The ongoing U.S. opioid crisis has currently captured the nation’s attention, but overdose deaths linked to anti-anxiety drugs, such as Xanax, can be just as dangerous and deadly. In recent years, there has been a noted surge in fatalities linked to the powerful class of medications known as benzodiazepines, which has coincided with their overwhelming overprescription.
Xanax, also known by its generic name alprazolam, is a powerful, fast-acting sedative that is prescribed to treat anxiety, as well as different kinds of phobias and panic disorders. The medication belongs to the benzodiazepines class of drugs which are known as central nervous system depressants. Xanax can only be obtained legally only through a prescription issued by a doctor or other healthcare professional.
Xanax is extremely useful for those dealing with the often debilitating effects of anxiety and various sleep disorders, but even people who take Xanax as prescribed are at risk of developing an addiction. This is why dosage and length of use require strict monitoring to avoid the high potential for abuse and addiction.
When people take Xanax more often, longer, or in different forms than prescribed, they will find themselves quickly building a tolerance, which can progress from misuse and abuse to full-blown addiction in as rapidly as just a few weeks.
How Does Xanax Work?
One of the first things you should know about the benzodiazepine drug is that it doesn’t affect everyone the same. While you may know someone who’s benefitted from its effects, it might affect you differently.
How Xanax affects you will depend on the following factors:
- Dosage
- Metabolism
- Age
- Weight
- Mental state at the time of use
Xanax, like the majority of other benzos, works by mimicking a neurotransmitter called gamma-aminobutyric acid (GABA), which regulates feelings of anxiety by blocking the nerve signals that trigger those feelings from being able to reach the brain. GABA can help calm you down, induce sleep, or manage stress.
Xanax is chemically similar enough to GABA that it can activate the brain’s GABA receptors into overproduction in order to suppress activity in the brain and central nervous system. The brain then floods with GABA, which produces the intense feelings of relaxation and sedation. Users typically feel relief within an hour after taking, and this feeling can last for a few hours.
After a while, this binding can start to lose its effects as the GABA receptors become less sensitive, requiring heavier doses to keep working normally. The resulting dependence on Xanax can lead to worsening insomnia or anxiety symptoms, which then leads to a strong physical and psychological Xanax addiction that can be difficult to break.
When your limbic system, also known as the brain’s reward system, responds to the relaxation and anti-anxiety effects of Xanax, it may begin to confuse the drug use for life-sustaining activities. However, there are several signs and symptoms of dependence and addiction that you should be aware of if you or a loved one has been prescribed benzodiazepines.
What Are The Signs of Xanax Addiction?
It is important to note that Xanax abuse and Xanax addiction are different things. Recreational users may still maintain some control over their use. But abuse can lead to addiction, which is when no matter what the user does, the pull of Xanax is stronger than leaving it alone.
It can be difficult to spot the signs of a Xanax addiction while it is still in its early stages even if you are the one who happens to be misusing it, and often the problem will not be recognized until it is too late and Xanax abuse has escalated and progressed to addiction. Signs of Xanax addiction that may seem obvious in hindsight can be easy to miss if you are not looking for them.
However, there are many physical and mental signs that point towards a developing addiction to Xanax, including:
- Memory problems
- Withdrawal symptoms when not using
- Frequent periods of confusion
- Paranoia
- Depression
- Headaches
- Nausea and vomiting
- Tremors
- Excessive drowsiness
- Noticeably altered sleep patterns
- Swollen arms and legs
- Chronic dry mouth
As someone becomes more and more dependent on Xanax to function—prioritizing obtaining and using it over nearly everything else in their life—they begin to exhibit abnormal behavior. These red flags are based on the fact that Xanax has become the driving force behind their decisions. These signs are associated not only with an addiction to Xanax but also with substance use disorders in general.
Some of these behavioral signs of Xanax addiction include:
- Taking Xanax more often or at a higher dose than prescribed
- Forging prescriptions to get more Xanax
- “Doctor shopping” to get more prescriptions for Xanax
- Attempting to justify Xanax abuse
- Needing to take Xanax to perform basic daily functions
- Lack of personal hygiene
- Using Xanax in ways it was not intended (crushing, snorting, etc.)
- Loss of interest in previously enjoyed hobbies and activities
- Lying about or hiding Xanax abuse
- A noticeable decline in performance at work or in school
- Legal or financial difficulties resulting from Xanax abuse
- Being unable to stop taking Xanax despite wanting to
These behaviors are all signs of Xanax addiction, or at the very least, Xanax dependency and abuse that is in very real danger of progressing to full-blown addiction. If you have observed these signs in yourself or someone you care about, it is vital that you seek out professional addiction recovery treatment as soon as possible, ideally starting with medical detoxification to flush the Xanax from your system and safely handle Xanax withdrawal.
How Does Xanax Impact the Brain?
All benzodiazepine medications, including Xanax, impact a neurotransmitter called gamma-Aminobutyric acid (GABA). Many central nervous system (CNS) depressants, including barbiturates, sedative-hypnotic sleep drugs, and alcohol, manage how rapidly GABA is absorbed into the brain.
GABA regulates how rapidly neurons communicate with each other in the brain, typically by inhibiting or reducing how often neurons fire. Rapid firing can trigger many conditions, from a sense of low-level dread or a seizure. With enough GABA available to the brain, however, these reactions calm down.
Drugs like benzodiazepines act like GABA and bind to the GABA receptors in the brain, allowing the naturally produced GABA to be more available. With more GABA available, the brain relaxes, the body’s reactions slow down, and a sense of pleasant relaxation or sleepiness will wash over the person.
These reactions are important on an as-needed basis for people who have serious medical conditions. However, this sedation is also addictive, and it can lead to mental and physical harm.
Serious Mental Effects When Abused
Xanax was designed as an anxiety and panic disorder treatment alongside cognitive behavioral therapy. Taking this benzodiazepine by itself can alleviate short-term symptoms of anxiety, panic attacks, or insomnia, but it will not manage these conditions overall.
Because Xanax quickly affects how the brain functions, many people begin to take the drug too often. They feel like they need it to avoid suffering.
Short-term mental effects: Because Xanax leads to feeling sedated, mental effects may include forgetfulness, sleepiness, slowed thinking, and trouble learning. Paradoxical insomnia may be a symptom of taking Xanax more than a few days in a row. Lightheadedness and daytime drowsiness are also common side effects of taking this drug, even if you take it as prescribed. A two-week study in which participants took 0.5 mg (milligrams) of Xanax did not find significant changes in memory in the short term, but memory loss is possible in the long term.
Long-term mental effects: There are few long-term studies on the risks of chronic Xanax abuse and memory loss, but if the drug works on the brain in a similar pattern as alcohol, periods of intoxication may lead to blackouts, during which memories do not move from short-term to long-term storage.
A Harvard Health study involving 2,000 older adults with Alzheimer’s disease and a control group of 7,000 without dementia found that risk for Alzheimer’s increased 32 percent among those who had taken Xanax and other benzodiazepine sedatives for three to six months at any point in their lives.
Among those who took the drug consistently for more than six months, the risk rose to a shocking 84 percent.
What is Involved in Xanax Addiction Treatment?
The National Institute on Drug Abuse (NIDA) defines addiction as a chronic, relapsing brain disease that is treatable though not curable. Addiction treatment programs can be designed to fit the needs of the client. They vary by the client and substance(s) used as well as factors such as how long the person has been in active addiction.
Recovering Xanax users will need to start a medical detoxification at a facility equipped to oversee this process. A medically-monitored detox handled by a health care professional is necessary to rid the body of the toxins and to help manage painful and uncomfortable withdrawal symptoms. Medications used in Xanax detox include a longer-acting benzodiazepine, such as Valium. Other medications also may be administered to treat other conditions that arise during the withdrawal and post-withdrawal period, including:
- Anticonvulsants – which are typically only given in the case of someone experiencing seizures during the Xanax withdrawal process. However, they have been found to be useful for treating the general symptoms of Xanax withdrawal.
- Antidepressants – like Prozac and Zoloft, which are serotonin reuptake inhibitors and are used to help curb symptoms of depression, as well as suicidal thoughts and behavior.
- Melatonin – which is an over-the-counter supplement used to help induce and regulate sleep. Melatonin can be used to help with the symptoms of insomnia and anxiety as a workaround to the tolerance someone will have built up to Xanax.
After detox is complete, the next step is to enter an addiction treatment program that allows recovering users to come face to face with their addiction to Xanax to understand its causes and how they can work toward recovery.
A drug rehabilitation center offers a supportive network of medical staff as well as addiction counselors, therapists, and others who are trained to support recovering users on their journey to sobriety. Such support at the beginning stages of recovery as well as throughout the process helps to ensure that the recovery attempt is successful.
Recovering Xanax users will have to learn or re-learn coping strategies and essential life skills as they manage their disease. Behavioral therapies, such as cognitive behavioral therapy (CBT), can assist them in their journey to achieve mental and emotional stability as they rebuild their lives. CBT helps clients recognize thinking patterns that are inaccurate, negative, or distorted and teaches them coping skills and strategies to correct those patterns.
These tools help them identify and process their thoughts and emotions and respond to challenges in effective ways that support them during recovery. Treatment also can incorporate 12-step fellowship programs, such as Alcoholics Anonymous and Narcotics Anonymous, motivational therapy, trauma therapy, and individual counseling and group counseling.
Inpatient or residential treatment, which can last anywhere from 28 days to 90 days in a facility, depending on the program, uses diverse therapies to help users work through, and overcome their dependence on addictive substances. According to NIDA, however, addiction recovery treatment generally requires at least 90 days in length for it to be at all effective in preventing relapse.
Outpatient therapy can help Xanax users who are in the early stages of their addiction or have a mild case of it.
This kind of therapy does not require an on-site stay at a treatment center, which means there is more flexibility to incorporate treatment into established schedules, such as for work or school. Outpatient clients are still required to attend structured sessions three to five times a week or more, depending on the person’s situation. Outpatient clients are completely responsible for keeping their environment free of any negative influences that can set back their recovery.
Recovering Xanax users also can benefit from aftercare services that help them reach their recovery goals and avoid relapse. After treatment is completed, recovering users may struggle with depression, anxiety, and other post-acute withdrawal symptoms (known as PAWS) for months or years down the road.
Similar to how alcohol affects the body, Xanax users may feel mentally impaired, have poor coordination, and may struggle with performing mechanical tasks such as driving or operating machinery. Slurred speech, dizziness, drowsiness, and lethargy are also other effects that make this drug dangerous to abuse.
It is also common for Xanax users to mix the benzodiazepine with alcohol, prescription opioids, and heroin, which is incredibly dangerous.
Alcohol, in particular, has what is known as a synergistic effect with Xanax. This means that they build off of each other to increase the intensity of their respective effects. Mixing Xanax with alcohol increases your risk of overdose, which causes severe sedation, depression, slowed breathing, hypotension, fainting, muscle weakness, or even a coma.
It is also possible to overdose fatally on Xanax. The symptoms of a Xanax overdose include:
- Hypertension
- Psychosis
- Suicidal Behavior
- Memory loss
- Hallucinations
- Delirium
- Seizures
- Panic attacks
- Rebound insomnia
- Rebound anxiety
Tonic-clonic seizures involve two phases. The tonic phase comes with sudden muscle contractions where the limbs are pulled in, close to the body. The clonic phase comes immediately after with violent convulsions. Deaths associated with seizures are usually due to them causing fatal accidents. However, other serious medical complications can occur.
Rebound anxiety and insomnia are caused by the central nervous system going into overdrive without the suppressing effects provided by Xanax. Now in withdrawal, the nervous system goes into shock and hyperactivity, causing old symptoms of insomnia and anxiety that the Xanax had been treating to re-emerge.
The difference between regular anxiety and insomnia and the rebound variety is that the hyperactive nervous system makes these symptoms significantly stronger than they may have been before someone started abusing Xanax. Rebound insomnia can keep someone awake for days on end, and rebound anxiety can cause debilitating panic attacks.
Xanax Abuse Statistics
- There were more than 50 million prescriptions written for Xanax in 2013.
- An estimated 70 percent of teenagers with Xanax addictions reported as obtaining it from the medicine cabinet in their homes.
- More than 30 percent of opioid-involved overdoses also involved benzodiazepines like Xanax.
- Between 2002 and 2015, overdose deaths resulting from benzodiazepines, including Xanax, have more than quadrupled.
