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Before going out with friends, 20-year-old Mei felt a lump in her throat, sweaty palms, and a fear she might say something wrong, which frightened her greatly.
The Chinese university student later learned via social media about various medications prescribed by doctors for anxiety and other conditions.
She initially began taking pregabalin, commonly used to treat skin conditions, anxiety, and nerve pain. She also started using beta blockers, which typically treat heart conditions and help reduce physical symptoms of anxiety.
Both medications were obtained illegally from online vendors and used without medical supervision.
“I felt extremely confident, as if I were the most attractive person in the room,” she says. “It felt like I could drink ten glasses of alcohol without any effect.”
Taking these medications in large quantities can produce effects similar to alcohol intoxication.
Risks
However, experts warn that taking these drugs without medical oversight can be very dangerous and potentially life-threatening. Long-term use can lead to dependency, causing users to rely on the medication for every social interaction.
When attempting to quit, individuals often experience increased anxiety, insomnia, and suicidal thoughts.
What began as occasional use before going out with friends for Mei (name changed) has escalated to daily use at social gatherings. She now takes the medication every day.
“I can’t leave the house without this medication anymore,” she admits.
Mei is not alone in this trend. Many young people worldwide are avoiding alcohol and increasingly using these medications and experimental substances instead.
Among Generation Z, defined as those born between 1997 and 2012, anxiety disorders appear somewhat more prevalent. A study tracking ages 10 to 24 globally from 1990 to 2021 shows the number of individuals with anxiety rose from 10 million to 16 million. A review of 61 studies confirms anxiety increased in youths even before the pandemic.
The trend to seek alternatives to alcohol has spurred new markets on social media promoting substances free from the hangover effects associated with drinking and culturally accepted in social contexts.
“Young people perceive these medications as cleaner and safer options,” says Liam Knowles, an addiction researcher at Teesside University. “But this is a misconception of safety.”
The exact number of young users consuming these medications is unknown because many obtain and use them illegally.
A study published in Nature Communications found global pregabalin consumption quadrupled between 2008 and 2018, alongside a significant increase in misuse and deaths linked to it.
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Pregabalin misuse was first documented in China in 2024, the same year the Chinese government announced plans to tighten controls. India followed with increased restrictions in May 2024. Researchers in Jordan and Ukraine have also reported rising misuse.
Role of Social Media?
Searching hashtags related to these medications on social media reveals thousands of videos encouraging users to mix different drugs—a practice called “stacking.”
Social media not only provides information about these drugs but also facilitates easy access to them.
Some influential social media personalities have been found promoting these medications for sale through their profiles.
Mei revealed she also bought these drugs through Chinese social media platforms.
“Thousands of posts advertise these medications for sale,” she said. “Finding and ordering them is very easy.”
This trend is not limited to China alone.
Ukrainian 26-year-old Lora told the BBC that these drugs are easy to obtain online or through friends.
The ‘Sober Generation’
As younger adults distance themselves from alcohol, interest in these substances is rising, giving Generation Z the moniker “the sober generation.”
According to Bloomberg, global alcohol company share prices dropped by $830 billion in 2025, largely due to changes in youth drinking habits, with cost and health concerns cited as major factors.
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Addiction researcher Knowles notes many young people using pregabalin recreationally remain highly health-conscious.
“They tend to avoid calories from alcohol, effects on body weight, or the impacts of aging,” he said.
This viewpoint is shared by 22-year-old Matt from the UK, who regularly goes to the gym and believes these drugs affect the liver and heart less than alcohol.
“People in this community see these medications as a healthier alternative to alcohol,” he said.
Not a Free Pass
Alcohol increases risk for seven major types of cancer, and the World Health Organization warned in 2023 that any amount of alcohol consumption poses health threats.
Professor David Nutt, a neuropsychopharmacologist at Imperial College London, notes that heavy pregabalin use dramatically changes users’ conditions.
“If used for intoxication, there’s a risk of dependency,” he said. “In this sense, it’s not something freely and casually consumed.”
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Pregabalin requires high doses to induce a euphoric effect.
Excessive intake can lead to breathing difficulties and, in some cases, fatal outcomes.
High doses of beta blockers can cause fainting or dangerously slow heart rates.
Risk of Dependency
According to Professor Emily Jones, a psychologist at King’s College London, when comparing physical harms of these medications and alcohol, a key question emerges: what if people start believing they cannot socialize without chemical substances?
“Excessive alcohol consumption is dangerous, but regularly taking medication without medical supervision is also risky,” she says.
“If you convince yourself you’re only safe when taking these drugs before social events, this belief can extend into other situations,” she adds.
“Eventually, you lose confidence in your own abilities and fail to cope with circumstances,” she warns.
Lora from Ukraine shares a similar experience.
“It helped me. Talking to people and solving problems at work became easier,” she says.
“I didn’t even realize what was happening to me. I was anxious, couldn’t eat, and avoided meeting friends,” she adds.
Black Market for Medications
As many countries tighten regulations on these drugs, some argue that restricting access may create new risks.
Mukita Lapin, head of the Mind Games organization in Ukraine, says restricting these drugs won’t cause users to stop.
According to Knowles, illegally sold pregabalin poses greater risks as users may not know what or how much they are consuming.
Many recreational users like Mei fear they cannot quit completely.
“It’s scary to think about; I don’t know how I’d control myself without these,” she says.
If you or someone you know is affected by the topics discussed in this article, please consult a local healthcare professional or seek help from support organizations.
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