Xanax, the brand name for the drug alprazolam, is a common medication for the treatment of anxiety and panic disorders. As a central nervous system depressant of the benzodiazepine variety, it works by slowing down heart rate and promoting a feeling of calm and peace. It has both sedative and hypnotic properties to make users feel relaxed and quickly eliminate feelings of anxiety.
The medication was first released to the public in 1981 and quickly became a popular choice for the treatment of generalized anxiety disorder, anxiety related to depression, and panic attacks. It became a “blockbuster drug,” with doctors prescribing Xanax even for mild symptoms. In 2010, it was the 12th most prescribed drug in the United States.
Unfortunately, it was soon found that there were a number of downsides to this very effective drug. Xanax has the potential to be abused and to be addictive, and it can have severe and potentially dangerous withdrawal symptoms, particularly if people are left on the drug for too long. By the time this was discovered, however, Xanax had already flooded the market. It became part of the increasing trend of people abusing prescription drugs by taking it without a prescription or taking more than directed. People began to die from overdoses, and a few from trying to get off the medication.
Because of this, Xanax is now legally considered to be a Schedule IV controlled substance, meaning that there are some legal restrictions for its distribution due to the fact that it’s addictive and has some potential for abuse, though less so than drugs like cocaine and prescription opioids. Despite this, Xanax is still very often prescribed by doctors and recreational use of the drug remains a serious problem.
Many prescription medications, even those that are not considered to be addictive, produce withdrawal symptoms when a person stops taking them. However, those of Xanax and similar benzodiazepines are unique in how severe both the psychical and psychological symptoms can be and how long they can last.
Benzodiazepine Withdrawal Syndrome
Xanax withdrawal can include a host of possible symptoms, meaning that the condition is considered to be a “syndrome.” The severity of the symptoms depends largely on how high the ending dose was, how long the drug was taken, and whether the individual stopped taking it all at once or slowly tapered off the dose.
Possible Xanax withdrawal symptoms include:
- Trouble sleeping
- Panic attacks
- Excessive sweating
- Trouble concentrating
- Memory issues
- Intestinal problems
- Muscular weakness
- Weight loss
- Suicidal ideations
The most severe and dangerous of these symptoms tend to only happen to individuals who have been taking high doses of the drug for a very long time and/or those who quit taking the drug suddenly without tapering off. However, severe symptoms can appear even after a small decrease in the dose. There have even been cases of people dying from seizures caused by benzodiazepine withdrawal, as well as of people taking their own lives due to sudden and intense suicidal thoughts and urges.
It’s much more common for individuals to experience more mild withdrawal symptoms, particularly anxiety. Benzodiazepine medications like Xanax are known for their tendency to cause a condition called “rebound anxiety,” which is a bout of anxiety that is more intense than what the person experienced before starting the medication. People can end up having intense panic attacks, which can make it very difficult to resist the temptation to take more Xanax. This is a serious problem considering that relapse rates for any drug addiction range from 40-60 percent.
What Causes Withdrawal Symptoms?
The reason withdrawal symptoms happen is because drugs like Xanax physically change the brain over time. Benzodiazepines work by enhancing the activity of the neurotransmitter called GABA (gamma-aminobutyric acid) that naturally produces sedation effects. When a person takes a medication that artificially activates a part of the brain like this, the brain attempts to compensate by making the receptors less sensitive or generally decreasing activity in this area of the brain.
This is called developing a tolerance to a drug. When this happens, people find that the same dose of their medication no longer produces the desired effect. They must increase the dose in order to control anxiety symptoms, or, in the case of abuse, achieve a high. As doses increase, the GABA neurotransmitters become less and less naturally active.
At this point, if someone stops taking the drug, there is suddenly a severe lack of activity in the GABA area of the brain. Because this area is meant to sedate and calm people naturally, without it working properly, people can experience severe anxiety that seems like it will never end, along with other disturbing symptoms.
In addition to this, the lack of activity in the GABA area prompts the brain to increase activity in the excitatory systems, producing more serotonin, dopamine, and noradrenaline. This produces more anxiety and can also cause suicidal thoughts and urges, tension, and even seizures.
The very idea of going through withdrawal can be daunting, and in fact acts as a deterrent for many addicted individuals who want to take back control of their lives. This is part of the reason why only 11.2 percent of all people with an addiction disorder received treatment in 2009.
There isn’t a typical timeline that Xanax withdrawal follows since a tapered approach is generally used with benzodiazepine withdrawal. Oftentimes, individuals who are addicted to Xanax are switched to a longer-acting benzodiazepine and then slowly tapered off that medication over a period of weeks or months. A tapered approach can largely reduce or even eliminate withdrawal symptoms.
Of the more than 14,500 addiction treatment centers in the US, many of them offer medically assisted detox. This is simply a service in which addicted persons can check into a hospital setting and stay there for the duration of the acute withdrawal symptoms. This is highly recommended for those who need to detox from a benzodiazepine due to the fact that withdrawal symptoms from these drugs can be fatal.
The goal of medically assisted detox is to make the withdrawal period as comfortable as possible for the client. Any symptoms that appear are treated with nonaddictive medications. For those addicted to Xanax, other anti-anxiety medications are likely to be administered to control this likely symptom. The individual can also be constantly monitored for seizures and suicidal ideation.
After detox, it’s important for an addicted person to enter a rehabilitation program and follow through with a complete course of treatment. Without rehab, incidences of relapse are very high, and relapsing on a drug like Xanax increases the chance of overdose and dangerous withdrawal symptoms if detox must be attempted again.
The important thing to remember about Xanax withdrawal is that no one should attempt to go through it on their own. Addiction treatment centers exist to help people get through the process safely while minimizing the risks involved. Professional medical help is always needed to safely withdraw from Xanax.