Whenever there are highly desirable restricted products within society, there will be people willing to produce, and sell “knock-offs” of the products. It doesn’t matter if it is a Gucci handbag, concert tickets, or a pill. Within the drug-using community, it is becoming more common for the “People’s Choice” of benzos (Xanax) to be mimicked and sold by “bootleggers.” In the majority of instances, the fakes are good enough to pass as the originals… but every now and again, a “bad fake” will come along and make its presence known, usually through a fatality or hospitalisation due to overdose. This is what has happened recently in South Australia.
Three people were recently hospitalised after ingesting what they thought was Xanax. It led to the arrest of a young man and the seizure of more than 10 000 tablets marked Xanax. The pills were found to contain the “Designer Benzo,” Clonazolam; an alprazolam and clonazepam mix, with a potency up to 2.5 times stronger than Xanax.
A well-intentioned, however slightly naïve response from Detective Superintendent Billy Thompson was
"We want the community, including young people, to be aware that products for sale on the internet or via other sources are dangerous. Criminals manufacture these products using potentially dangerous and poisonous ingredients, for their own gain. Ingesting tablets or substances from unknown sources can be potentially fatal or lead to an overdose."
We can see here an attempt to create some Demand Reduction, by letting the consumer know of the risks they are potentially exposing themselves to if they choose to take these substances.
In previous instances, we can see how the Therapeutic Goods Administration has responded to the presence of counterfeit pills. When there were fake alprazolam pills circulating in Queensland and New South Wales in 2020, the TGA issued the following notification:
“The TGA is working with the Australian Border Force (ABF) to help stop any future shipments of counterfeit Alprazolam 2mg tablets from entering Australia.
If these tablets are found at the border by the ABF, they will be seized and destroyed.
The TGA is advising consumers to exercise extreme caution when purchasing medicines from unknown overseas Internet sites and has produced a short video on the risks associated with buying medicines and medical devices online. Products purchased over the Internet:
- may contain undisclosed and potentially harmful ingredients
- may not meet the same standards of quality, safety, and efficacy as those approved by the TGA for supply in Australia.”
This is a great example of Nationally coordinated Supply Reduction, coupled with some Demand Reduction.
“What’s missing from this conversation is a nationally coordinated, Harm Reduction, Overdose Response when these events take place.” Says Jake Docker, CEO of The Australian Injecting and Illicit Drug Users League.
“People who use drugs need to be reminded that overdosing is not criminal, with messaging as clear and simple as that… AN OVERDOSE IS NOT A CRIMINAL EVENT…YOU ARE NOT A CRIMINAL, NOR HAVE YOU COMMITTED A CRIME IF YOU HAVE OVERDOSED.”
Docker believes that lives can be saved if media responses to overdoses incorporate vital Harm Reduction information. “Remind people to be wary of mixing a number of different depressants. Remind people who are scoring from a new source to expect there to be some difference in potency: if in doubt, use a bit less the first time. Remind people that overdosing is not a crime, and to seek help early. A Nationally co-ordinated Harm Reduction response is needed just as much as a Nationally co-ordinated Supply and Demand Reduction response.”
Adrian Gorringe, AIVL Project Officer added that “there is a general misconception that has been born out of drug criminalisation, media alarmism and scaremongering campaigns, that police will be present at the scene of an overdose should you phone for help or if you disclose to ambulance or paramedics that you or your friend have consumed illicit substances. This is not true. Ambulance officers and paramedics only involve the police if there is a genuine threat to their safety or the location has a documented history of aggravated assault against ambulance officers and paramedics, otherwise, there is no police involvement. It is both disheartening and counterproductive to the human rights and safety of people who use drugs, that such narratives continue to proliferate and cause drug-related harms, injuries and deaths that could have been avoided.”
Police say the drugs were stamped with the word 'Xanax' but actually contained a variety of illicit substances. (Supplied: SA Police)
Know the risks: Taking non-prescribed pills can cause overdose or death, but the risk of harm is higher if:
- you take a counterfeit product
- you take a higher dose
- you use other sedative drugs (e.g., opioids, alcohol, GHB, Lyrica (pregabalin)) on the same day. Counterfeit alprazolam can be poorly manufactured, and the ingredients and amounts can vary a lot, even within the same batch. The time from taking the drug to feeling any effect can vary significantly depending on the drug as well as the individual person.
Information and advice
- Do not take alprazolam you suspect to be counterfeit. Products not purchased at pharmacies are at the highest risk.
- Get help immediately if you or someone else have taken tablets and feel unwell and tell someone what has been taken.
- Signs that you should seek help immediately: difficulty speaking or walking, difficulty / slowed breathing, difficult to rouse / unconscious, seizures. Get help If you see the warning signs of overdose or distress. Call Triple Zero (000) for emergency assistance.
SA Police have seized thousands of fake Xanax tablets.
Charlie Lay - Project Officer, AIVL.
AIVL is the national organisation representing people who use/have used illicit drugs and is the peak body for the state and territory peer-based drug user organisations.
Jake Docker, CEO, AIVL – email firstname.lastname@example.org