Xanax Addiction: Dangers and Risks of Its Abuse
Doctors commonly prescribe Xanax® to patients with anxiety and panic disorders, generalized anxiety disorder (GAD), and social anxiety disorder. Xanax comes with side effects and carries a high risk of abuse and addiction. It’s important to use it as your doctor orders.
Learn about the side effects of Xanax, Xanax withdrawal, and treatment for Xanax addiction.
How Does Xanax Work?
Xanax is the brand name for the prescription drug alprazolam. It’s part of a group of drugs called benzodiazepines. Doctors usually prescribe benzos as treatment for anxiety. Benzos act on the brain and central nervous system (CNS) and produce a calming or sedating effect.
Xanax boosts the effects of a neurotransmitter (chemical) in your brain called gamma-aminobutyric acid (GABA). GABA reduces tension, anxiety, and panic by slowing down the activity of nerve cells in the brain. By working on the central nervous system, drugs like Xanax offer rapid relief for anxiety disorder symptoms. Ideally, Xanax is paired with behavioral therapy like cognitive behavioral therapy (CBT). The effectiveness of Xanax depends on the individual and the dosage.
What Are the Risks of Xanax?
The U.S. Food and Drug Administration approved Xanax in 1981, but its use has spiked in the last few years.1 The effects of Xanax can be dangerous when other drugs are used in combination. Xanax can also be physically and psychologically addictive. Taking Xanax under medical supervision can reduce these risks.
Some risks of Xanax include the following:
Combining Xanax With Other Drugs
The most serious risk to people taking Xanax is what can happen when it’s combined with other drugs and alcohol. Taking Xanax with other GABA-inducing drugs such as opiates, hypnotics, barbiturates, or alcohol raises the risk of overdose exponentially. Your central nervous system gets bombarded with billions of messages to slow down, which can cause a dangerously slow heartbeat, cessation of breathing, and even death.2 This is particularly alarming considering 49% of teens take Xanax with at least one other drug, including alcohol.3
The National Institute on Drug Abuse published data showing that deaths from overdoses involving benzos like Xanax quadrupled between 2002 and 2015.4 You can put yourself at risk for Xanax overdose if you take larger than prescribed amounts. This risk also increases when you combine large quantities of Xanax with other substances like alcohol and opioids.
Xanax is 10 times stronger than Valium® (another benzo) and should never be taken in amounts other than indicated by your doctor.5 More than 30% of overdoses involving opioids also involved benzos such as Xanax.6 Benzos are involved in approximately one-third of intentional overdoses or suicide attempts.7,8
If taken as prescribed by a doctor, Xanax can help conditions like anxiety and insomnia, but those who abuse it often do so because it’s a fast-acting sedative and has relaxing effects.
A study published in the journal Psychiatry showed that general practitioners wrote 55% of all prescriptions for benzos.9 According to two clinical studies, most people who are prescribed Xanax do not develop a substance use disorder, but it is fairly common for Xanax users to become physically dependent on the prescription drug.10 When you have a physical dependence, your body has become accustomed to the drug you’re taking, and you need larger and larger amounts to get the desired results.
Even if you take Xanax for a short period of time at a prescribed dose, there’s a risk of psychological and physical dependence. That said, data suggests the risk of dependence and its severity appear to be more pronounced in people treated with doses of more than 4 mg/day and for more than 12 weeks.
If you take benzos for long periods of time, you’re likely to experience several symptoms, including:
Poor balance or coordination
Loss of sex drive
Appetite or weight changes
Swelling in hands and feet
A limited number of studies have analyzed factors that might increase people’s risk of abusing or becoming addicted to benzos. A Norwegian study found a greater number of people who started taking Xanax became excessive users compared to those using any other benzo.11
A 2018 study analyzing opioid overdoses in Medicare Part D recipients uncovered troubling prescribing patterns. On the day of or leading up to the overdose, 20,665 of 71,248 people with an opioid prescription were also using benzos. An estimated 14,132 of 20,665 concurrent users (68.4%) had more than 180 days of overlapping supplies of both medications. Researchers found simultaneous benzo and opioid use during the first 90 days was associated with a fivefold increase in the risk of opioid overdose. This study highlights why doctors need to closely monitor individuals taking Xanax and opioid medications.12
Those abusing Xanax may take it in pill form or inject it after crushing the pill. Xanax does not fully dissolve in water. This means it can cause severe damage to the arteries when it’s injected.
What is Xanax Withdrawal Like?
The severity of Xanax withdrawal symptoms depends on dosage and how long you’ve been taking the drug. Some people who’ve been taking Xanax for even short periods at recommended doses (e.g. 0.75 to 4 mg/day) have reported withdrawal symptoms, including seizures. The physical and psychological withdrawal symptoms of Xanax may include:13
Dissatisfaction with life
Hypersensitivity to light, sound, touch, and taste
If you’ve been taking Xanax with alcohol or other drugs, Xanax withdrawal symptoms can be more severe and even deadly.
How Do You Treat Xanax Addiction?
If you’ve been abusing Xanax, talk to a doctor before quitting abruptly. A sudden decrease in dosage can lead to withdrawal symptoms like the ones listed above. If you’ve been abusing alcohol or other drugs as well, detoxing on your own can be dangerous. Xanax detox should be medically supervised, and the right course depends on how much Xanax you’ve been abusing and for how long. Medical detox may involve a taper, gradually reducing your dose over several days or weeks to prevent intense withdrawal symptoms and risk of seizure. Alternatively, your drug rehab team may prescribe less harmful, longer-acting benzos for a period of time to ease your Xanax withdrawal. Doing this under the care of a medical professional will help to keep you safe both physically and mentally.
Effective Xanax addiction treatment goes beyond drug detox. For the best chances of recovery, it’s necessary to address the underlying reasons behind your addiction, not just the symptoms. Entering residential drug rehab after medical detox can give you the space you need away from triggers and teach you new coping skills, so you can handle your anxiety or panic disorder without depending on drugs.
Individual therapy and group therapy, relapse prevention training, and continued involvement in support groups will help you learn to manage any underlying mental health disorders. These approaches can also allow you to heal from any trauma or emotional issues that contribute to substance abuse.14
Miller L. Listening to Xanax. How America learned to stop worrying about worrying and pop its pills instead. New York Magazine. http://nymag.com/news/features/xanax-2012-3/ March 18, 2012. Accessed February 3, 2019.
Alprazolam (Xanax). NAMI website. https://www.nami.org/Learn-More/Treatment/Mental-Health-Medications/alprazolam-(Xanax). Updated January 2019. Accessed February 13 2019.
20 Profound Xanax Addiction Statistics. Health Research Funding website. http://healthresearchfunding.org/20-profound-xanax-addiction-statistics/ Published February 1, 2015. Accessed February 3, 2019.
Antianxiety drugs – often more deadly than opioids – are fueling the next drug crisis in the US. CNBC website. https://www.cnbc.com/2018/08/02/antianxiety-drugs-fuel-the-next-deadly-drug-crisis-in-us.html. Published August 3 2018.. Accessed February 3 2019.
Xanax misuse: doctors warn of ’emerging crisis’ as UK sales rise. Guardian website. https://www.theguardian.com/society/2018/feb/05/xanax-misuse-uk-dark-web-sales-health Published February 5, 2018. Accessed February 3, 2019.
Benzodiazepines and Opioids. National Institute on Drug abuse website. https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids Updated March 2018. Accessed February 3, 2019.
Top 25 Psychiatric Medication Prescriptions for 2013. Psych Central website. https://psychcentral.com/lib/top-25-psychiatric-medication-prescriptions-for-2013/ Updated February 4, 2018. Accessed February 3, 2019
Sun EC, Dixit A, Humphreys K, et al. Association Between Concurrent Use of Prescription Opioids and Benzodiazepines and Overdose: Retrospective Analysis. BMJ 2017; 356:760-767.
Cascade, E. & Kalali A. (2015). Use of Benzodiazepines in the Treatment of Anxiety. Psychiatry, 5(9): 21-22. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2687085/
How to Recognize and Treat Xanax Addiction. Healthline website. https://www.healthline.com/health/addiction/xanax-addiction. Published June 25 2018. Accessed February 13 2019.
Fride Tvete I, Bjørner T, Skomedalc T. Risk factors for excessive benzodiazepine use in a working age population: a nationwide 5-year survey in Norway. Scand J Prim Health Care. December 2015; 33(4): 252–259.
Hernandez, I, He, M, Brooks MM, Zhang, Y. Exposure-Response Association Between Concurrent Opioid and Benzodiazepine Use and Risk of Opioid-Related Overdose in Medicare Part D Beneficiaries. JAMA Network Open. 1.e180919.10.1001/jamanetworkopen.2018.0919.
Pétursson H.The benzodiazepine withdrawal syndrome. Addiction. 1994 Nov; 89(11):1455-9. Review.
Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152–155. http://doi.org/10.18773/austprescr.2015.055