Alprazolam is the generic name for a popular benzodiazepine drug, prescribed mostly under the brand name Xanax.
This prescription sedative is one of the most important medications used to treat generalized anxiety disorder (GAD), anxiety associated with depression, and panic attacks. It may be prescribed, in rare cases, to treat insomnia and epilepsy, but Xanax’s active effects do not last long in the brain, so it is not an effective first-line treatment for these conditions.
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.
Unlike some other sedative substances, especially alcohol, GABA does not cause serious harm to organs in the body. There are short-term side effects associated with abusing Xanax, like dangerous levels of sedation that can lead to accidents, but long-term harm tends to be more associated with tolerance and dependence, which can quickly escalate into drug abuse.
Physical side effects associated with Xanax abuse during the short term include less physical coordination leading to slurred speech and stumbling, which looks like being drunk. Drowsiness, lethargy, and fatigue may lead to the person nodding off or passing out. They may shake or experience tremors from a loss of muscle coordination.
At very high levels, the person may have a Xanax overdose. Shaking, rapid heartbeat, slow reflexes, muscle weakness or uncontrollability can all indicate a Xanax overdose. However, the most harmful effect of overdosing on Xanax is respiratory depression, or irregular, shallow, slowed, or stopped breathing. Oxygen deprivation can be deadly very fast.
Tolerance for Xanax and dependence on the drug to manage brain chemistry, are the two most serious long-term risks associated with abusing this substance.
When you develop a tolerance for Xanax, you will need more of the drug — a larger dose, doses more often, or both — to achieve the initial level of intoxication. Dependence begins when the brain cannot manage chemical equilibrium on its own, and it requires the presence of a drug to feel normal.
Both tolerance and dependence occur very quickly with benzodiazepine drugs, especially Xanax. Its effects become active in the brain within an hour after a standard prescription dose is taken.
It is possible to become tolerant for and dependent on a prescription medication even if you take it as your doctor ordered. If your doctor does not want to raise your dose of a medication like Xanax, they will be available to supervise tapering you off the medication so that you do not suffer withdrawal symptoms.
Unfortunately, if you do not have a medical professional overseeing your Xanax consumption, you are abusing this drug. If you cannot take enough of it, you may begin to have withdrawal symptoms, which are physically dangerous.
Withdrawal symptoms associated with Xanax include:
Taking more Xanax than prescribed, taking it consistently, or abusing it without a doctor’s prescription are all forms of drug misuse and abuse. This treatment can lead to serious harm. With benzodiazepines like Xanax, the biggest risk is withdrawal, which can be deadly.
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.
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.
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.
If you have been prescribed Xanax and find that you feel the need to take a dose fairly often, you should speak to your doctor about the risks of taking the drug frequently. If you do not have a mental health condition and abuse Xanax without a prescription, this is very risky. It can cause serious side effects in the short and long term.
Working with medical professionals to safely detox from the drug and avoid harmful withdrawal symptoms, then entering an evidence-based treatment program with behavioral counseling, is the best approach to avoiding chronic health problems.
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