Xanax is a brand name for alprazolam. Doctors prescribe the medication to treat anxiety, depression, panic disorders and phobias. It’s part of the benzodiazepine family, which is a group of psychoactive drugs that affects the central nervous system. The drugs slow brain activity, causing relaxation and drowsiness.
That’s why a lot of people misuse Xanax. They want relief from social anxiety, and Xanax helps them wind down. Others desire a loose, goofy feeling that’s similar to how people feel when they get drunk. Like alcohol, Xanax is a depressant. In high doses, both substances make people feel carefree.
But like alcohol abuse, Xanax abuse is dangerous. It can lower a person’s ability to make responsible decisions. Many people pass out after taking too much Xanax. They become vulnerable to sexual assault, theft and other transgressions.
Xanax is one of the most addictive benzodiazepines when not properly used. People who misuse the drug experience unpleasant symptoms when they stop taking it. They can experience anxiety, trouble sleeping and unhappy thoughts. Those feelings make quitting difficult.
Withdrawal from long-term Xanax abuse can be deadly. To recover from Xanax addiction, people should taper off the prescription drug by taking lower doses over the course of several days or weeks. Physicians and addiction professionals should oversee the tapering process to ensure safety.
Doctors like prescribing Xanax because it has a short half-life, meaning its effects wear off more quickly than long-acting benzodiazepines, such as Valium (diazepam). People who need the drug can take it for the short-term treatment of anxiety or panic attacks without disrupting their entire day.
“Xanax tends to be a little more potent than other benzos,” Dr. Berney Wilkinson, a Central Florida psychologist, told DrugRehab.com. “It is one of the ‘fast-acting’ benzos. You start to feel the effects within 30 to 45 minutes. Unlike Valium and other benzos, Xanax leaves your system pretty quickly because it has a shorter half-life. While people who take other benzos complain of feeling hungover or emotionally flat, Xanax does not seem to create such issues.”
People who take Xanax usually feel some effect within 10 to 15 minutes. Peak effects begin after 30 minutes, and the effects usually wear off after six hours.
When Xanax is taken as prescribed, common side effects include:
Xanax is safe for most adults to consume. Benzodiazepines rarely cause deadly overdoses when taken alone. But the drugs can cause life-threatening side effects when taken with other depressants, such as alcohol or opioids.
About 75 percent of deadly benzodiazepine overdoses involve opioids, according to a 2015 study in the American Journal of Preventive Medicine.
Taking Xanax without a prescription is risky. Individuals who take it recreationally often mix it with alcohol, marijuana or other drugs. Mixing drugs like alcohol and Xanax is dangerous because it’s difficult to know how the drugs will interact with one another. The drugs can make people pass out or breathe at a dangerously slow rate.
It’s even more dangerous to take Xanax that you buy on the street because it’s impossible to know exactly what you’re buying. A pill labeled Xanax could actually be a stronger benzodiazepine or a totally different drug.
Doctors usually start patients who have never taken benzodiazepines on low doses of Xanax, such as 0.25 milligrams or 0.5 milligrams. Everyone who takes the drug regularly will develop tolerance, meaning they’ll require higher doses to feel the same therapeutic effect. Patients with a high tolerance to Xanax may require doses greater than 4 milligrams per day, increasing their risk for dependence.
Dependence occurs when a person experiences physical or mental withdrawal symptoms when they stop taking a substance.
Xanax withdrawal symptoms include:
Being dependent on Xanax is not necessarily a bad thing. People who need anti-anxiety medication to control anxiety or panic disorders may be dependent on Xanax and never experience negative consequences. As long as they communicate with their doctor about their treatment, they can develop a plan to discontinue Xanax when necessary.
In many cases, people addicted to Xanax believe they need it to relieve anxiety. But the anxiety that they experience when they stop taking the drug is actually a symptom of Xanax withdrawal. Many Xanax users refer to this phenomenon as rebound anxiety.
Large doses or misuse of Xanax can lead to dangerous side effects, including:
Dependence becomes a problem when individuals take Xanax for nonmedical reasons or when they don’t communicate with their doctor. Some people take the medication recreationally to feel carefree or overly relaxed.
But people with a valid prescription may develop an addiction to Xanax because they don’t know how to stop taking the drug on their own. They continue taking it to avoid withdrawal.
Some people get addicted to Xanax quicker than others. Those who take large doses of Xanax regularly are more likely to develop a substance use disorder than individuals who take low doses of the drug infrequently.
Taking a benzodiazepine such as Xanax for longer than three or four weeks can lead to dependence. Dependence turns into addiction when a person keeps taking the drug despite negative consequences.
People addicted to Xanax compulsively seek the drug. They may visit multiple doctors to get Xanax prescriptions or buy it on the street. They may also turn to alcohol or other depressants when Xanax isn’t available.
According to a 2015 medical journal article about managing benzodiazepine misuse, doctors can limit alprazolam prescriptions to a one- to two-week supply to prevent patients from developing a dependence to the medication.
Upjohn Laboratories introduced Xanax in the United States in 1981. Unlike Valium, the most popular anti-anxiety drug during the 1970s, Xanax was marketed as the first drug to reduce panic attacks.
Today, Xanax is one of the most popular psychiatric drugs and one of the most prescribed medications in the United States. As prescriptions increased, so did adverse events and overdose deaths associated with the drug.
Less than one out of every 200,000 adults died from a benzodiazepine overdose in 1996. More than six out of every 200,000 adults died from a benzo overdose in 2013, according to a 2016 study.
“Xanax is misused because of its potency and price,” Wilkinson said. “There are reports of people purchasing a 30-day supply of Xanax from the pharmacy for less than $3. You cannot buy a six-pack of beer for that price.”
In 2015, more than 17 million people used Xanax and generic alprazolam products. More than 4 million of those people misused the products, according to the National Survey on Drug Use and Health. That’s more than the combined number of people who misused lorazepam (Ativan), clonazepam (Klonopin) and diazepam (Valium) products.
The majority of people who misuse Xanax are between the ages of 18 and 25. A small percent of those young adults are introduced to the drug in high school. Xanax is more than twice as popular among high school seniors as the next most popular benzo.
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Alprazolam has a half-life of 12 hours, which means it takes 12 hours for half of the dose to clear the bloodstream. Withdrawal symptoms can be felt within six hours of the last dose.
“Alcohol and benzos are the most potentially serious withdrawals because you can have seizures,” Dr. Kevin Wandler told Drug Rehab.com. Wandler is the chief medical officer of Advanced Recovery Systems, which operates rehab facilities across the United States.
Xanax withdrawal symptoms begin to peak after 12 hours. The most intense withdrawals last for up to four days. Withdrawal from long-term Xanax addiction can last for up to two weeks, but symptoms slowly improve after the first few days.
Tapering off Xanax without medical supervision can be dangerous. Detox facilities or outpatient treatment centers can help individuals ease withdrawal symptoms.
“For the benzos, we’re going to give you a different class of drug and anticonvulsants so you don’t seize,” Wandler said. “It can take 14 days to get off benzodiazepines, and we’re watching the client 24/7.”
While monitoring clients, treatment centers slowly taper them off Xanax by gradually reducing their daily dosage. Long-acting benzos, such as Klonopin or Librium (chlordiazepoxide), may be substituted for Xanax during tapering. Urine screenings, which are sometimes used during treatment to encourage abstinence, can detect Xanax for up to a week after last use.
Buspirone may be used to combat benzodiazepine withdrawal. Flumazenil can also be used to treat withdrawal symptoms in long-term benzodiazepine users. However, flumazenil could worsen symptoms in patients with a history of seizures or head injuries.
Detox is followed by proven therapies, such as cognitive behavioral therapy or family-based therapies. Therapy can help individuals develop healthy ways to relieve anxiety and reduce a person’s need for anti-anxiety medications.