pills laying next to glass

Xanax Addiction: Dangers and Risks of Its Abuse

Xanax is commonly prescribed to treat anxiety and panic disorders, generalized anxiety disorder and social anxiety disorder. It carries a high risk for abuse and addiction. 

If you’re using Xanax other than as prescribed by a doctor, you could be at risk for Xanax addiction. Learn about the dangers of misusing Xanax as well as Xanax withdrawal sand Xanax addiction treatment.

How Does Xanax Work?

Xanax is the brand name for the prescription drug alprazolam, one of several in a group of drugs known as benzodiazepines. Benzos are typically used to treat anxiety. Benzodiazepines act on the brain and central nervous system (CNS) by producing a calming or sedating effect. The brand name medication as well as alprazolam boost the effects of a neurotransmitter (chemical) in the brain called gamma-aminobutyric acid (GABA). GABA reduces nervous tension and anxiety and panic by inhibiting postsynaptic neurons and slowing down the activity of nerve cells in the brain. By working on the central nervous system, these types of drugs offer rapid relief for anxiety disorder symptoms — usually within a week of beginning treatment. Ideally, treatment with Xanax is paired with behavioral therapy like cognitive behavioral therapy (CBT). The effectiveness of Xanax depends on the individual and dosage. 

What Are the Risks of Xanax?

Xanax was approved by the U.S. Food and Drug Administration in 1981, but has soared in popularity in the last few years.2 Xanax can be dangerous when combined with other substances and can also be physically and psychologically addictive. It’s important that Xanax use is medically supervised. Some risks of Xanax include

Combining Xanax With Other Drugs

The most serious risk to people taking Xanax is the effects when it’s combined with other drugs and alcohol. When taken with other GABA-inducing drugs such as opiates, hypnotics, barbiturates or alcohol, the risk of overdose rises 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.3 This is particularly alarming considering 49% of teens take Xanax with at least one other drug, including alcohol.4

Xanax Overdose

Deaths from overdoses involving benzodiazepines like Xanax, Librium, Valium and Ativan quadrupled between 2002 and 2015, according to data reported by the National Institute on Drug Abuse. You can put yourself at risk for Xanax overdose if you take larger than prescribed amounts or when combining large quantities 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 benzodiazepines such as Xanax.6 Benzodiazepines are involved in approximately one-third of intentional overdoses or suicide attempts.7,8

Xanax Addiction

Substance abusers take Xanax for its fast-acting sedative and relaxing effects. If taken as prescribed by a doctor, Xanax treatment can have benefits for conditions like anxiety and insomnia. 

A study published in the journal Psychiatry in 2008 showed that 55% of all prescriptions for benzodiazepines were written by general practitioners. According to two clinical studies, the majority of people who are prescribed Xanax by a medical professional do not develop a substance use disorder. However, it’s fairly common for Xanax users to become physically dependent on the prescription drug. When you have a physical dependence, your body has become accustomed to the drug and you need larger and larger amounts to get the intended results. 

Even if you take Xanax for a short period of time at recommended doses for short-term anxiety and anxiety disorders, there’s risk of dependence. Psychological dependence is well-documented with some users experiencing considerable difficulty reducing and discontinuing use of Xanax, especially at higher doses for extended periods of time. Data suggest the risk of psychological and physical dependence and its severity appear to be more pronounced in substance abusers treated with doses of more than 4 mg/day and in excess of 12 weeks. You’re at risk for several symptoms if you take benzodiazepines for long periods of time. These include:9

  • Nausea
  • Headaches
  • Dizziness
  • Irritability
  • Lethargy
  • Sleep problems
  • Memory impairment
  • Aggression
  • Depression

A limited number of studies have analyzed factors that might increase people’s risk for abusing or becoming addicted to benzodiazepines. A Norwegian study found a greater number of people who started using alprazolam became excessive users compared to those using any other benzodiazepine.10

While a small number of teens start using benzos at the same time they start using alcohol or marijuana, most begin abusing drugs such as Xanax as young adults to ease withdrawal from stimulants, such as ecstasy and cocaine. Research on clubgoers indicates benzos are often used with other drugs to enhance their high. A 2011 study found young adults had the highest rates of benzodiazepine abuse in the U.S. and the most common concurrently abused substances were alcohol, marijuana, cocaine and ecstasy.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 benzodiazepines. 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 benzodiazepine and opioid use during the first 90 days was associated with a fivefold increase in the risk of opioid overdose. This study highlighted the importance of especially close monitoring in individuals taking both medications.12 

Substance abusers may take it in a pill form or inject it after crushing the pill. Xanax does not fully dissolve in water, therefore it can cause severe damage to the arteries when injected.

What’s Xanax Withdrawal Like?

The severity of Xanax withdrawal symptoms depends on the dosage you’ve been taking and how long you’ve been using the drug. Some people who’ve been taking Xanax for even brief 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

  • Sense of dissatisfaction with life
  • Insomnia
  • Nightmares
  • Panic attacks
  • Increased anxiety and panic
  • Abdominal pain
  • Muscle cramps
  • Vomiting
  • Nausea
  • Hypersensitivity to light, sound, touch and taste
  • Depression
  • Sweating
  • Confusion
  • Tremors
  • Seizures

If you’ve been using Xanax with alcohol or other drugs,  Xanax withdrawal symptoms can be more severe and deadly. It’s important that medical detox is followed by a treatment plan and comprehensive drug rehab. This should include proven addiction treatment approaches like cognitive behavioral therapy.

How Do You Treat Xanax Addiction?

If you’ve been abusing Xanax, consult a physician before quitting abruptly. A rapid reduction in dosage can bring on withdrawal symptoms. If you’ve been abusing alcohol or other drugs as well, detoxing on your own can be dangerous. Xanax detox should be medically supervised to safeguard your physical and mental health. Following medical detox, residential treatment can provide space away from triggers and teach you new coping skills.

Approaches in drug rehab depend 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 benzodiazepines for a period of time to ease Xanax withdrawal.

Effective Xanax addiction treatment goes beyond drug detox. For the best chances of recovery, it’s necessary to address the underlying reasons behind Xanax addiction, not just the symptoms. Individual behavioral therapy and group therapy, relapse prevention training, as well as continued involvement in support groups will help you learn to manage any underlying mental health disorders and heal from trauma and emotional issues that contribute to substance abuse.14

  1.   Xanax: Side Effects, Drug Information. Medical News Today website.http://www.medicalnewstoday.com/articles/263490.php Updated December 7, 2017. Accessed July 24, 2018.

    2.     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 July 24, 2018.

    3.     Is Xanax Dangerous? What’s Hype and What Are the Real Threats?http://www.alternet.org/story/154165/is_xanax_dangerous_what’s_hype_and_what_are_the_real_threats Published February 15, 2012. Accessed July 24, 2018.

    4.     20 Profound Xanax Addiction Statistics. Health Research Funding website. http://healthresearchfunding.org/20-profound-xanax-addiction-statistics/ Published February 1, 2015. Accessed July 24, 2018.

    5.     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 July 24, 2018.

    6.     Benzodiazepines and Opioids. National Institute on Drug abuse website.https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids Updated March 2018. Accessed July 24, 2018.

    7.     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 July 24, 2018

    8.     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.  

    9.     Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018;12(1):4-10.

    10.     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.

    11.     Kurtz SP, Surratt HL, Levi-Minzi MA, Mooss A. Benzodiazepine dependence among multidrug users in the club scene. Drug Alcohol Depend. 2011;119(1-2):99-105. .

    12.     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.

    13.     Pétursson H.The benzodiazepine withdrawal syndrome.Addiction. 1994 Nov;89(11):1455-9. Review.

    14.     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

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