Chinese teenagers who take medication to numb their minds and 'escape from reality' — Photo: Getty Images via BBC
At the age of 14, elite student Xiaomei* from a coastal province in China took an overdose of cough medicine.
She wanted to impress an older boy who had said the medicine would help her relax. The pills were only available with a prescription, but she was able to buy them online.
Xiaomei initially noticed that the medicine made her a little dizzy. But she soon let herself be carried away by that feeling of slight numbness that, for her, represented a brief respite from the pressure of the upcoming exams.
In high doses, the medicine can cause serious side effects, such as hallucinations and loss of coordination.
As time went on, she tried other medications recommended in internet chat groups. Some were struggling with pain or epileptic seizures.
Sometimes, Xiaomei would take as many as five pills. On other occasions, she tried more than 10, to feel the effects of different medications.
To combat the pressure of exams, many Chinese teenagers turn to pharmaceutical products — Photo: Getty Images via BBC
For two years, the young woman consumed large quantities of various medicines sold only with a prescription. None of them had been prescribed for her, nor for any member of her family. They were all purchased online.
"When I felt very pressured by my studies, did poorly in exams or even when I argued with my parents, I took these medications," she told the BBC. "I was trying to escape reality."
'Pharmaceutical euphoria'
The BBC had access to similar stories told by dozens of Chinese teenagers, in chat rooms on different social networks.
Almost everyone seemed to want to escape for the same reason: the pressure. They were looking for the so-called “pharmaceutical euphoria”.
A girl shared a voicemail after taking high doses of a neuropathic pain medication. Her words seemed slurred and you could barely understand what she was saying.
"I feel like my body doesn't belong to me. I'm very dizzy."
"Just sleep," people advised. "Tomorrow, you'll be fine."
A young man offered to use his father's old prescription, which would allow him to falsify a new prescription for the same medicine.
Chinese students spend a lot of their time studying, which increases their anxiety, according to experts — Photo: Getty Images via BBC
Some gave advice.
"If you want to have hallucinations, you can buy it [...]. It's not controlled yet," said one user.
He was referring to a pharmaceutical product used by people with Parkinson's to control tremors. In excessive doses, it can cause confusion or even delirium.
“What keyword should I use to search for it on online platforms?” asked another user.
Access to medicines
Assessing the magnitude of the problem is not easy, as there are few official numbers.
But the situation is serious and led the Chinese government to launch a national offensive two years ago against the cough medicine consumed by Xiaomei. It was classified as psychotropic and became available only with a prescription.
This decision made it very difficult to purchase the medicine online.
Later, in April this year, authorities observed that young people began to consume another medication and imposed stricter controls on its prescription and sale in pharmacies.
Even so, the BBC received an offer of the product in an online chat for just 10 Chinese yuan (US$1.50, approximately R$7.65) per gram.
Getting hold of unregulated substances is easy. And when authorities control a specific medication, young people quickly find alternatives, according to a 2025 report prepared for the Crime Prevention Institute of the country's Ministry of Justice.
Students practice yoga to relieve tension, before the competitive entrance exam to enter university — Photo: Getty Images via BBC
In some cases, the BBC even discovered that teenagers used different names to refer to drugs and avoid detection. The 2025 study had already highlighted this practice.
There is increasing evidence that young people around the world turn to prescription medications to combat pressure and anxiety.
Therefore, easy access to low-cost prescription drugs in China is not so surprising. After all, the country produces the vast majority of the planet's pharmaceutical ingredients.
Academic pressure
Xiaomei says that when she decided to buy the cough medicine, it only took a few clicks for her to receive a complete box at her door.
"I could simply enter my identity number on the purchasing platforms and purchase it directly," according to her.
The national identity number indicates your age. Even so, she bought the medicine without answering any questions. And it was also cheap: 50 pills often cost the equivalent of less than a dollar (about R$5.10).
On paper, China is winning the war against illegal drugs. Official data from 2025 shows a drastic reduction of 41% in the number of new drug users among people under 35 years of age.
But authorities have had to recognize that misuse of prescription drugs is becoming a widespread problem.
This phenomenon has seen a particularly significant increase among minors, warns China's National Narcotics Control Commission in a recent report.
Xiaomei says that many classmates in her elite chemistry class talked about ways to take excessive doses of prescription drugs to avoid feeling like "total failures."
"It's very difficult to pass exams and stay in elite classes," according to her.
"At our school, these classes operate on an elimination system. If your grades drop, you are kicked out of the group."
"When the results are bad, you feel like a failure and start to believe that you don't have any opportunities in life," says Xiaomei.
Part of this pressure comes from parents, who consider their children their only hope for the future, according to renowned Chinese sociologist Xiang Biao, director of the Max Planck Institute for Social Anthropology.
Experts indicate that pressures on teenagers increase because their parents see them as their only hope for the future — Photo: Getty Images via BBC
The consequences of consumption
The one-child policy (in force in China for decades and which was eliminated in 2016) meant that many families had only one child, on whom all expectations fell, explains Biao.
"What sets Chinese teenagers apart is their isolated environment."
"They spend at least nine or 10 hours at school and have very few opportunities to form social relationships and observe what life is really like," according to him.
Even more concerning is the link Biao sees between prescription drug abuse and the rise in cases of self-harm.
The BBC observed, for example, young people encouraging each other in chat rooms to cut themselves "to feel something."
As an extremely competitive high school entrance exam approached, Xiaomei tried another medicine as a way to reduce anxiety.
"But my memory deteriorated quickly," she says. "I couldn't remember anything clearly and lived in a constant state of daze."
This other medication is usually prescribed to control epilepsy attacks and also acts against neuropathic pain.
When Xiaomei explained the side effects in one of her chat groups, people suggested another medicine used to relieve pain. She says this new medication provided some relief, but higher doses were soon needed.
Competitive exams are a common part of teenagers' lives in China — Photo: Getty Images via BBC
Months before appearing for the exam, Xiaomei went too far. She took 50 pills and started to panic.
"I was afraid that something serious might happen, but I didn't want my stomach to be pumped," she says. "So I preferred to wait before telling my parents."
But she felt so bad that she had to tell him first. Her parents decided to listen to what they considered a cry for help from their daughter.
"They mostly expressed how painful it was to see me like that," according to her. "They didn't scold me or criticize me. Their approach was kind."
And for her, that made all the difference.
Mental health crisis
"A lot of kids get a lot of attention, but what they really want is for people to ask them how they feel," explains Biao. "Do you feel alone or stressed?"
"In China, parents often downplay this situation and simply say they need to be stronger."
He highlights that "a very clear warning signal is emerging throughout Chinese society."
"Adults need to reflect on how to assume their responsibility towards teenagers", warns Biao. "Maintaining an open dialogue as a family is probably the most rewarding part of life."
This is where the real battle lies, experts say.
Instead of trying to stop online sales of prescription drugs with isolated and ineffective measures, the Chinese government should, they say, focus on what could very well be a mental health crisis.
In 2023, a study carried out for China's Blue Book of Mental Health revealed that around 95 million people suffered from depression and, among them, more than 30% were under the age of 18.
The Chinese government has recognized the need to provide support to promote adolescent mental health.
These plans include creating counseling rooms in every school, psychiatric services in at least one hospital in each county and increasing the number of mental health professionals. The objective is to establish a national system of psychological support and crisis intervention by the year 2030.
So far, the results have been quite positive. According to the Chinese State Council, 92% of primary schools and 95% of basic secondary education establishments already have counselors.
Mental health experts say it is essential to listen to teenagers and have open conversations with them — Photo: Getty Images via BBC
Many large cities have begun to integrate mental health into their curriculum, including the capital, Beijing. But there continues to be a huge shortage of psychiatrists specializing in children and adolescents in the country.
A 2020 study, published in the British medical journal The Lancet, indicated that there were only 500 qualified pediatric psychiatrists in China, many of them practicing in large cities such as Beijing and Shanghai.
This is an enormous challenge in a country that has experienced three decades of unprecedented social and economic change.
Uncertainty about the future
The China where Xiaomei's parents grew up is very different from the future she will face.
His parents followed the script set by the Communist Party: work hard and you will be rewarded. Now, even with good qualifications and a university degree, young people are not guaranteed a prosperous future.
After the strenuous restrictions of the Covid-19 pandemic, the Chinese economy faced difficulties in recovering. It is estimated that one in five young people currently face difficulties finding a job and that their families are reducing their spending.
"People, in general, have become more pessimistic", acknowledges Biao. And he highlights that anxiety also affects adults.
"I believe that parents feel confused and anxious, seeing a problem in their children, without finding an alternative", according to him.
"If my son has a problem, it's the end of the world. If my son doesn't do well in school, it's the end of the world. If my son doesn't talk to me, it's the end of the world."
"I believe we should pay more attention to both parents and children."
Despite the country's immense economic leap, many Chinese believe that achieving prosperity is increasingly difficult — Photo: Getty Images via BBC
"Before, my parents didn't really understand me and said very harsh things", says the young woman. "I felt like I had no help and that I was completely alone."
But everything changed when she was urgently taken to the hospital after the overdose. They began to listen to her and talk to her.
“Knowing that someone is by my side made me feel really good,” says Xiaomei. This new situation helped her achieve good results in that much-feared entrance exam.
How to get out of addiction
The 22-year-old spent a long time battling depression. He had difficulty overcoming the euphoria produced by the medications and suffered more than four overdoses over a four-year period.
"Drugs drove me to the brink of madness," he says. "You run the risk of sinking into an abyss of addiction and destroying your health."
Currently, he has abandoned all medications and dedicates his time on social media to encouraging others not to start taking them.
Lu also offers advice to young people facing the same pressures he experienced in the past.
“I hope they can face life head on, without the need for sleeping pills,” he advises. “If they overdose, I want to offer them the courage to stop.”
"I believe their lives will get better. I believe everyone will find happiness."
*The names of the young people have been changed to protect their identity.
