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Xanax Addiction

Benzodiazepines like Xanax provide a tranquilizing effect on the central nervous system, encouraging muscle relaxation and lowering anxiety levels. It is commonly abused due to its euphoric effects and the extremely easy access many addicts have to the drug.

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What Is Xanax?

The prescription drug Xanax is a brand-name prescription medication. Xanax tablets contain the chemical Alprazolam, a member of the benzodiazepine class of drugs primarily utilized in the treatment of anxiety disorders.

It is believed that excessive nerve activity may be the cause of anxiety and other psychological disorders. Studies have shown Alprazolam affects a neurotransmitter whose purpose is to suppress the activity of nerves. This is why Xanax is often employed to enhance this nerve suppression and provide short-acting relief to sufferers.

Xanax Addiction Video Thumbnail

In this informative video, Dr. Kent Hoffman, co-founder of AddictionHelp.com and a physician board-certified in addiction medicine, delves into the complexities of Xanax.

Duration: 15 min 03 sec

[00:00:00] Dr. Hoffman: My name is Dr. Kent Hoffman. I’m an osteopathic physician. I’m board-certified both in addiction medicine and family practice. I have been board-certified in family practice for about 30 years, and I’ve been board-certified in addiction medicine for about 13 or 14 years now, and I’ve been practicing addiction medicine for approximately 20 years.

[00:00:25] What Xanax is typically prescribed for would be anxiety panic disorders. Um, and technically, it’s a benzodiazepine. So it falls within the sedative-hypnotic class of drugs. Way back in the day, benzodiazepines were actually what they thought to be a very much safer alternative to barbiturates.

[00:00:45] They Were kind of, which were their precursors in the sedative-hypnotic class. And I think the first one was Librium, which is chloridase epoxide. That was initially brought to the market in about 1960. Now we [00:01:00] predominantly use it for alcohol detox and things like that. It’s not used so much because it has such a long half-life.

[00:01:08] It’s a period of time that the medication, there’s half of it left in your system. So they’re much, uh, shorter, you know, cleaner drugs, uh, if you want to look at it that way. There’s, uh, several off-label uses that Xanax is prescribed for, and those would be things like, uh, seizure disorder, perhaps. They use it sometimes as a preoperative medicine, although typically, Valium, Versed (midazolam)would be used for those things.

[00:01:42] Benzodiazepines prior to surgeries and, or procedures would be, helpful in calming people down, but they also act synergistically with some of the narcotic medicines such as, uh, pain medications. For example, with, uh, Colonoscopy is one of the common [00:02:00] cocktails would be Versed (midazolam), which has kind of an amnesiac effect and calms you down.

[00:02:06] And then either fentanyl or, you know, one of the other opioid medications. Xanax actually within the body stimulates the GABA receptors. And GABA is like our brain and our body’s natural valium. And so by stimulating these receptors, it gives you, you know, a valium like response. That would be, you know, you’d be more chill, more relaxed, less anxious.

[00:02:34] If you’re taking the Xanax consistently and, you know, with prolonged use, you will develop tolerance. And so, whereas initially, A given dosage might, uh, you know, really chill you out or put you to sleep, even sedate you, uh, later on, you’ll notice very few effects. Um, again, it depends on how high the anxiety level is compared to how high the dosage is.[00:03:00]

[00:03:00] And if you meet those two, then you shouldn’t get a lot of sedation with the medication. If, however, you’ve had very little anxiety, and you’re taking a high dose of Xanax. Well, then you’re going to be very sedated. If you’re wondering what Xanax looks like with the generic medications in this day and age, it can honestly look in a variety of shapes.

[00:03:22] And historically, the lower doses were round tablets. The one milligram was football-shaped, so the kids on the street would call them footballs. Then, the two-milligram divi dose bar is shaped like a bar with four demarcations in it. So you can break it to one milligram, you can break it to a half milligram, or one and a half milligrams.

[00:03:54] And on the street, the kids call those, uh, you know, ladders, school buses, bars, a variety of things. For a safer alternative, moving out of the benzodiazepine class, which are all potentially addictive, moving to either a longer half-life benzodiazepine, something like a Librium, or, you know, some people consider Klonopin to be safer.

[00:04:20] I’m not sure I believe that so much, but, uh, otherwise, there’s a variety of other medications, uh, SSRI drugs that can be used for, um, Anxiety, which are things like, uh, Zoloft and Prozac and Paxil or, uh, medications, uh, you know, such as Gabapentin has been used for anxiety. Buspar is a nonnarcotic medication, a nonaddictive solution to anxiety.

[00:04:50] So there are a lot of different medications that might be safer to use for anxiety. There are some people who take Xanax every day and use it long-term. [00:05:00] Uh, I think its greatest benefit would probably be as a short-term medicine for acute situations. A death in the family, seeing something extremely traumatic, maybe a car accident, things such as that.

[00:05:16] Because it has a pretty much immediate onset. And about a six-hour half-life. So, uh, it’s potentially, you know, our brain likes anything that takes off very quickly. Kind of like Learjet, much more than something that takes off slowly like a 747. Xanax starts at dosages as low as 0. 25 milligrams.

[00:05:39] Then there’s 0. 5 milligrams. Then there’s 1 milligram. And then finally, 2mg, the bars or the school buses, as we mentioned. So, 1mg is a relatively high dose, and of course, it depends on how many times a day you take it. So as far as overdose is concerned, Xanax, [00:06:00] uh, certainly, depending on what your tolerance is, um, doses as low as, you know, 4 or 6mg would perhaps cause an overdose.

[00:06:10] In general, the benzodiazepines, In and of themselves, when only taken by themselves, uh, cause rare, infrequent overdoses. It’s more common that they’re a, uh, part of a cocktail of drugs that will cause an overdose. You know, trying to take the edge off of cocaine. Uh, the cocaine high or, um, adding it to, uh, either alcohol, which is liquid benzodiazepine as far as our brain’s concerned, or otherwise opiates, which will increase the, uh, opioid levels.

[00:06:49] When I talk about alcohol being a liquid benzodiazepine or. The benzodiazepine being alcohol in a pill, um, they affect the exact same [00:07:00] GABA receptor in the brain. So, really, your brain can’t tell whether you just took a Xanax or an Ativan or whether you just did two shots of tequila. And the withdrawal is very much similar in both drugs, the, you know, alcohol and benzos.

[00:07:19] So the benzodiazepine and alcohol withdrawal are considered, in general, uh, some of the most potentially life-threatening withdrawal processes, because you can have things like seizures, uh, hallucinations, and then ultimately the DTs, which is the delirium tremens. And that’s really an ICU-like condition.

[00:07:41] So with any of the benzodiazepines, you definitely want to. Figure out what your tolerance was. If you were started on one of these medicines, I wouldn’t recommend driving or taking other medications and certainly not drinking alcohol with it because it’s just going to be amplified in [00:08:00] this effect. So you definitely would want to figure out, you know, what it does to you and how much it impacts you before you’d want to do any of the kind of normal lifetime activities, like take care of your kids or, you know, drive to work or drive them to school.

[00:08:16] Some of the side effects that are common to Xanax would be, you know, first of all, sedation. If you take a higher dose than you need for, say, anxiety, or if you’re taking it recreationally, um, certainly sedation is going to be a major side effect. Um, it’s not going to help, uh, sexual performance, certainly.

[00:08:37] Uh, otherwise, really it’s mostly sedation and, uh, you know, those types of side effects. It’s discouraged to take it while pregnant or breastfeeding because it’s actually, uh, can potentially have adverse effects on the baby. And of course you wouldn’t want to breastfeed while you’re on it because your baby, [00:09:00] um, could get some of the medication.

[00:09:02] It can certainly lower blood pressure. Um, the benzodiazepines in general, one of the potential side effects or adverse effects. is hypotension, uh, which is lowering of the blood pressure. In general, there are actually multiple studies that have looked at people who’ve been on the long-term benzodiazepines.

[00:09:22] I think the average was about 10 years and they showed that the cognitive abilities, uh, speech, uh, recall, you know, a variety of the, you know, what we call the executive function centers of the brain perform much more poorly. So it makes you kind of stupid. The whole family of benzodiazepines, as you can imagine, it is a family, but just like family members, um, each one is a little bit different.

[00:09:50] they’re a little bit different with respect to, um, how fast they take action, you know, their onset. They’re also different in as far as how [00:10:00] long they last, their half lives. So you can imagine that with a benzodiazepine that’s made to, for a sleeping pill to put people to sleep, it’s going to have to have very fast action and a relatively short half-life.

[00:10:15] With Xanax or other benzodiazepines, especially the short-acting ones. People can have withdrawal symptoms after being on it for just a couple of months. Most people will have withdrawal symptoms if stopping it abruptly if they’ve been on it for a year or longer. And again, getting back to the fact that benzodiazepine withdrawal and alcohol withdrawal are two of the most dangerous withdrawals to go through.

[00:10:42] You don’t want to stop these things cold turkey if you’ve been on them for any length of time, meaning months to years. So, Xanax is a drug of abuse because of its rapid onset and relatively short half-life. That’s what our brain likes, anything that takes off quickly and [00:11:00] impacts us quickly, especially when it’s combined with other, uh, drugs or alcohol.

[00:11:06] So people, uh, like the feeling of, uh, you know, being sedated, being down. Uh, sometimes they like The fact that, uh, it takes the edge off of cocaine or meth or other stimulants, Adderall. When combined with alcohol, you don’t have to be on much Xanax or drink much alcohol in order to be in blackouts. It’s almost a guaranteed blackout.

[00:11:33] Where you’ll be functioning, it’ll look like you’re just fine. Where the light’s on, and there’s nobody home. You know, you don’t remember it the next day. Typically they would abuse Xanax by taking it orally, snorting it. Um, rarely is it used IV. I just haven’t seen that a lot. Mostly, it’s an oral or [00:12:00] nasal insufflation, i.

[00:12:00] e. snorting it. One of the sure signs that you’re dependent Xanax is going to be that if you miss a day, or if you can’t get it off the street, or if your prescription runs out and you start to feel shaky and clammy and, uh, you know, antsy, those are all signs of early withdrawal for the benzodiazepines.

[00:12:26] And then it goes on to seizures, hallucinations, or at least potentially to seizures, hallucinations, and the DTs. Traditionally, when we do medication-assisted withdrawal, Aka detox, we use longer-acting benzodiazepines and try to bring them down slowly because, again, our brain likes anything that takes off quickly and is short-acting.

[00:12:51] So when we use longer acting benzodiazepines, things like Librium, uh, it helps to bring the brain in for a smooth landing. [00:13:00] Essentially, we use the same medications. To do detox from benzodiazepines, as we do from alcohol use, the thing that makes any treatment that just brings the brain in for a smooth landing.

[00:13:11] So people don’t have seizures, uh, hallucinations, other symptoms and withdrawal. So we try to get them to survive the early detox, but then really the heavy lifting is done and counseling group meetings, uh, AA, NA, things like that. A lot of people ask, how long does it take to detox from things like Xanax or other benzodiazepines?

[00:13:39] And it really depends on how short acting it is and the amount that people are taking. Again, if you’re on very low dose, it doesn’t take nearly as long. Or if it has a longer half-life, it doesn’t take as long to detox somebody. So the higher the dose, the shorter the acting, the [00:14:00] longer it’s going to take, um, to do detox, especially if you do that as an outpatient.

[00:14:05] Well, the most successful, uh, you know, programs for people who are addicted to Xanax would be, um, to use, to do an inpatient, uh, detox or an outpatient detox if they were an applicable candidate. And then go on from there and be able to do counseling. Potentially, uh, Inpatient treatment, um, especially if they were on very high doses where it would be dangerous or if they had ever had, previous Benzo withdrawal seizures, then it would be very dangerous to try to detox them as an outpatient.

[00:14:45] So you’d want to detox them as an inpatient and then frequently they would go on to their either a residential program, um, or say an IOP program.[00:15:00]

[00:15:03] ​

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Xanax Prescriptions

Xanax is used to treat the symptoms of anxiety, panic disorder, and anxiety associated with depression. The drug can also be used for sedation prior to surgery, muscle relaxation, alcohol withdrawal, drug-associated agitation, and insomnia.

  • Xanax (brand name)
  • Alprazolam (generic)

Effects of Xanax Use

Benzodiazepines like Xanax act on the central nervous system (CNS), produce sedation and muscle relaxation, and lower anxiety levels. Because of its long-term side effects, prolonged benzodiazepine use requires tapering off the drug should you wish to safely discontinue taking it.

The short-term side effects of Xanax may include:

  • Drowsiness
  • Dizziness
  • Irritability
  • Muscle weakness
  • Trouble concentrating
  • Poor balance or coordination
  • Blackouts (if taken with alcohol)

The long-term side effects of Xanax may include:

  • Depression and suicidal thoughts
  • Decreased appetite
  • Sudden change in behavior
  • Confusion
  • Slurred speech
  • Difficulty breathing
  • Significant physical dependence
  • Developing substance use disorder

Xanax Abuse and Addiction

Benzodiazepines are often abused due to their toxic effects and widespread availability.

As some of the most commonly prescribed central nervous system depressants in the United States, it is incredibly easy to gain access to them, along with similar drugs like Klonopin and Valium. Many people use benzos chronically, potentially leading to accidental or intentional overdoses.

Signs of chronic misuse or dependence can present as changes in appearance and behavior that affect relationships and work and cause abrupt changes in mood. Some may even develop symptoms that mimic what the drug is prescribed for in the first place, such as anxiety and insomnia.

Death and serious illness rarely result from Xanax abuse alone. Xanax is frequently abused by combining it with alcohol or other medications. This combination of Xanax and alcohol can be dangerous—even lethal.

Signs of a Xanax Addiction

Xanax abusers, like abusers of opioids, come in all shapes and sizes but generally display similar behaviors. The following symptoms can be red flags of someone suffering from substance use disorder due to abuse of Xanax.

  • Using the drug in a harmful manner
  • Withdrawal or problems with relationships due to drug use
  • Neglecting duties due to drug use
  • High drug tolerance (needing higher doses to achieve the same effect)
  • Withdrawal symptoms when the drug is reduced or stopped
  • Cravings for the drug
  • Spending excessive time obtaining, using, or recovering from the drug

Existing behavioral health issues and the period of time necessary to become addicted can have a large effect on the severity of these behaviors, so it’s important to catch these symptoms as soon as possible.

A person could be struggling long before the signs of addiction become apparent.

Xanax Overdose

Symptoms of a Xanax overdose may include:

  • Drowsiness
  • Dizziness
  • Paranoia
  • Delirium
  • Suicidal ideation
  • Lack of coordination
  • Difficulty breathing
  • Coma
  • Death

While typical side effects of Xanax can include some of these symptoms, instances of acute symptoms can indicate a dangerous overdose.

Xanax Withdrawal

When Xanax is stopped abruptly (aka “quitting cold turkey”), withdrawal symptoms can manifest as:

  • Anxiety
  • Insomnia
  • Depersonalization, derealization
  • Gastrointestinal reactions (e.g., nausea, vomiting, diarrhea, weight loss, decreased appetite)
  • Headache
  • Hypertension
  • Muscle pain and stiffness
  • Tachycardia (rapid heart rate)
  • Tremors

More serious withdrawal symptoms may include:

  • Convulsions
  • Catatonia
  • Delirium tremens (rapid onset of confusion)*
  • Hallucinations*
  • Psychosis
  • Seizures*
  • Suicidality

*These side effects are similar to the dangerous symptoms of alcohol withdrawal. This is because both benzodiazepines like Xanax and alcohol target the brain’s GABA receptors, causing relaxation. When these receptors no longer receive the chemical causing relaxation, the brain becomes overexcited and produces these effects.

In general, alcohol and benzodiazepine withdrawals are considered the most dangerous. These risks can be reduced with a gradual taper off the drug. It is vital that this tapering is done under the supervision of a physician to ensure safe discontinuation.

Xanax Addiction Treatment

While it may be a difficult road, safe recovery from Xanax addiction is possible with a combination of family support and the aid of medical professionals. Identifying the signs of addiction in yourself or a loved one is the vital first step, followed by finding help from a doctor or finding a treatment program that’s right for your situation.

Xanax Detox

Xanax addiction withdrawal symptoms can be dangerous, so it’s important that dosage is gradually decreased and a medical professional will monitor for any severe withdrawal symptoms. The duration of this period depends on many factors, such as the dose or length of use.

Xanax detox is generally performed at an inpatient facility due to the seriousness of Xanax’s withdrawal effects. However, if the patient has a minor addiction and no previous history of seizures, they may be cleared to safely detox in an outpatient setting instead.

Xanax Addiction Treatment

Many drug rehab centers offer programs to successfully and safely overcome substance abuse, ranging from inpatient rehab programs to intensive outpatient ones.

While the detox process focuses on mitigating dangerous withdrawal symptoms, an integral part of maintaining recovery from Xanax addiction is the use of behavioral therapy.

There are a variety of approaches, including:

These methods, combined with careful tapering off Xanax and support from friends and family, will assist you in creating motivational incentives to modify your behavior. You will learn to better understand the relationship between your thoughts, feelings, and behavior and your addiction.

Post-Treatment for Xanax Addiction

Many of those who exit inpatient care will pursue a continuing recovery program to maintain abstinence or stabilization and maintenance. Support groups can help assuage the shame that often comes along with addiction.

Alternative treatments that are non-addictive may also be implemented to assist in continued sobriety. Antidepressants, antipsychotics, antihistamines, beta-blockers, and anti-convulsants have all demonstrated efficacy in controlling anxiety and may be prescribed for future anxiety management.

Xanax Addiction Statistics

According to the National Institute on Drug Abuse (NIDA), in 2019, 16% of opioid-related deaths also involved benzodiazepines (such as Xanax.) Additionally, NIDA reports an increase of 67% in prescriptions for benzodiazepine medication since 1996.

In 2018, NIDA also gathered the following data:

Among past-year benzodiazepine misusers, 46.3% reported that the motivation for their most recent misuse was to relax or relieve tension, followed by helping with sleep (22.4%). About 5.7% reported “experimentation” as their main motivation for misuse, and 11.8% reported using them to “get high” or because of being “hooked.”

The data also showed that most misusers obtained benzodiazepines from friends or relatives, with only about 20% receiving them from their doctor.

Support for Friends and Family Members

Addiction to Xanax, like many other prescription drugs, can have a devastating effect on the lives of those around the addict. Your loved one must receive the help they need before further harm can be done to them and to you.

Confronting a loved one can be difficult, painful even, but you’re not alone in this task. There are many treatment centers and providers ready to jump in and assist with Xanax addiction treatment.

The sooner you help find solutions for them, the sooner they can start down the road to recovery and a happy, fulfilling life.

Xanax Addiction FAQs

Why is Xanax so addictive?

Xanax is a fast-acting benzodiazepine that can cause pleasant feelings of euphoria and sedation, giving it the ability to create huge changes in the brain in a short amount of time.

Are there non-addictive alternatives to Xanax?

Yes, there are many alternatives including antidepressants (SSRIs) and anti-anxiety prescriptions such as gabapentin and buspirone. A licensed mental health care professional can show you the available options and find the right one for you.

Is mixing Xanax with alcohol dangerous?

Yes, incredibly dangerous. Both Xanax and alcohol are depressants, meaning they slow everything down from your speech to your heart rate. Combining them only exaggerates these effects to a potentially dangerous degree.

To make matters even worse, Xanax and alcohol are both processed by the same enzymes in your liver, causing both substances to stay in your body even longer—more time for something to go wrong.

Kent S. Hoffman, D.O. is a founder of Addiction HelpReviewed by:Kent S. Hoffman, D.O.

Chief Medical Officer & Co-Founder

  • Fact-Checked
  • Editor

Kent S. Hoffman, D.O. has been an expert in addiction medicine for more than 15 years. In addition to managing a successful family medical practice, Dr. Hoffman is board certified in addiction medicine by the American Osteopathic Academy of Addiction Medicine (AOAAM). Dr. Hoffman has successfully treated hundreds of patients battling addiction. Dr. Hoffman is the Co-Founder and Chief Medical Officer of AddictionHelp.com and ensures the website’s medical content and messaging quality.

Jessica Miller is the Content Manager of Addiction HelpWritten by:

Editorial Director

Jessica Miller is the Editorial Director of Addiction Help. Jessica graduated from the University of South Florida (USF) with an English degree and combines her writing expertise and passion for helping others to deliver reliable information to those impacted by addiction. Informed by her personal journey to recovery and support of loved ones in sobriety, Jessica's empathetic and authentic approach resonates deeply with the Addiction Help community.

  1. Annette (Gbemudu) Ogbru, P. D. (2021, April 1). Benzodiazepines drug class: List, uses, side effects, types & addictions. RxList. Retrieved February 6, 2024, from https://www.rxlist.com/benzodiazepines/drug-class.htm.
  2. RxList. (2021, March 11). Xanax (Alprazolam): Uses, dosage, side effects, interactions, warning. RxList. Retrieved February 6, 2024, from https://www.rxlist.com/xanax-drug.htm.
  3. Casarella, J. (2021, March 9). Benzodiazepine abuse. WebMD. Retrieved February 6, 2024, from https://www.webmd.com/mental-health/addiction/benzodiazepine-abuse#1.
  4. Xanax side effects: Common, severe, long term. Drugs.com. (n.d.). Retrieved February 6, 2024, from https://www.drugs.com/sfx/xanax-side-effects.html#consumer.
  5. National Institute on Drug Abuse. (2021, February 3). Benzodiazepines and opioids. National Institute on Drug Abuse. Retrieved February 6, 2024, from https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids.
  6. National Institute on Drug Abuse. (2020, May 5). Research suggests benzodiazepine use is high while use disorder rates are low. National Institute on Drug Abuse. Retrieved February 6, 2024, from https://www.drugabuse.gov/news-events/science-highlight/research-suggests-benzodiazepine-use-high-while-use-disorder-rates-are-low

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