What is Xanax (Alprazolam)?
Xanax, a brand name for the drug alprazolam, is a widely prescribed benzodiazepine medication.1,2
In this article, we will discuss common uses of Xanax, its side effects, health risks, and finally, how to get help if you are experiencing signs and symptoms of misuse or addiction.
What is Xanax Used For?
Reasons to take Xanax is because it is commonly used for short-term symptomatic treatment for specific anxiety disorders.1 In 2017, U.S. pharmacies dispensed approximately 45 million alprazolam prescriptions, making it one of the most commonly prescribed anti-anxiety medications.2
Xanax is typically taken orally and comes in tablet form.1
In clinical practice, benzodiazepines such as Xanax are considered a second-line or short-term option for the treatment of anxiety due to their risk of side effects and potential for misuse and addiction.3
Misuse of Xanax includes:2,4
- Using the drug for its euphoric effects.
- Taking excessive doses of Xanax or using it more often than prescribed.
- Taking someone else’s prescribed Xanax or purchasing Xanax on the black market.
- Using Xanax to enhance the effects of other drugs or to relieve their unwanted effects (e.g., insomnia caused by stimulant use).
Side Effects of Xanax
Xanax side effects are most often an extension of the drug’s primary sedative function, such as increased drowsiness or light-headedness.1
Common Xanax side effects include:1
- Speech defects.
- Memory impairment.
In rare cases, Xanax side effects may include paradoxical reactions such as:1
- Increased muscle spasms.
- Disturbances in sleep.
- Increased mania in people with pre-existing mood disorders.1
Is Xanax Addictive?
Yes, Xanax is potentially addictive.5 There are several reasons why people that use Xanax can become addicted.
Chronic use can cause powerful dependence on Xanax. Dependence is a physiological adaptation wherein the person’s body becomes so used to Xanax being present in the system that when they quit or reduce their use, withdrawal symptoms emerge.5
Withdrawal symptoms from Xanax can be very unpleasant and, in some instances, dangerous. Withdrawal can cause someone to continue misusing Xanax to avoid these symptoms.6
Additionally, benzodiazepines are often someone’s secondary drug of use (they combine Xanax with other substances such as alcohol, opioids, or other benzodiazepines.7 Facing multiple drug dependencies can further complicate the withdrawal process. Patients with prior history of drug misuse or polysubstance use (i.e., using more than one substance simultaneously) are at increased risk for benzo misuse and dependence.2
Xanax—like most addictive substances—also increases levels in the brain.5 Researchers believe that the increase of dopamine from drug use serves to reward or reinforce continued use and thereby increases the likelihood of developing an addiction.8
Signs of Xanax Addiction
The clinical term for Xanax addiction is “sedative use disorder” and is defined by the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as “a problematic pattern of Xanax use leading to significant impairment or distress.”6
Sedative use disorder must be diagnosed by a medical professional with training in substance use;6 however, knowing the signs can be beneficial to anyone that uses Xanax or knows someone that takes it.
Exhibiting 2 or more of the following 11 criteria within a 12-month period would result in a diagnosis of sedative use disorder:6
- Taking Xanax in more significant amounts or for a longer period than originally intended
- Having the desire to quit or cut back on Xanax use or making failed attempts to do so
- Spending a lot of time trying to obtain Xanax, using it, or recovering from its effects
- Experiencing cravings or urges to use Xanax
- Using Xanax despite negative consequences in one or more major areas of one’s life, such as work or school
- Using Xanax despite significant problems in personal relationships with friends, family, or partners
- Giving up important recreational activities because of Xanax use
- Using Xanax in physically dangerous situations, such as while driving
- Using Xanax despite knowing that it has caused or worsened physical or psychological health problems
- Developing a tolerance, meaning that the desired effects of Xanax become blunted and more and more Xanax is needed to achieve the same effect
- Experiencing withdrawal symptoms when Xanax use is ceased or reduced
Can you Overdose on Xanax?
Yes, but Xanax overdose is much more likely to occur when it is used in conjunction with other drugs, such as opioids or alcohol.9 In 2020, approximately 12,290 people died from an overdose involving benzodiazepines.4 Xanax overdose symptoms can be difficult to detect, as many people will be awake and present with near-normal vital signs.9
In some cases, Xanax overdose symptoms may also include: 9
- Slurred speech.
- Ataxia (poor muscle control).
- Altered mental status.
Combining Xanax with other central nervous system (CNS) depressants or opioids can weaken someone’s pulse, slow their breathing, and cause them to lose consciousness.10
If you believe that you or a loved one are experiencing a Xanax overdose, contact 9-1-1 immediately and:4,10
- Administer Narcan (naloxone) if you suspect opioids were involved. Naloxone is a fast-acting medication that can reverse an opioid overdose. Please note that administering Narcan does not eliminate the need for emergency medical attention.
- Try to keep them awake and breathing.
- Turn the person on their side to prevent them from choking.
- Wait with them until emergency services arrive.
Dangers of Mixing Xanax with Other Substances
Mixing alcohol and benzodiazepines can also worsen pre-existing psychiatric conditions and cause grave injury to different bodily organ systems (e.g., cardiovascular, gastrointestinal, hepatic, neurological).13
Studies have shown that people who use opioids and benzodiazepines simultaneously are admitted to the emergency department or hospital at higher rates for drug-related reasons. In 2016, 16% of fatal opioid-involved overdoses also involved benzodiazepines, and one North Carolina study found that patients prescribed both opioids and benzodiazepines are 10 times more likely to suffer a fatal overdose than individuals who were prescribed opioids alone.12
Mixing stimulants and benzodiazepines is also highly dangerous. This combination can make someone feel like the drugs are not affecting their body as strongly as they really are, leading them to take higher doses and increasing their overdose risk.10
Polysubstance use can also complicate withdrawal symptoms, as the body is withdrawing from multiple drugs at the same time.14
Xanax Withdrawal Symptoms
Xanax withdrawal symptoms may include:1,6
- Heightened sensory perception.
- Difficulty concentrating.
- Appetite and weight loss.
- Rapid heart rate.
- Hand tremors.
- Nausea or vomiting.
- Visual, tactile, or auditory hallucinations.
- Psychomotor agitation.
- Grand mal seizures.
Xanax withdrawal typically begins 6-8 hours after stopping Xanax use. Symptoms usually peak by the 2nd day and greatly improve by the 4th or 5th day.6
Some patients may experience post-acute withdrawal symptoms (PAWS), in which low-intensity withdrawal symptoms may continue for weeks or months.15
Xanax Addiction Treatment Options
In some cases, medical detox may be necessary for quitting Xanax. Medical detox can help to mitigate withdrawal symptoms and to make the process safer as well as more comfortable.14
Medical detox for Xanax dependence often involves tapering doses of a long-acting benzodiazepine to reduce the risk and severity of seizures and other dangerous symptoms of Xanax withdrawal.14
Detox is just the first step in recovery, and most people need continued treatment for long-term sobriety. Continued care typically includes a combination of behavioral therapy, peer support, psychoeducation, and other interventions that can be practiced in various settings.16,17
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