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.