Young Adults Swap Alcohol for Prescription Drugs, Alarming Experts on Addiction Risks

Matt is 22, works in a warehouse in northern England, and used to drink until he felt sick just to get through a night out with friends. Without alcohol, he would sit silent and terrified, convinced he was saying the wrong thing, locked out of conversations everyone else seemed to navigate with ease. Two years ago, he found another way through social media: prescription drugs.

Now, before heading out on a Friday, Matt takes a medication normally prescribed for epilepsy and nerve pain, combined with a beta blocker meant to slow a racing heart. He says it gives him the effects of alcohol without the hangover—a euphoric calm that quiets his anxious thoughts and makes socializing feel possible. The cost is minimal: as little as 18 pence per night out. He buys these drugs illegally online, without medical supervision, and he is not alone.

Across the world, young adults are swapping alcohol for prescription medications and experimental substances marketed on social media as cleaner, safer alternatives. Some come in pill form—pregabalin and propranolol, the drugs Matt takes. Others are injected peptides, proteins gaining popularity online. The trend reflects a broader shift: Gen Z is increasingly moving away from alcohol altogether. A survey by the charity Drinkaware found that 26 percent of 18- to 24-year-olds in the UK did not drink alcohol in 2024, compared with just 7 percent in 2012. The nickname "sober generation" has stuck. But experts are alarmed, not reassured.

Social anxiety appears to hit Generation Z particularly hard. More than a quarter of people in their early 20s in England report high levels of anxiety, according to research from University College London, which also found that serious mental illnesses are far more common among Gen Z than they were among millennials at the same age. The Covid pandemic may have contributed, according to Prof Emily Jones, a psychologist at King's College London. "Lockdown effectively taught everybody to be afraid of social interaction," she says. Into this vulnerability, influencers have stepped. A controversial figure known as 'Clavicular' has spoken openly on livestreams about taking these medications as part of a "stack"—a cocktail of drugs designed to reduce social anxiety. Celebrities including Rachel Sennott, Kristen Bell, and Khloé Kardashian have spoken publicly about taking beta blockers. Hashtags relating to these medications bring up thousands of videos on social media, with users encouraged to create their own combinations.

The consequences are becoming visible in mortality data. Deaths involving pregabalin in England and Wales more than tripled between 2015 and 2024. Between 2020 and 2024, pregabalin was mentioned on 2,360 death certificates for drug-related poisonings, compared with 768 between 2015 and 2019. One of those deaths was Alex Cottam, a 27-year-old software engineer from Eccles. His mother, Michelle, describes him as "lovely, clever, and popular." He was prescribed pregabalin for anxiety but became addicted and began buying the drug from illicit websites to boost his supply. "I can't help thinking every day that pregabalin killed my son," Michelle told the BBC in 2024.

Addiction researchers warn that the danger extends beyond overdose. Liam Knowles, an addiction researcher at Teesside University, says many young people using these drugs recreationally don't recognize their own dependence if they are broadly functioning—holding a job, maintaining relationships. They associate addiction only with visible collapse. But the pattern is clear in the stories of users. Mei, a 20-year-old university student in China, began taking the drugs for parties, where she felt "like I could be the most interesting person in the room." Within months, she was taking them every day. "Now I can't leave the house without it," she says. Sofia, a customer-service worker from Ukraine, started with pregabalin before social events, then began using it at work, then every day. When she couldn't access the drug for two weeks, she experienced depressive episodes and suicidal thoughts. "I was anxious, I couldn't eat, I couldn't see friends," she says.

Prof David Nutt, a neuropsychopharmacologist at Imperial College London, argues that pregabalin and propranolol may be less harmful than heavy drinking. But he draws a sharp line: "If they're using it as a sort of intoxicant to get drunk, then they are at risk of dependence. It's not a free lunch in that sense." Prof Jones raises a deeper concern. Comparing physical harms misses a fundamental question: what happens when people begin to believe they can only socialize with chemical help? Using medication to avoid anxious feelings can reinforce the belief that ordinary social situations are scary. What begins as a pill before a party can spread to dates, work meetings, everyday life. "You lose your faith in your own capacity to deal with things effectively," she says.

As countries tighten controls—pregabalin was reclassified as a Class C controlled drug in the UK in 2019; China banned most online sales earlier this year—harm-reduction experts warn of a different danger. Mykyta Lapin, an epidemiologist and head of the Ukrainian harm-reduction organisation Mind Games, says banning substances does not stop people taking them. It pushes them toward the black market, where drugs are of dubious quality and users may not know exactly what they are taking. Matt, despite all this, remains convinced he is making the healthier choice. "When I look at the improvement in my quality of life compared with what I see as a very minimal impact on my health, it's such a clear trade-off," he says. "For me, it's an exchange that's worth it." But with millions of young adults looking for an easy cure for anxiety, the numbers using these alcohol alternatives are likely to rise—and the question of what they are losing in the process remains unanswered.