What’s the deal with fake Xanax in NZ?

In August and October 2020, High Alert issued notifications related to fake ‘Xanax bar’ tablets across the country:

• Increase in the availability of fake ‘Xanax bar’ tablets
• Flualprazolam found in fake ‘Xanax’ tablet

It’s an area we pay close attention to because illegally-produced fake ‘Xanax’ tablets containing other novel psychoactive substances is a growing trend internationally – the UK also recently issued alerts about it. 

What is Xanax exactly?

Xanax is the brand name of alprazolam which is a short-acting benzodiazepine. Other names include Xannies, Xans, or bars. Tablets come in different colours and shapes, often ‘bars’ or oblongs.

Benzodiazepines (benzos) are medications prescribed as sleeping pills and muscle relaxants, and to help treat anxiety, epilepsy and alcohol withdrawal. It’s risky to take any benzodiazepine that hasn’t been prescribed to you – even if you think it’s a legit pill. It’s also illegal to use benzos not prescribed by a doctor.

Using benzos can make you feel relaxed, calm and sleepy. A higher dose can make you feel drowsy, confused, aggressive, and uncoordinated.

Benzodiazepine withdrawal symptoms can include headaches, heart palpitations, nausea, sweating and shakiness. Other symptoms can include muscle aches and pains, hallucinations, nightmares, fatigue, numbness, anxiety, panic attacks, depression, confusion, rapid mood changes, memory loss, and hyperactivity.

The background of fake benzos in New Zealand

Traditionally, illegally used benzos in New Zealand were diverted from legal sources. The fake ‘Xanax’ tablets currently being seen in the country are designed to imitate 2mg Pfizer produced, alprazolam-containing Xanax brand tablets, which are not legitimately dispensed here.

KnowYourStuffNZ tested two of these ‘Xanax’ tablets in Wellington. There was a possible presence of etizolam in the white ‘Xanax’ tablets, a novel psychoactive substance that was implicated in the death of 548 people in Scotland alone in 2018, accounting for more than 80% of ‘street benzodiazepine’ deaths.

Between April and June 2020, etizolam was the most common novel benzodiazepine detected by the Centre for Forensic Science Research and Education in the United States. Novel benzodiazepines accounted for 59% of all novel psychoactive substance detections.

KnowYourStuffNZ provided another sample of a yellow ‘Xanax’ pill for further testing, and forensic analysis by the Institute of Environmental Science and Research (ESR) indicated the presence of flualprazolam. This is a dangerous and potent novel benzodiazepine with a relatively short on-set of action and heavy sedative effects.

Flualprazolam hasn't been approved for medical use, and limited information about it is available. It is known to be 50x more potent by weight than alprazolam, with the common dose being less than 0.5mg. The dose-response curve of flualprazolam is particularly steep, meaning a dose over 2mg can easily be fatal.

In 2019, the Centre for Forensic Science Research and Education identified flualprazolam as a contributing factor in over 40 deaths in the US.  It is now the second most commonly detected novel benzodiazepine in the US. Twelve deaths have been attributed to flualprazolam in the UK.

How to reduce harm from benzos

High Alert strongly urges people not to take rectangle shaped/2 mg ‘Xanax’ tablets in New Zealand. They are not approved nor legitimately available in this form and are almost certain to be counterfeit.

Counterfeit Xanax pills that have been illegally manufactured often have unpredictable dosages, increasing the risk of unintended overdose. Many pills internationally have been shown to have varying doses even within the same batch.

Benzos are highly addictive. Many people report developing a tolerance, and experiencing craving and withdrawal symptoms.

Benzos are also central nervous system depressants, which makes them especially dangerous when mixed with other benzodiazepines, opioids and alcohol. This increases the risk of fatal overdoses.

Always call an ambulance if someone:

• is unconscious;
• stops breathing;
• has a seizure;
• is extremely agitated for longer than 15 minutes;
• has chest pain or breathing difficulties for longer than 5 minutes.

The NZ Drug Foundation has more resources on how to reduce harm from benzos.

If you have any concerns about your own drinking or drug taking, get in touch with the Alcohol Drug Helpline on 0800 787 797, or text 8681. You’ll be able to speak with a trained counsellor who can provide you with helpful information, insight and support. They’re available 24/7, all calls are free and confidential. You can also chat to the team through their website.