Chinese teenagers' prescription drug abuse linked to mental health support shortage

China has some of the world's toughest laws on drugs, and official data shows a dramatic double-digit fall in the use of traditional narcotics among young people. But a more hidden problem is emerging: a sharp rise in the abuse of non-medical prescription drugs and other unregulated addictive substances among minors, according to the latest government report.

The abuse is thought to be driven in part by academic and parental pressure, as well as a severe shortage of mental health support in schools. Youth unemployment remains high, adding to the pressure on young people to perform well in the college entrance exams, one of the most important events for many Chinese families.

BBC News spoke to teenagers in online chat rooms who have struggled with this issue for years. One 16-year-old girl, referred to as Xiaomei, started abusing prescription drugs at the age of 14. She initially tried a cough suppressant in large doses to impress an older boy, and found it gave her a numbing sensation that allowed her to escape from daily pressures. She was in elite classes at school and felt under intense pressure from her parents. Over time, she moved on to other drugs, encouraged by others in chat rooms. The situation escalated until she took 50 tablets of a drug used to treat epileptic seizures, causing an overdose that led to hospitalisation. Her parents' reaction, which she feared would be strict, ultimately saved her life because it opened a conversation about her struggles.

The chat rooms are an endless conversation among teenagers who inform one another about which drugs to use and how much to take. These are prescription drugs, normally taken in small doses under medical supervision, but teenagers are taking five, ten, or in Xiaomei's case, fifty tablets at a time.

Several factors unique to China are piling pressure on young people. The one-child policy, in place until 2016, meant that entire family hopes, both economic and social, rested on a single child. Academic pressure is also extreme, with China having one of the toughest exam systems in the world. Young people told reporters they need more help from specialists, but China has only set a target of installing trained psychologists in schools by 2030, and there is a severe shortage of trained psychiatrists.

The authorities have tried to clamp down on the problem. In the last two years, they have restricted access to certain drugs, requiring a doctor's prescription for those that young people are abusing. But as soon as one drug is limited, teenagers turn to another, making it a very difficult problem to crack down on. Experts say the issue ultimately comes down to family dynamics and the need to educate Chinese parents on how to deal with teenagers, and to have a national conversation about the pressure young people face.