Xanax is a prescription medication used to treat anxiety and panic disorders, and it is sometimes prescribed to treat alcohol withdrawal and insomnia. The generic name of this medication is alprazolam, and it is one of the medications in the family of benzodiazepines, which are central nervous system (CNS) depressants. These drugs interact with GABA receptors in the brain to induce a calming effect.
In large doses, benzodiazepines can induce a relaxed euphoria, or “high,” which can become addictive. If a person takes Xanax or another benzodiazepine as prescribed for more than two weeks, they can still develop a physical dependence on or tolerance to the medication, even if they are not addicted to it.
In some cases, a person can experience side effects from taking Xanax. This is especially likely if the person has taken Xanax for a long time or has taken a large dose of it for recreational reasons. Potential side effects of Xanax include:
- Impaired coordination
- Memory problems
- Decreased concentration
- Muscle weakness
- Slurred speech
- Sudden anxiety, aggressiveness, or mood swings
- Delusions or hallucinations
Although prescription drug addiction has increased in the last 20 years, and benzodiazepines like Xanax are some of the most abused drugs, the Drug Enforcement Administration classifies Xanax as a Schedule IV medication. This means that the drug has a low rate of potential for abuse or risk of dependence, so it is often treated as completely safe.
How Xanax Addiction Begins
People who are most likely to develop an addiction to Xanax are people who have received a prescription for this medication. Addiction is a disease of the brain and it is not fully understood, but for people who struggle with this condition, exposure to a substance of abuse like Xanax can lead to addictive behaviors. Additionally, physical dependence on the medication may lead to withdrawal symptoms when the individual stops taking Xanax, and that can lead to addictive behaviors in order to prevent those symptoms. Addiction is especially likely for people who receive high-dose prescriptions, because they could experience euphoric effects, not just calming effects.
Alprazolam, especially under the brand name Xanax, is one of the top three most frequently found benzodiazepines on the black market, according to the DEA. Because Xanax has a short half-life, it begins to affect the body quickly, but the effects fade away quickly. This can rapidly lead to a cycle of abuse.
People who abuse Xanax often abuse other drugs, especially alcohol, prescription painkillers, cocaine, and heroin. According to the American Family Physician (AFP) website, 80 percent of benzodiazepine abuse occurs alongside abuse of other drugs.
People with alcohol abuse problems can be exposed to Xanax in a rehabilitation program or through a medical professional who is trying to ease symptoms of alcohol withdrawal. According to AFP, studies show that between 3 and 41 percent of people struggling with alcohol abuse also abused benzodiazepines at some point in their lives. Seizures are a potential risk with alcohol withdrawal, and benzodiazepines are often prescribed to reduce that risk. Alcohol is also a CNS depressant, however, so a person who struggles with alcohol addiction might receive some of the same benefits from benzodiazepine use. This can lead to relapse and concurrent abuse of alcohol and Xanax, which increases the risk of overdose and death.
Opioid abuse is another factor for benzodiazepine abuse, according to the Substance Abuse and Mental Health Services Administration’s DAWN report. Opioid painkillers are CNS depressants, and abusing opiates and benzodiazepines together can compound the effects of both medications. People who abuse these drugs together aim for a more intense euphoria, but they put themselves at a much greater risk of overdose and death. The report noted that, between 2005 and 2011, there were 943,032 visits to the emergency room due to benzodiazepines like Xanax either alone, or in combination with opiates or alcohol. When Xanax was combined with alcohol and/or opioid drugs, admitted patients were 20 percent more likely to suffer serious outcomes, such as long-term hospital stays or death, compared to those who overdosed on benzodiazepines alone.
Teenagers are at a greater risk of abusing prescription drugs, including Xanax. A survey conducted by the Centers for Disease Control found that one in five high school students has abused some kind of prescription medication, typically without their own prescription. The survey specifically investigated prevalence of OxyContin, Percocet, Vicodin, Ritalin, and Xanax abuse. There was no difference in prescription drug abuse by gender, but white students were more likely to abuse prescription drugs (23 percent of those surveyed had abused medications).
Risks of Xanax Abuse and Addiction
Benzodiazepines by themselves rarely produce a fatal overdose, but people who abuse benzodiazepines tend to do so in combination with other drugs, which increases the risks of serious, long-term side effects, and death.
- Blurred vision
- Hallucinations and delirium
- Physical weakness and lack of coordination
- Ataxia, or the inability to control the body’s movements
- Respiratory depression
In many cases of benzodiazepine overdose, doctors will likely give the person a dose of flumazenil, which is specifically a benzodiazepine antidote; however, this medication can cause withdrawal symptoms, particularly seizures, in people who have struggled with Xanax abuse for a long time. Additionally, flumazenil is less effective in polydrug overdoses, such as overdoses involving Xanax and alcohol, or Xanax and opioid painkillers.
People who have abused Xanax or other benzodiazepines for a long period of time, and developed a tolerance to these medications, are also more likely to suffer benzodiazepine withdrawal syndrome. This is a cluster of withdrawal symptoms that can last for weeks, and some of the symptoms are physically dangerous. Symptoms include:
- Rebound insomnia
- Nausea and vomiting
- Increased anxiety and panic attacks
- Weight loss
- Heart palpitations
- Muscle pain and stiffness
- Perceptual changes, hallucinations, and delusions
Typically, Xanax withdrawal symptoms appear roughly 3-4 days after the person’s last dose, and they can last up to two months. It is important for people who have struggled with Xanax addiction to get professional help to safely withdraw from these medications. Going “cold turkey” can lead to benzodiazepine withdrawal syndrome, which can be life-threatening, or relapse.
Real Help through Treatment
To safely detox from a benzodiazepine like Xanax, consult a medical professional. A doctor will likely help the person detox from Xanax via a tapering regimen. This can include switching to a long-acting benzodiazepine, since Xanax is a short-acting benzodiazepine, to reduce withdrawal symptoms and help the individual get out of the habit of taking several doses. Diazepam (Valium) or clonazepam (Klonopin) are the most commonly prescribed long-acting benzodiazepines in this situation. The prescribing doctor may also just taper existing doses of Xanax over time.
Short-acting benzodiazepine tapering schedules often cover 7-10 days. AFP recommends this regimen using Valium as the replacement benzodiazepine, but it is most important for the individual to speak with their doctor regarding tapering and what treatments might work best. Individuals should never attempt a tapering schedule on their own; medical supervision is required.
Therapy makes up the foundation of Xanax addiction treatment, and it will address the psychological issues related to substance abuse. Treatment must be customized, and any co-occurring mental health issues must be simultaneously addressed. Though the path to wellness can be bumpy at times, complete recovery is possible for every person who
struggles with addiction.