A Jimmy's Cab taxi drops Josh off at University Village, the six-building apartment complex at Towson University, to pre-game for the bars like he does almost every Thursday.
He’s already started drinking, around 9:30 p.m. at the house he shares with four fraternity brothers.
He opens the door to apartment hosting the party. House music from one of the residents’ iPhones is blaring through speakers.
As Josh weaves his way through the 50 or so people packed into the apartment, he slaps hands, hugs his friends and kisses girls on the cheek. He makes his way to the middle of the room with a handle of Jim Beam in his hand.
Josh, whose full name is being withheld to protect his privacy, takes a five-second swig right from the bottle, passing it back and forth between his roommates.
Then Josh gets exciting news. A friend at the party has Xanax, an common anti-anxiety medication. He finds the friend and they make the exchange in the middle of the living room. He pays $5, a typical price, for a single bar, the street name for Xanax.
Josh’s roommates get their bars as well. Theyake turns popping the white, rectangle-shaped pill into their mouths, still in the middle of the lviving room, chasing with the Jim Beam they brought with them.
"When you're on a bar, you're in a happy, content mood with everything," Josh said. "You just feel no pain. It's just happiness."
But it's not always happiness, as there is a concern about health risks and people using the drug without a prescription.
More and more, college students like Josh are taking a Xanax in addition to drinking, thus increasing the effects of both drugs and enhancing their buzz.
A recent report by the Drug Abuse Warning Network (DAWN) shows the increased number of emergency room visits as a result of non-medical use of alprazolam, known by the brand names Xanax, Xanax XR and Niravam.
According to the report, the estimated number of alprazolam-related emergency room visits involving non-medical use more than doubled from 57,419 in 2005 to 124,902 in 2010.
(Quote from a counselor at counseling center)
In the 18- to 24-year-old demographic, which includes many college students, the number of alprazolam-related emergency room visits jumped from 11,827 in 2005 to 20,929 in 2011, according to the report.
The DAWN report also notes that 20 percent of all emergency department visits involved alprazolam combined with alcohol.
"Xanax and alcohol are both central nervous depressants," said Lewis Lyon, a health professor at Towson University. "They magnify the effects of each other and that can result in significantly decreased mobility and a slowed respiratory system."
"When I take (bars), I try to realize when I should stop drinking," Josh said. "It's not a drug you should be stupid with."
Xanax was the 13th most commonly prescribed medication in 2012 and the most prescribed psychiatric drug in 2011, according to the DAWN report. Xanax was the number one prescribed psychiatric drug again in 2013, according to psychcentral.com.
No one at the party Josh attends makes a big deal about the Xanax. Party-goers remain focused on their current conversation or shot. They've seen it a thousand times.
"I just take it right there and then," Josh said. "No one makes a big fuss about it. I won't say 'hey everyone, watch me take this bar.' But I also won't try and be super discrete about it. There's no need."
It’s around 10:45 p.m. Josh has been drinking for about an hour already.
Josh goes about his night at the Village apartment, talking and laughing with friends, continuing to take shots.
"The number of shots I take on a bar mostly depends on the milligrams, but typically I'll take somewhere between eight and 10 shots," Josh said.
Twenty minutes pass. Josh can feel the Xanax start to kick in. His eyes are heavier, and his speech more slurred. Some alcohol spills on his blue button down and drips onto his Timberland boots.
“When you take a bar, you know it’s just going to be one of those nights,” Josh said.
Now it’s close to midnight and the pre-game is emptying. Everyone is calling a cab or an Uber to make the short two-minute drive to the bars in uptown Towson.
Josh and his friends order a taxi from Jimmy's Cab and a night "barred out" at the bars that Josh will likely not remember begins.
Xanax is a Benzodiazepine, which is most often prescribed for the treatment of anxiety and panic attacks. It releases certain neurotransmitters in the brain to reduce adrenalin and other stress related hormones.
"It essentially calms the system down," said Lyon.
Xanax works rapidly and is very effective, and alcohol makes it much worse.
"When you mix Xanax and alcohol, you don't get one plus one equals two," Lyon said. "Instead, you get a synergetic effect, and that increases the risk of blackouts."
Blackouts happen when the body essentially shuts down. The respiratory system slows so much that the person enters "psychomotor retardation," Lyon said. That's why many times students don't remember a night out on Xanax.
Lyon is adamant about the dangers of mixing Xanax with alcohol.
"People don't realize that when they feel the Xanax has worn off, it's actually still in the system and the system is still slowing down," Lyon said. "They will say, 'hey this feels pretty good I could use another.' And they take another. But the system is still slowing."
"It can be deadly," Lyon said.
Not only can combining Xanax with alcohol result in a trip to the emergency room or death, it also has strong addictive properties.
"You can become physically addicted, and when you suddenly stop taking (Xanax) after taking it for a while, it can result in deadly seizures," Lyon said.
When combined with alcohol, Xanax, which is normally intended to reduce panic attacks, can actually create more anxiety and increase the risk for panic attacks.
High levels of anxiety are the first sign of withdrawal, Lyon said.
Josh said he knows the risks but still isn't worried about the side effects.
"I think a lot of people make it out to be a worse drug than it is because there's a small percentage of people that ruin it for recreational users," Josh said.
"I know my body and if something isn't feeling right I'll say something."
Matt's phone vibrates. It's a text from a friend looking to buy a Xanax.
Smith, whose real name has been changed to protect his privacy, and the buyer talk for a few minutes, figuring out what time the buyer can come pick up his bar and where the two should meet. They decide on Smith's apartment.
Fifteen minutes pass and the buyer walks in without knocking. He is a fellow fraternity brother of Smith's. The two make small talk for a few minutes before Smith and the buyer go into Smith's room to complete the transaction.
Smith hands the buyer one Xanax, that he gets from a fraternity brother who has a prescription, from a bag that he keeps in the top drawer of his dresser. Smith will keep anywhere from 25 to 40 Xanax at a time. Smith charges the typical $5 for one bar.
The two exchange money for Xanax. The buyer places the Xanax in his pocket and the friend is out the door and on his way. As quickly as the transaction started, it's over.
When Xanax isn't readily available at a party, people like Josh have to go looking for someone selling bars. That's when people like Smith enter the equation.
"I never have [Xanax] on me," Josh said. "If I'm picking up (from a dealer) I'll usually be five minutes away (from home) so I'll take in the car and then drive back before it hits me."
Smith, a senior at the University of Miami and former Xanax dealer, began selling in fall 2014. His motivation: earn enough money to break even from buying Xanax from his prescribed frat brother to use for himself.
"My friends and I use Xanax all of the time," Smith said. "So we decided it was smart to buy in bulk to save money. Then I decided to sell some so that I could essentially take bars for free."
Smith estimates that he was making sales every week, re-stocking every three to four weeks when he was empty.
"I mostly sold to kids in my fraternity," Smith said. "I tried to stay away from people that I didn't know. That's how you end up in trouble."
Despite the risk, Smith said that he was never really nervous during his stint as a dealer.
"I was more nervous for the people that my friends and I would buy in bulk from," Smith said. "They are the ones who have the prescription and I think it's a felony to posses Xanax with the intent to distribute."
Information on the penalties for possessing and selling Xanax will go here. Looking to have a quote from the Towson Police.
It's not the risk of jail time that got Smith to stop selling. He just lost interest.
"I didn't really feel like spending the money to buy in bulk just to break even, "Smith said.
Even thought he no longer sells, Smith still regularly takes Xanax.
"If you take (Xanax) when you drink, you get really blacked out," Smith said. "It's also a really good way to chill out even when you're not drinking. It's nice when you're just smoking weed or on a long car ride or on a plane."
Josh barely remembers what happened after the cab picked him up from the Village.
One by one Josh's roommates wake up and slowly make their way to the living room of their three-story house and plop on to the black leather couch in the middle of the room. Most of them are hungover from drinks at the bar and the handle of Jim Beam they finished last night.
Josh's friends who didn't blackout on their respective bars and those who didn't take a bar or drink that much recall the events from last night.
The cab ride was loud. Six people crammed into the typical four-seat cab with two people sitting on the three lucky people to get an actual seat. The ones on the bottom argue the lap-riders were the lucky ones.
"Dude, I don't think Jimmy's cab is gonna pick us up again," one of the roommates jokes.
One of Josh's roommates starts recapping the events from the night.
The cab pulls up alongside Green Turtle, the bar many consider the central location of uptown Towson. The group rush out of the cab eager to get their night started. Josh describes the details that he remembers, the rest filled by his roommates.
"When we got out of the cab (the driver) started yelling at us but he was foreign so I don't think we could understand what he was saying," Josh said. "We actually forgot we took a cab."
The story continues. Not much of what his roommates are telling him rings a bell.
"Apparently we started running away when (the driver) started yelling," Josh said.
"Is this guy really yelling at us," Josh thinks he remembers saying.
As the barred out Josh and his friends are running toward their destination, they are still confused why the driver was yelling at them.
"It wasn't until five minutes later that we realized we totally forgot to pay him," Josh said.
The group laugh it off and head around the corner to B Lounge, a popular club-like bar almost always packed shoulder-to-shoulder on Thursdays with mostly underage students. They drink more, dance and have great night.
But Josh and the group come to a consensus that the cab incident was the best part of the night. And those events likely wouldn't have unfolded without the entertaining, yet dangerous, combination of Xanax and alcohol.
Until the next forgotten story.