Young adults are taking prescription drugs instead of alcohol - and it's dividing experts

ByIsabel ShawBBC Global Health and Jacqui WakefieldBBC Global Health

To enjoy a night out with friends, Matt once had to drink until he felt sick.

If he didn't, the 22-year-old from the north of England would spend the night silent, terrified of saying the wrong thing. The warehouse worker says it felt like there was "just no way into" the conversations everyone else seemed to be enjoying.

Then, two years ago, he swapped pints for prescription drugs he discovered through social media.

As he gets ready to go out on a Friday, Matt, whose name has been changed, now takes a medicine he purchases illegally online that usually treats epilepsy and nerve pain; alongside a beta blocker designed to slow a racing heart and relax trembling muscles (physical symptoms of anxiety).

He says it gives him the effects of alcohol without the hangover.

"The amount of alcohol you have to drink to replicate the effects of these is really unhealthy and it doesn't feel good," he says. Matt says the drugs he takes leave him feeling "euphoric," quietens his anxious thoughts and makes socialising easy, he says.

But experts say taking the drugs without medical supervision at high doses can be dangerous and, in some cases, life-threatening. Long-term use of the drugs can also result in dependency; users find they rely on it for any social situation. They also report increased anxiety, insomnia, and suicidal thoughts when they try to come off the drug.

For Matt, who says he has already tried therapy to treat his social anxiety, what began as a way to get through nights out now extends to dates and family gatherings. Without the drugs, Matt says, there are many social situations he "would not even bother to attempt".

Matt denies that he has become dependent on the drugs.

Around the world, evidence shows that young people are turning to medications and experimental substances as alternatives to alcohol. Some of them come in pill form - like pregabalin and propranolol, the ones Matt takes. And some are injected - like peptides, a type of protein that's becoming increasingly popular online.

It's part of an effort to quell social anxiety, which seems to affect Generation Z particularly sharply: more than a quarter (28%) of people in their early 20s in England report high levels of anxiety, according to a study published last year by University College London, which found that serious mental illnesses are far more common among members of Generation Z than they were among millennials at the same age.

The trend is alarming scientists - and prompting them to ask why some young adults feel they can only socialise with chemical help.

The 'sober generation'

A search for "healthier" alternatives to drinking has helped create a new market for substances touted on social media as social drugs without the hangover.

They are seen as the "cleaner, safer alternative," says Liam Knowles, an addiction researcher at Teesside University. "[Users] don't feel as bad the next day and it's a medication - so people think it's safer."

Exactly how many young people are using prescription drugs and unregulated peptides to socialise is difficult to know, with many obtaining them without a prescription. Knowles thinks there is "probably a substantial amount of people that are getting addicted".

Hashtags relating to the medications bring up thousands of videos on social media platforms, with users encouraged to create their own cocktail of medications, known online as "stacking".

The growing interest in these substances comes as young adults are increasingly moving away from alcohol, earning Gen Z the nickname of the 'sober generation'. The same influencers touting the benefits of these "stacks" also recommend steering clear of alcohol.

A survey last year by the charity Drinkaware found that 26% of 18 to 24-year-olds in the UK did not drink alcohol, compared with 7% in 2012.

Meanwhile, Prof Emily Jones, a psychologist at King's College London believes the Covid pandemic may have contributed to rising social anxiety, particularly among young people.

"Lockdown effectively taught everybody to be afraid of social interaction," she says.

For young people looking to experiment, pregabalin has become a particular focus.

A study published in the journal Nature Communications estimated that global consumption of the drug more than quadrupled between 2008 and 2018.

Meanwhile, there has also been a sharp increase in deaths involving pregabalin. Office for National Statistics data show pregabalin was mentioned on 2,360 death certificates for drug-related poisonings in England and Wales between 2020 and 2024, compared with 768 between 2015 and 2019.

One of those deaths was Alex Cottam, a 27-year-old software engineer from Eccles described by his mother, Michelle, as "lovely, clever, and popular". He was prescribed pregabalin to treat his anxiety, but his mother says he "became addicted" and started boosting his supply by buying the drug from illicit websites. "I can't help thinking every day that pregabalin killed my son", she told the BBC in 2024.

In England pregabalin was reclassified as a Class C controlled drug in 2019; those who buy it without a prescription face a two-year prison sentence (though in practice, very few people are jailed). It remains widely prescribed for epilepsy, nerve pain and anxiety. The UK government's independent drugs advisers have also launched a review examining misuse.

In Jordan, Ukraine and India, researchers have also noted an uptick in pregabalin abuse.

In China, the government tightened controls of the drug earlier this year by banning most online sales, and setting limits on how much of the drug can be manufactured in each province.

Matt first heard about the drugs he takes when he was 20 through Braden Peters, better known as 'Clavicular', a controversial influencer who has spoken openly on livestreams about taking the medicines as part of a "stack" to reduce his social anxiety.

And the medications have entered mainstream conversation. Actresses Rachel Sennott and Kristen Bell are among the celebrities who have spoken publicly about taking beta blockers, along with the influencer Khloé Kardashian.

Pregabalin, especially in higher than prescribed doses, can make users relaxed and happy - a similar feeling to being drunk.

For Mei, a 20-year-old university student in China, whose name has been changed, these were the effects she was after.

She says the drugs ease her physical symptoms of anxiety, and can make her feel "euphoric". She began taking them for parties. "It was like I could be the most interesting person in the room," she says.

And social media does not appear to be merely introducing young people to these substances - it can also help them get hold of them. Our research has found influencers selling some of these medications on websites linked through their social media.

Mei says she bought the medicine through a Chinese social media platform. "There are thousands of posts selling it," she says.

'Not a free lunch'

The medicines can also be significantly cheaper than alcohol.

Matt says he spends as little as 18p on the medicines for one night out - a saving he describes as a "nice bonus".

Knowles, the addiction researcher, says many of the young people he has encountered using these drugs recreationally in the UK are extremely focused on health. "People don't want the calories," he says. "They think, 'my doctor wouldn't prescribe them if they were bad for you,'" Knowles says.

That logic resonates with Matt, a keen gym-goer who believes these medications have a "much lower impact" on his body than drinking, especially his liver and heart. "People in this community believe that pregabalin is healthier than alcohol," he says.

Alcohol has been linked to at least seven types of cancer, and the World Health Organization warned a few years ago that any amount of alcohol consumption poses danger.

Prof David Nutt, a neuropsychopharmacologist at Imperial College London who has long campaigned for looser drug laws, argues that the drugs Matt takes may be less harmful than heavy drinking, even if they carry risks of their own.

"Propranolol and pregabalin are undoubtedly safer than alcohol, but not perfectly safe," he says.

But he says the picture changes when pregabalin is used in large doses for intoxication (as Matt says he is doing). "If they're using it as a sort of intoxicant to get drunk, then they are at risk of dependence," he says. "It's not a free lunch in that sense."

Propranolol also carries risks. While it is generally considered safe when taken as prescribed, inappropriate or high-dose use can cause dizziness, fainting and a dangerously slow heart rate.

The risks may be greater when medicines come from unregulated sources. "There's always a danger of getting medicines that aren't made to medical standards," Nutt says.

Addiction dangers

Jones, the psychologist from King's College, argues that comparing the physical harms of these drugs with alcohol risks missing a more fundamental question: what happens when people begin to believe they can only socialise with chemical help?

"Alcohol in large quantities is dangerous, but it is also dangerous to take medication too routinely without being under the supervision of a doctor," she says.

She is particularly concerned that using medicine to avoid anxious feelings can reinforce the belief that ordinary social situations are scary. What begins as a pill before a party can gradually spread to dates, work meetings, and everyday life, she says. "You lose your faith in your own capacity to deal with things effectively."

What started for Mei as a "going out stack" before nights out soon spread to exams, speeches and debates. Eventually, she says, she was taking the drugs every day. "Now I can't leave the house without it."

Sofia, a customer-service worker from Ukraine, followed a similar path: she initially took pregabalin before parties and social events, but soon began using it at work. "It helped me," she says. "I work with people. It made it easy to communicate and solve problems."

When she was unable to access the drug for two weeks, she says she experienced depressive episodes and suicidal thoughts. "I didn't understand what happened to me. I was anxious, I couldn't eat, I couldn't see friends."

Knowles says that younger users often don't recognise their own drug dependence if they are broadly functioning well (keeping a job or maintaining a relationship). Instead they associate addiction only with people whose lives have visibly fallen apart.

Black market drugs

As China, India and other countries move to clamp down on these drugs, some argue that restricting access further could create different dangers.

Mykyta Lapin, an epidemiologist and head of the Ukrainian harm-reduction organisation Mind Games, says banning substances does not necessarily stop people taking them.

"Banning certain substances simply leads to people turning to the black market and buying drugs of dubious quality," he says, risking overdoses.

Knowles says illicit pregabalin carries an extra risk because users may not know exactly what they are taking.

"If you buy an alcoholic drink from a shop [in the UK] and it says the amount of units it contains and its percentage, then that's what it is." He said the same certainty does not always apply to pregabalin bought online. "That's an added risk that doesn't come with a bottle of spirit."

Matt, despite taking the drugs primarily as a social lubricant, remains convinced that he is also making the healthier choice.

"When I look at the improvement in my quality of life compared with what I see as a very minimal impact on my health, it's such a clear trade-off," he says.

"For me, it's an exchange that's worth it."

Matt's illegal habit remains heavily discouraged by most doctors. But still, with millions of young adults looking for a seemingly easy cure for anxiety, the numbers of people using these alcohol alternatives is likely to rise.

If you have been affected by addiction, help and support is available at BBC Action Line. If you live in Northern Ireland, you can also call the 24-hour helpline Lifeline, on 0808 808 8000.

Top image credit: Getty Images.

BBC InDepth is the home on the website and app for the best analysis, with fresh perspectives that challenge assumptions and deep reporting on the biggest issues of the day. Emma Barnett and John Simpson bring their pick of the most thought-provoking deep reads and analysis, every Saturday. Sign up for the newsletter here

Get in touch

Are you personally affected by the issues raised in this story?