India's Little Helper
source:
http://www.time.com/time/asia/magazine/article/0,13673,501020722-320805,00.html
JULY 22, 2002 / VOL. 160 NO. 2
By blissing out on a generic tranquilizer, the subcontinent's urbanites are
flirting with danger
BY MEENAKSHI GANGULY/NEW DELHI
When his manager came in to report yet another mechanical breakdown in the
factory, New Delhi businessman Arun Goel broke down himself. His head throbbed
unbearably as he fretted in the sweltering heat about power outages, missed
deadlines and looming contract commitments. Seeing his distress, a friend handed
him a glass of water and a small, yellow pill. The businessman swallowed. "It
was like magic," Goel says. "Within 15 minutes, I had calmed down and was
feeling optimistic that things would work out."
The little yellow pill is Alprax, a generic tranquilizer and antianxiety
medication that is fast becoming the drug of choice among India's more
prosperous classes. Just as U.S. yuppies in the 1990s reached for the
antidepressant Prozac as a cure-all for the blues, India's shopkeepers,
executives, socialites, housewives and models everywhere seem to be popping "Al"
to help them cope with life's everyday stresses. Some parents are even
recommending Alprax to their children to calm their nerves prior to exams. "I
take the pill to gain a certain amount of confidence," admits a 34-year-old New
Delhi marketing executive, "especially before a party where you are expected to
be smart."
But it's hardly your typical party drug. Produced by Ahmadabad-based Torrent
Pharmaceuticals Ltd., Alprax (a.k.a alprazolam) is the generic version of Xanax,
approved in the U.S. in 1981 to treat people suffering from anxiety disorders
and panic attacks. The drug—which in India requires a doctor's prescription but
is readily available from pharmacists without one—is generally considered to be
safe when monitored by a knowledgeable doctor. But long-term users of Alprax—and
of other tranquilizers containing benzodiazepine, the drug's active
ingredient—can become dependent, hooked on the placid calm it imparts and
needing to take it more frequently to maintain this chemical serenity. When
taken in high doses or along with alcohol, coma or even death can be the result.
"It is a good drug and I prescribe it to patients who display stress symptoms,
but there are clear rules about dosage," says New Delhi general practitioner Dr.
S. K. Vohra. "The trouble is that many chemists sell it without prescriptions
and so people take it without supervision."
Other countries have already sounded the alarm over the potential pitfalls. In
the U.K., illegal possession of tranquilizers containing benzodiazepine is a
crime punishable by up to two years in jail. Benzodiazepines are classified as
dangerous drugs in Hong Kong. In the U.S., teenagers and twentysomethings who
take Xanax recreationally are known as "Xannie-poppers." Among their ranks:
President George W. Bush's niece, Noelle Bush. In January, she was arrested in
Florida for posing as a doctor in order to obtain Xanax without a prescription.
Despite the tranquilizer's well-known history overseas, perfectly healthy and
otherwise conservative Indians are gobbling Al blissfully unaware of the risks.
There's little stigma attached to it, nor do users endure the hassle of trying
to score it from street-corner dealers. Recently, a casual request for Alprax
tablets was greeted without a blink by a New Delhi pharmacist.
The cost: 50 for a strip of 10 0.25-mg tablets. Another chemist was reluctant at
first, but he relented. "You don't look the sort that might be an addict," he
said. Neither recorded the name of the prescribing doctor as required by law.
This lax attitude may change as awareness of the dangers of Alprax begins to
spread. In March, socialite Natasha Singh was found dead outside a New Delhi
hotel. Police concluded she had committed suicide by jumping from the roof. An
autopsy revealed she had swallowed more than 30 Alprax tablets before her death.
Singh, who reportedly suffered from depression, was a champion of Alprax and
used it almost compulsively, according to her friends.
Singh's death prompted an outcry over the ease with which Alprax can be
obtained. Five people, including a doctor, were arrested recently for exporting
Alprax without a license to Western consumers who bought the drug at a steep
discount over the Internet. But officials say that it is almost impossible to
stop over-the-counter sales in India. "There are many medicines that are abused
as psychotropic substances," says M. K. Singh, head of the country's narcotics
board. "It is highly dangerous, but in this country, that awareness, that
consciousness, is yet to come."
Indeed, the realization that Alprax is no magic pill is dawning too late for
some. Two months after Singh died, her sister-in-law was found hanging from her
bedroom ceiling. The coroner found she had taken at least 10 Alprax tablets
before she committed suicide.
