Trapped by Exam Pressure? BBC Exposes the Dangerous Reality of Prescription Drug Abuse Among Chinese Teens

At 14, Xiaomei (pseudonym), a high-achieving student from a coastal province in China, decided to overdose on cough medicine. She wanted to impress an older boy who told her it would help her relax. The pills typically require a doctor's prescription, but she managed to buy them online. At first, she felt slightly dizzy. But she quickly became addicted to the mild numbing sensation, which for her was a brief escape from mounting exam pressure. Taking large amounts of the drug can cause serious side effects, including hallucinations and impaired coordination. Later, she began trying other drugs recommended by members in chat groups. Some were painkillers, others used to treat seizures. Sometimes she took five pills at once; other times more than ten, experimenting with different effects. Over two years, she consumed large quantities of various prescription drugs—none of which were prescribed to her or her family. She bought them all online. She told BBC: 'Whenever I felt too much academic pressure, failed an exam, or argued with my parents, I would take these drugs.' 'I was escaping reality.' In multiple social media chat rooms, BBC heard dozens of similar stories from Chinese teenagers. Almost all seemed to be fleeing the same thing: pressure. And their chosen method was chasing a state described as a 'pharmaceutical high.' One girl shared a voice message after taking a large dose of a drug used to treat nerve pain. Her speech was slurred and hard to understand: 'I feel like my body doesn't belong to me. I'm so dizzy.' 'Just sleep,' someone advised. 'You'll be fine tomorrow.' A boy said he was willing to forge a new prescription using his father's expired one for the same medication. Others shared tips: 'If you want hallucinations, just buy... this drug isn't regulated yet,' said one user, recommending a medication used by Parkinson's patients to control tremors. Overdosing can lead to confusion or even delirium. Another user asked, 'What keywords should I use to search on online platforms?' Due to lack of official data, accurately assessing the scale of the problem is difficult. But the issue has become serious enough for the government to launch a nationwide crackdown two years ago—targeting the very cough medicine Xiaomei first used. Authorities classified it as a psychotropic drug, requiring a doctor's prescription for purchase. This made it much harder for young people to buy it online. Yet by April this year, authorities found youth had shifted to another drug, prompting tighter controls on its prescription and pharmacy sales. Despite this, BBC found the drug still being offered in an online chat room for as little as 10 RMB per gram ($1.50; NT$47). A 2025 article by researchers at the China Institute for Crime Prevention under the Ministry of Justice, titled 'Prevention and Control of Adolescent Abuse of Non-Controlled Addictive Substances,' noted that adolescents easily access non-controlled addictive substances. One challenge in governance is the abundance of substitutes. Once one drug is regulated, teens quickly shift to other available alternatives. BBC found that in some cases, teens refer to drugs by different names online to avoid detection—a practice also mentioned in the study. Growing evidence shows young people worldwide are turning to prescription drugs to cope with stress and anxiety. China produces the vast majority of the world's pharmaceutical ingredients, so easy access to cheap prescription drugs may not be surprising. Xiaomei said that when she wanted to buy the cough medicine, all she needed was a few clicks, and the pills arrived at her doorstep. 'You just enter your ID number on a shopping platform and buy it directly.' Although her ID included her age, she said sellers still shipped the medicine without asking any questions. And the price was extremely low—50 pills often cost less than $1. On the surface, China appears effective in combating illegal drugs. Official 2025 data shows a 41% sharp decline in new drug users under 35. However, authorities have had to admit that prescription drug abuse is becoming an increasingly common problem. China's National Narcotics Control Commission warned in its latest report that the trend is particularly pronounced among minors. Xiaomei said many students in her elite chemistry class discussed how to overdose on prescription drugs so they wouldn't feel like 'complete failures.' 'Exams are really hard, and staying in the elite class is even harder. Our school uses an elimination system—if your grades drop, you get kicked out. When you fail, you feel like a total failure, like there's no hope in life.' Xiang Biao, a renowned Chinese sociologist and director at the Max Planck Institute for Social Anthropology in Germany, said part of the pressure comes from parents. Many view their children as their only hope for the future. Xiang added that due to the decades-long one-child policy, which ended in 2016, many families have only one child, who carries the entire family's expectations. 'What makes Chinese teenagers different is their isolated environment. They spend at least nine to ten hours a day in school. They rarely have chances to build social relationships or truly understand what real life is like.' More worrying, he believes there's a link between prescription drug abuse and rising self-harm. For example, BBC observed in many chat rooms, young people encouraging each other to cut themselves to 'feel something.' As a fiercely competitive high school entrance exam approached, Xiaomei tried another drug, hoping to numb her anxiety. 'But my memory deteriorated rapidly,' she said. 'I couldn't remember many things, just spaced out all day.' The drug is typically used to control seizures and treat nerve pain. When Xiaomei mentioned these side effects in a chat group, others recommended another painkiller. She said it did give her some relief, but she soon needed higher doses for the same effect. Months before the crucial exam, she overdosed. She swallowed 50 pills at once and then panicked. 'I was afraid of serious consequences but didn't want to go for stomach pumping, so I decided to wait and tell my parents later.' But she felt extremely unwell and eventually had to confess everything. Her parents decided to see it as a cry for help. 'They mainly expressed how heartbroken they were to see me like this. They didn't scold or criticize me. Their attitude was very gentle.' For her, it made a huge difference. Xiang said: 'Many kids get a lot of attention, but what they really want is someone asking how they feel. Are you lonely? Are you stressed? But in China, parents often brush these feelings aside and tell their kids they just need to be stronger.' 'The entire Chinese society is actually sounding a very loud alarm. Adults must reflect on how they are responsible for teenagers. Honest dialogue within families—this might be one of the most valuable things in life.' Experts believe the real battlefield is here. Rather than constantly cracking down on online prescription drug sales, efforts should focus on the potential mental health crisis forming beneath. According to the '2023 China Mental Health Blue Book,' 95 million people nationwide suffer from depression, over 30% of whom are under 18. The Chinese government has recognized the need for youth mental health support. Plans include setting up counseling rooms in every school, ensuring at least one psychiatric service provider per county, and increasing the number of mental health professionals. The goal is to establish a nationwide psychological support and crisis intervention system by 2030. So far, these measures have achieved considerable success. According to State Council data, 92% of primary and 95% of middle schools now have counselors. In many major cities, including Beijing, mental health education has begun to be integrated into curricula. However, qualified child and adolescent psychiatrists remain severely lacking. A 2020 study published in The Lancet noted there are only about 500 qualified child psychiatrists nationwide, many concentrated in major cities like Beijing and Shanghai. For a country that has undergone 30 years of unprecedented social and economic change, this is a massive challenge. The China Xiaomei's parents grew up in is vastly different from the future she faces. Her parents followed the Communist Party's prescribed path: work hard, and you will be rewarded. Today, even with excellent grades and a university degree, a bright future is no longer guaranteed.