before. That number rose slightly in 2017, to 38.8%.

E-cigarette smoking in California. The study also asked how often teens vaped marijuana.


E-cigarette smoking in California. The study also asked how often teens vaped marijuana. Photograph: Justin Sullivan/Getty Images

For the first time this year, Monitoring the Future asked teens how often they vaped nicotine, marijuana or only flavoring, though researchers warned the numbers are likely to skew low since teens may not know what is in a vaping product. They found one in four 12th graders had vaped nicotine, and 11.9% had vaped marijuana.

Vaping devices turn liquid flavorings laced with nicotine or marijuana into a vapor. In the US, they are largely unregulated. Although Congress passed a law meant to regulate the devices in 2009, nearly a decade later the Food and Drug Administration failed to issue regulations to guide manufacturers. They don’t expect to do so before 2021.

Those delays have followed heavy lobbying by tobacco companies such as RJ Reynolds and Altria (formerly Philip Morris USA), who fought against the 2009 law.

Koval also said evidence of vaping marijuana was worrying. Emerging research shows marijuana can be detrimental to the development of teens’ brains.

“But as concerns this audience, which are young people, it’s not a good idea for them to be consuming nicotine in any way, shape or form,” Koval said. “It’s concerning to see that.”

Researchers have conducted Monitoring the Future surveys among US high school students in their final year since 1975, adding lower grades in the 1990s. In all, approximately 50,000 students in about 420 public and private secondary schools are surveyed annually.

Politics and protocol leave Indian teen’s life in the balance pending TB drug ruling | Amrit Dhillon

Shreya Tripathi sleeps most of the day. At night, she lies awake. Only 18, she has been fighting tuberculosis for five years. Her voice on the telephone from her home in Patna, eastern India, is a whisper. If she speaks for more than a few minutes, she becomes breathless.

Though exhausted, Shreya is also fighting another battle – in the Delhi high court – to demand a new TB drug. Every other medication she has tried has failed to beat the disease.

Shreya has a form of TB caused by bacteria resistant to treatment even with the most powerful drugs. She wants the Indian government to give her bedaquiline, the first new TB drug to be registered in more than 50 years. Its use is tightly controlled. Only six government hospitals are allowed to administer it, and even then only as a last resort.

India has one of the highest levels of drug-resistant tuberculosis in the world. To preserve bedaquiline’s effectiveness – if the bacteria mutate to resist it, there is nothing else available – the Indian government is strict on who can have it and how they are monitored. The National Institute of Tuberculosis and Respiratory Diseases in New Delhi, one of the authorised six centres, has refused to give Shreya the drug.

Shreya was diagnosed with TB in 2012, when she was 13. Doctors in Patna started her on a TB regimen but she proved resistant to the first and second lines of treatment. She and her father, Kaushal, a civil servant, are tired of running around hospitals getting nowhere, while Shreya’s condition worsens.

Two years ago, she had to drop out of school because she was so weak. She needs a wheelchair to get around. Swimming and badminton – her favourite sports – have become distant memories.

Shreya is a category five patient, which means she needs treatment for “extreme” drug resistant tuberculosis, or XDR-TB.

The family only became aware of bedaquiline in October, after a visit to Dr Zarir Udwadia, a consultant chest physician at Hinduja hospital in Mumbai. “It gave us hope. I was desperate by then because nothing had worked for my daughter,” says Kaushal.

Udwadia knew the exact combination of drugs that Shreya needed to take with bedaquiline, which does not work on its own. However, government protocol concerning the drug prevents him, as a private doctor, from accessing it. He told the family to get the drugs from the national institute in New Delhi, but they were refused because Shreya was not a resident.

“We argued and fought with them,” says Kaushal. “They agreed to take a sputum sample from Shreya in November for a drug susceptibility test to see which drugs she is resistant to, but they already knew she was drug resistant from earlier such tests. They wasted precious time.”

They kept calling the hospital for the result. Two months later, they were told the sample had been contaminated. On 28 December, Shreya provided a fresh sample and was told to wait four to six weeks for the culture.

“It was then I told Papa to go to court. Even if it’s too late for me, at least other patients will benefit from it. Just imagine how hard it must be for really poor people to get this drug,” says Shreya.

The case has been heard in Delhi high court this week. Saket Sikri, counsel for the national institute, says that the hospital cannot prescribe the other drugs that must be administered with bedaquiline until it gets the culture report.

“A wrong combination can kill and, since this drug is her last hope, we have to get it right. We are being humane, not bureaucratic, and are following World Health Organisation guidelines,” says Sikri. “The institute cannot choose which parts of the WHO protocol to follow and which to ignore.

“I think the judge’s final decision will hinge on whether he thinks my client is following WHO’s guidance on the use of [bedaquiline]. The judge can’t decide which doctor or which line of treatment is correct but he can judge if the guidelines are being followed and, in that respect, the institute is justified in waiting for the drug susceptibility test report to come.”

However, TB experts have said the culture the institute is awaiting is unnecessary, since it is already known that Shreya is drug resistant.

Anand Grover, a senior lawyer with the Lawyers Collective, which represents Shreya, says that the government has failed to update its own protocol to reflect the latest WHO guidance on bedaquiline, under which several XDR-TB patients have been put on drug regimens similar to the one prescribed by Udwadia. “There is evidence from other countries, including South Africa, showing that this combination has been successful in treating XDR-TB,” says Grover.

Grover has told the court that the prospect of Shreya losing her life without access to bedaquiline should outweigh concerns about any possible resistance that might occur. He has also told the court that the government is following the WHO protocol dating from 2013, when there was limited data on the efficacy and safety of the new drug.

Backing Shreya’s team is testimony from Dr Jennifer F Furin, from the Department of Global Health and Social Medicine at Harvard Medical School, who said Shreya should have been started on a bedaquiline-containing regimen in October.

“Additional delays … threaten her life and the effectiveness of this agent. It is unfortunate that there have already been so many significant delays in providing [bedaquiline] to Ms Tripathi,” said Dr Furin in her written testimony.

Dr Furin has previously criticised India for its slow rollout of the drug. In her Delhi high court testimony she said that scientific publications have set a benchmark that between 30% and 45% of patients with multi-drug resistant TB in a country should be able to access bedaquiline.

“In India, this means a minimum of 30,000 persons per year, based on 2016 estimates. As of 1 December 2016, only 164 individuals had been reported … to be receiving [bedaquiline]. This slow rollout … was noted as a problem by the WHO,” said Dr Furin.

There will be a further hearing on 18 January. “I don’t think the court will give it to me,” says Shreya. “But because of Papa’s efforts, at least other patients may get it later.”