Let’s talk about alprazolam, which you may probably know better as Xanax, a drug prescribed for anxiety. As part of the benzodiazepine compound family, it functions as a brain sedative that slows and suppresses negative symptoms.
This medication is incredibly popular despite the debate as to whether the use of benzodiazepines, especially alprazolam, is actually beneficial. The side effects range from insomnia to alterations in liver function and the withdrawal symptoms are said to cause worse mental trouble than the original manifestations pre-medication. Not to mention the extreme dependency that comes to haunt those who take it long-term. Understanding this is very important since the main users of not only Xanax but a range of antipsychotics and antidepressants are women.
Hoffmann-La Roche introduced benzodiazepines in the pharmaceutical market in the 1960s. The first one was Librium (chlordiazepoxide), followed by Valium in 1963. Anti-anxiety meds promised to reduce the stress of daily life and were primarily marketed to women, leading them to be seen as “women’s drugs” or “mothers’ little helpers”. A quick search on Google for anti-anxiety meds advertisements will show you how focused they were on gendered roles and emotional stereotypes. One of them reads, “Now, she can cook again”, and another says, “Now, she can cope”. This meant that many women were expected to use them as a way to fulfil their role as mothers and housewives. Interviews from a 1979 Canadian research show that almost all women shared the same narrative, one that positioned their gender role as a reason behind their pill-taking.
Quickly, women started to use these drugs, especially Valium, in large quantities. It was only a few years later that people began to realise how addictive these drugs were. In the United States, where millions of white middle-class women took the drug almost religiously, it soon came to light that it wasn’t as good as it seemed. A collective panic started to surround Valium and many began to take other drugs, such as Xanax and Prozac. Given that these were said to be less addictive and with less side effects, by 1980, they became the leading antipsychotic and antidepressant on the market.
The carelessness when prescribing drugs, and especially those, was and is still tied to profit and how well Big Pharma has been able to market these drugs. One of their many tactics is to ‘disease monger’ to get ordinary feelings to be medicalised. They do so by working in close partnership with some psychiatrists who prescribe, advertise, and promote their medication as a cure rather than an aid. In Japan for instance, the idea of depression was not even termed before 1999 where feelings of sadness and fragility were seen as a natural condition of life. A campaign was put in place to educate the public on this new condition, creating a term for it and claiming that it could be cured with medicine. The sales of antidepressants quintupled between 1998 and 2003. This goes to show how easily patients and consumers might be enticed by the idea of being ‘fixed’ by a magical pill. While medication can mitigate certain conditions and allow some people to improve their well-being, they are not always the solution and are definitely not one-size-fits-all.
As we have seen, it has not been that different with benzodiazepines. Anti-anxiety meds provide no cure, they suppress symptoms and don’t function to eliminate root causes. In 2005, a scholar studied the websites of brands that sold antipsychotics and antidepressants in the United States. When exploring the Pfizer website to check Xanax, she noticed how even though the side effects were mentioned, they were still severely minimised, claiming they only appeared at the beginning of use. Such a strategy may alter people’s perception of the drug and incentivise its use, since the risks are not explained clearly in the advertisement. This kind of omission does not only hurt those who use the prescription as a treatment but also the many who choose to use it recreationally.
Due to popularity and access, the use of Xanax to reach a sense of high and euphoria has increased over the years. Beyond the recommended amount, the pill can trigger feelings of desinhibition, clumsiness, confusion and in extreme cases, blackouts, and death. During 2018, the United Kingdom reportedly made up 22% of the global trade and consumption of addictive anti-anxiety medication sold on the dark web. Some of those sales were done online illegally for as little as £1. Along with that, hospitals have reported an increasing number of young people overdosing from it. Surprisingly though, data has shown that many of those who do use it recreationally are men rather than women.
That information, however, is not particular to Xanax but to all drugs. Researchers claim that men in general take more illicit/recreational drugs than women while women take more pharmaceuticals than men. This is because men tend to have more access to drugs and alcohol, which is directly related to notions of masculinity. Drinking and drug culture have long been associated with men in which “holding one’s liquor,” for instance, is seen as a way of reinforcing one’s manhood. Getting intoxicated is also an activity promoting bonding and camaraderie between men, the more it’s done the more it reinforces one’s manhood.
Such behaviour can also be related to how men are socialised into believing they shouldn’t express their feelings. Men have to be tough and showing emotion is understood as a weakness. Alcohol and drug abuse not only work as a way to reinforce these ideals of strength and confidence but also to suppress emotions. Therefore, when it comes to mental health, men are also more likely to seek substance use as a coping mechanism rather than acknowledging the problem. Xanax as a recreational drug, becomes an escape – similar to the way one would use it as a treatment, helping to numb and ignore the stress of daily life.
As we have seen, the idea of getting medicated to treat mental health issues is one that needs to be questioned. This was already being interrogated during the Valium epidemic and should continuously be put in front of the mental health debate. For many, getting help is strictly connected to being prescribed drugs like benzodiazepines. This simplistic way of dealing with mental health ignores how much of that is influenced by the pharmaceutical industry and the harm that might cause to the body.
Be it in terms of treatment or recreationally, addressing the use of Xanax is of extreme relevance. And it is necessary to continue to highlight how gender affects the discourse surrounding mental health, anxiety and drug/medication usage.