A pioneering clinic set up to help teenagers addicted to Xanax and other prescription drugs is being sought out by adults who use pills purchased illicitly on the internet.

At the beginning of the year Dr Owen Bowden-Jones opened the Addiction to Online Medicine (Atom) service in London, a free, easy-to-access NHS clinic run by Central North West London NHS Foundation Trust that offers one-to-one meetings and group mindfulness sessions.

The clinic, thought to be the first of its kind in the UK, was established in response to the growing problem of teenagers addicted to prescription drugs, particularly Xanax, bought illegally on the web.



What has surprised Bowden-Jones is that a third of current referrals are over 20. “When we established the clinic we were at the peak in terms of interest in Xanax and we were seeing a lot of young people using it,” he says. “But one of the cohorts we have seen are people in their 20s and 30s – people who are prescribed a medicine and then they seek it online, either because the dose they have is not enough or the medicine is stopped by their GP .”

He adds: “Teenagers tend to use [prescription drugs] for the intoxicating effect, to get giddy and drunk, but older people tend to use it to treat symptoms, particularly anxiety. We have had a number of patients with traumatic experiences and for them these medicines are being used to anaesthetise themselves.”

The adult group tend to use benzodiazepines to treat anxiety and tend to be women, he says. They have a job, have a partner, friends and a social network, “but have a secret that they have been buying drugs online and not telling people. They are often quite ashamed about it, but they found they cannot cope without prescription medicines.”

Facebook Twitter Pinterest Owen Bowden-Jones in the garden behind his clinic. Photograph: Jill Mead/The Guardian

Benzodiazepines are currently prescribed on the NHS but are only supposed to be used in the short term. Research shows around four in every 10 people who take them every day for more than six weeks become addicted.



In the UK, alprazolam is not available on the NHS and can only be obtained on a private prescription. Tranquillisers are controlled under Class C of the Misuse of Drugs Act and possession without a prescription could lead to a prison sentence of up to 2 years and an unlimited fine.



Yasir Abbasi, a psychiatrist with Mersey Care NHS Trust, says: “In modern society we are so connected and always on the go. It can, on occasion, lead to individuals feeling more anxious compared to 30 years ago: constantly being connected and engaged in social interaction through smartphones which are constantly buzzing and sending us alerts. This can be part of the problem, which leads to people feeling more anxious.”

He adds: “Self-medicating becomes the solution for some. In modern society we feel that there must be an answer in a pill for something we experience.”

Abbasi gives the example of someone he saw recently, who was in their mid-40s. They had an accident years ago and began using painkillers. Three years down the line they still felt anxious and six months ago started taking benzodiazepines. Their GP eventually refused to prescribe them so they started buying the pills online. They ended up having an accidental overdose after increasing the dose themselves.

Abbasi says: “This is how it usually starts – people are prescribed [the pills] ... these are highly functioning individuals who become hooked on drugs.”

They feel the fact they are buying these pills from online pharmacies legitimises what they are doing, he says. But buying drugs on the web is dangerous not only because of the legal implications but also because people cannot guarantee what they are actually getting. While websites may purport to sell pharmaceutical-grade substances, it is difficult to verify what is actually on offer. Some medicines can be bought legally on websites bearing a logo linking to the online register of regulated pharmacies.

Ellen (not her real name), 31, says she takes valium purchased online to cope with anxiety. “I tend to buy around 50 to 60 tablets and they will last me the year,” she says.

Ellen has a busy job in communications and says she has to be on the ball: “I take valium when I feel like everything is getting on top of me or I need to get through a big presentation at work. Or if I need to sleep better ... I probably take a tablet a day for a few days once every two weeks maximum. It depends on the situation but there is no way I would be able to get these tablets on the NHS. Doctors would say my anxiety was not serious enough to warrant it.”

She gets valium through a friend who buys it for her online, and says she hasn’t built a tolerance because she uses the benzodiazepine infrequently throughout the year: “I would almost compare it to taking ... strong painkillers for a bad headache. It just takes away the physical experience of anxiety for a while. It calms me down so I can sleep better through the night.”

The government has ordered an investigation into prescription drug misuse in the UK. Steve Brine, the public health minister, acted after it emerged that one in 11 (8.9%) patients treated by the NHS in England last year were given drugs that can induce dependency.

Abbasi welcomes government attention on the subject but says services must quickly adapt to the growing problem: “We have traditional services for addiction but the face of addiction is changing rapidly and we cannot just rely on traditional services. We need to invest to meet the challenges of 21st century.”



Bowden-Jones hopes his clinic can open up a conversation about the scale of the problem and the type of issues people are facing. “If there is one common link between [all our patients] it is that they are underestimating the risks of medicines bought online and making an assumption that they are safer,” he says.