Counterfeit versions of the drug have led to at least 204 deaths in the United Kingdom since 2015, according to reports, with 126 cases in Scotland between 2015 and 2017.
Although the number of fake medicines sold in nations like Britain is estimated at 1%, the pharma company producing Xanax, Pfizer, has reported that between 2004 and June 2016, counterfeit versions of 26 of its medicines were detected in the legitimate supply chain of at least 60 countries, including the US, Canada and the UK.
Widely common in the US as treatment for anxiety and panic attacks, Xanax, is not available from the UK's NHS. One can obtain the drug on a prescription. However, cases of purchasing the drug via illicit channels — including dark web and unregulated community and online pharmacies — have caused alarm among drug producers and healthcare professionals.
According to Oxford University academics, in the UK supply chain alone, 11 cases of fake medicines were detected between 2001 and 2011.
"These products vary immensely — fake medicines may be contaminated, contain the wrong or no active ingredient, or could contain the right active ingredient at the wrong dose. In any of these scenarios, patient safety is compromised," the scientists explained.
Like other benzodiazepines, alprazolam in the short term causes over-sedation, collapsing and overdose, while in the longer-term its use can lead to physical dependence and severe withdrawal upon reducing or stopping use.
"Many of the Xanax tablets available on illicit markets are not of pharmaceutical grade, but are in fact counterfeit. This is a major concern because these counterfeit products may contain very variable amounts of alprazolam, making it hard for drug users to decide how much to take. Counterfeit Xanax has also been shown to sometimes contain other drugs and/or potentially dangerous adulterants," explained Public Health England.
The Office of National Statistics reported 35 deaths in England and Wales between 2015 and 2018 and 43 deaths between 2015 and 2017 in Northern Ireland, after having misused Xanax with other drugs.
In order to prevent spread of fake, life-threatening meds, UK's Medicines and Healthcare products Regulatory Agency (MHRA) in cooperation with pharmaceutical companies puts systems in place, such as application of a unique identifier on products, to prevent or detect counterfeit or fake healthcare products entering the supply chain.
Fake Xanax medication, valued at more than £1m, has been seized at UK ports and airports since 2016.