Prescription drugs are easy to get hold of, whether they come from a doctor or not. The other week I bought three Valium from my flatmate. I used one to catch up on sleep and gave the others to a friend who likes to mix them with alcohol. She practically fell asleep standing up. It was only then that I thought about how I probably shouldn't be buying prescription medication and doling it out. But because Valium is technically legal, and because I was four drinks down at a free bar when I gave them to her, it didn't really register at the time.
Drugs like these - the painkiller Tramadol, psychoactive benzodiazepines like Xanax and Valium, or anti-epilepsy drug Lyrica - make you feel like you're floating on a cloud. They come with lower penalties than illegal drugs if you're caught buying or selling them, no penalties for possession, and are generally cheaper. This is their appeal and also their danger.
In Britain last year, 220 registered deaths were attributed to Tramadol - almost 2.5 times the number seen five years ago in 2009 - while 342 deaths from drug poisoning reportedly involved benzodiazepines like Valium - a 20 percent increase from 2012 and the highest number since records began in 1993.
In America, the problem is far worse. Over the last year, one in nine young people took prescription drugs non-medically, and over 2500 young Americans abuse prescription drugs for the first time each day. These kind of stats, along with high profile celebrity deaths like those of Heath Ledger and Michael Jackson, mean that we often think of prescription drug abuse as an American problem. It's not.
Last month, a British couple in their twenties were found dead in a hotel room in Agra, India, due to an overdose from a cocktail of prescription drugs that included sleeping pills, antidepressants and cough medicine. The man, a 27-year-old teacher named James Gaskell, had spent the previous weeks posting a worrying series of Tweets about all the prescription drugs available to him over and under the counter there. "One prescription in India (after you have told the doctor what to write) will take you faaaaaar..." he wrote, and "'Codeine under the counter here. With Valium, Xanax and Lyrica. Winning."
The couple's overdose from these substances didn't surprise me, and nor did James' Tweets about how readily available the prescription drugs were to him overseas. In England, the main kind of addictive drug available over the counter is Codeine, as well as some kinds of cough medicine. Other countries however, particularly those in Asia and central America, have less stringent policies.
The first time I went to India, at 19, I bought several packs of Valium from a chemist, just because I could. I was young and probably quite enamoured by the idea of getting high off something that I could buy in a shop. I'd like to say that I have grown up since then, but I did the same in Cambodia this year, when I was 22. I walked into a pharmacy and bought two packs of Valium, in both 5mg and 10mg doses. I only took them to sleep on the flight home, but I know a lot of my friends - also in their twenties - would knock them back with a beer unthinkingly.
"They make you feel like you are stoned: mellow and laid back. People tend to be inoffensive on them."
When I was in Cambodia, for example, I met a number of young British travellers or expats who were taking a regular cocktail of pharmaceuticals with alcohol. The most common were Xanax, Valium and Tramadol, but I was told that it's also possible to buy liquid Ketamine, Morphine and Oxycontin. "You can get this stuff from any pharmacy," says Paul, 27, living in Siem Reap, when I called him this week to refresh my (hazy) memory of what it was like out there. "Prescription drugs are cheap and readily available here. It's pretty lawless." Why are they so popular, though? "They make you feel like you are stoned: mellow and laid back. People tend to be inoffensive on them."
But there is also a danger, as the Gaskells' death proved. "There's such a huge drug culture at universities, especially in the UK, that when graduates come here they think they are invincible," Paul tells me. "People come travelling to 'experiment'. I know people who have shot ketamine, or who have anally inserted Tramadol. It's scary, the amount of drug overdoses in young travellers." Said overdoses often go unreported, too. "If someone dies in your hostel you have to pay a huge amount of money to the police, so what often happens is that bodies are chucked out and later discovered."
These overseas deaths are alarming. But what is also alarming is the fact that you can bring the drugs back to the UK and continue the party.
Technically, Valium, Xanax and Tramadol are controlled under the Misuse of Drugs Act 1971 as Class C substances. Importation into the UK without a prescription is prohibited and, if you have more than three months' worth, you need a Home Office import licence. I asked the UK Border Force why, then, I'd never heard of them asking to see a prescription, and they said they operate "an intelligence led approach towards their targeting and enforcement activity", which basically means that unless they're specifically looking for you, or you have so many you can barely shut your suitcase, no one gives a shit.
Import seems to be the most common way that they enter circulation among my friends, and it's often the "gap-year" type kids - people that wouldn't dare to trade in Class-A drugs - that are selling drugs like Valium.
Ex-dealer Dan tells me that, because Valium has a relatively low street value, the margins on sales are small unless you're trading in huge quantities. When he used to sell Valium, he would buy them at between 20p and 30p each and sell them on for £1 if they were singles, or 50p in bulk. He bought them in their thousands off steroid users back home in Southampton, ("roiders who used them to stop them from going mad") but his main customers were students: "All the kids at uni loved them," he said, "because they got them to chill out and go to sleep after long sessions on uppers."
Valium and Tramadol don't necessarily need to be bought from a dealer, though. A report by the Home Affairs Committee in December last year identified a growing problem of "doctor shopping", whereby prescription drug addicts sign up to multiple GPs to get multiple prescriptions. The report - which revealed that as many as 1.5 million people are addicted to prescription drugs in the UK - stated that deaths from Tramadol, Benzodiazepines and Diazepam (Valium) have seen an overall increase in recent years and yet, as MP Keith Vaz claimed, "GPs are not collating data about how many people they suspect are abusing the system."
If a lot of GPs aren't seeing this as a concern, neither are the police. As well as finding that doctors and nurses were self-prescribing or giving drugs to friends and family, the Home Affairs Committee report includes a statement from the Metropolitan Police's Drugs Directorate claiming that they found seven London pharmacies selling prescription drugs under the counter. Prosecutions were only made at three. According to a police spokesperson, the lack of involvement of organised crime groups means that the misuse of these drugs were "unlikely to be a priority for Policing and Crime Commissioners" - which sort of makes sense - only, more people in the UK died from addictions to prescription drugs than heroin in both 2012 and 2013. This isn't a problem that we, the police, or the Government can ignore.
It's also hard to know exactly how many of the 807 deaths from prescription drug-related causes in 2013 were accidental, and how many were deliberate overdoses. Yet one thing we can be relatively certain about is that, once you're taking enough mind-altering medication on a daily basis, any decision you make to take your own life is going to be a blurry one. Ex-Valium addict George, from Sunderland, tells me that the drug left him with a "complete lack of rational thought process", and among his friends, he's seen the way in which the drugs create a slippery slope to suicide. "It makes you numb, and that lack of emotion distanced me from those closest. It was all about wanting to escape."
Alix, a 25-year-old from London, had a similar experience. "I was taking Valium, sometimes with Lyrica, from morning to night for about three months, from January to March 2012." Plenty of her friends were taking prescription drugs, she says, but the ones taking them daily were limited to a group of four. "We didn't take anything seriously," she says. "We did runners from restaurants, stole from shops for fun and drove around wasted. Doing Valium for long periods of time takes your anxiety down so much that you don't give a shit about anything. You also don't remember anything. Twenty-four hours will roll into an hour. Time goes by without you feeling it."
After coming off the Valium Alix felt "psychotically paranoid"
What's ironic, though, is that when you abuse drugs like Valium, their medical effects are put in reverse - a bit like how I occasionally take prescription painkillers before I go to sleep but wake up with a banging headache. Nick Barton, Chief Executive of drugs charity Action on Addiction, told me that benzodiazepines are often introduced to help people cope with anxiety, but people build up a tolerance, take more and more, and then tend to get a far worse case of anxiety when they try to come off the drugs. Alix agrees. After coming off the Valium she felt "psychotically paranoid", and "thought everyone knew something that [she] didn't". Likewise, George admits that he "never actually had anxiety in the past, but developed anxiety as a result of abuse". He describes it as a vicious cycle.
I asked Barton how Action on Addiction tends to treat young benzodiazepine addicts in their clinics. "You would have to find out what kind of levels the person is taking. People are not always accurate about that," he says. "Then you'd start to withdraw them in a tapered way, sometimes substituting another drug that isn't quite as addictive." Withdrawal symptoms can include panic attacks and seizures, as well as severe psychological symptoms such as depression, often meaning that antidepressants have to be described. It's messy.
"People are dying because they are stupid," said Paul over the phone from Cambodia. "It's common sense that you shouldn't mix opiates with alcohol." But he's wrong. It's not common sense, because people with a brain like George, Alix and myself have done it in the past, and will probably do it again. As Barton puts it to me when we talk, "You use the word recreation, but for some people it's quite a dangerous recreation because for them it can begin a slide into addiction or overdose."
I ask him whether certain people are predisposed towards addiction, and he says that, although a family history of abuse can heighten your chances, the answer's a "not really". Barton could, perhaps, hear my intonation that addiction or overdose wouldn't happen to me. But speaking to George and Alix, it became clear to me that it could. They had both felt invincible, as we all do, but could only stop taking prescription drugs when their family and friends, respectively, sat them down and staged one of those awkward interventions you think will never happen to you.
"I was pissed off when they did it," says Alix. "My friends were going to call my parents, which I thought was ridiculous. I thought 'I'm an adult.' Obviously though, in hindsight, I'm glad they said something because I was on a downward spiral."
The idea of approaching a friend who you think - or know - has a problem with prescription drugs is going to be scary. You're probably not going to get a friendly response. But you'll feel better that you said something. Because there's no way of dressing it up: drugs like Valium can and do ruin people's lives. Looking back, George says it changed him, that he was "no longer himself". That, to me, seems like the paradox at the heart of drug abuse. We take drugs to alter our natural state, and then we wind up not liking the new person we become. Barton describes it as "a general social unease", whereby we feel we have to do something chemical to our bodies in order to relax, enjoy life, celebrate and commiserate.
A complex question resounded: What the hell is so wrong with us that we have to spend so much time changing the way we feel? But his suggestion struck me as simple: "Perhaps we could try it without?"
*Names have been changed.
If you need to talk to someone about prescription drug abuse, contact Action on Addiction on 0300 330 0659 or visit their website.
You can also get confidential drugs advice from Talk to Frank on 0300 123 6600.
More stuff like this:
The Rise and Rise of the UK's Student Drug Dealers
Seven Important Truths About How the World Takes Drugs in 2014
Will 'Smart Drugs' Really Make Us Smarter? Or Just Ruin Our Lives?
This article was amended at 4PM on Tuesday 4 November to reflect that it was James and not Alex Gaskell who was tweeting about prescription drugs before the pair passed away