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Is Xanax a Controlled Substance: How Does It Work?

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Xanax, also known by the name alprazolam, is a Schedule IV controlled substance. It is classified under the Controlled Substances Act of 1970. Although Schedule IV drugs are considered to have a much lower potential for abuse and dependency, that doesn’t mean Xanax can’t be addictive or dangerous. When used as prescribed, Xanax is a safe medication used to treat anxiety. However, when abused, it can be fatal. 

Anxiety disorders are the most common mental illness in the United States and affect nearly 40 million adults over the age of 18, translating to 18.1 percent of the population. Since a significant portion of the population struggles with the condition, it’s important to establish a proper treatment regimen. Xanax is a drug used to ease the nerves of someone and help them lead a normal life. 

People with anxiety disorders are three to five times more likely to visit a doctor and six times more likely to be hospitalized for psychiatric disorders. The condition develops from a complex set of risk factors that includes brain chemistry, genetics, personality, and life events. Unfortunately, only 36.9 percent will get the help they need. 

Xanax accounted for more than 48 million prescriptions in 2013, and misuse liability is shown to result in more severe withdrawal syndrome than other benzodiazepines, even when following a taper regimen. Xanax is the second most common prescription medication and the most common benzo to be involved in emergency department visits due to misuse. 

What Is a Controlled Substance?

A controlled substance is defined as a drug that can be abused and possibly cause addiction. The Controlled Substances Act was put in place to reduce manufacturing, drug trafficking, and illegal possession. Most of the drugs that are regulated today by this act also provide medical benefits and are legally prescribed. However, they’re unlawful to use or obtain without a prescription. 

The objective is to allow people to access medications that improve their mental and physical health but also preventing these medications from getting abused. There are various levels of classification within the act, from commonly used cold medications to illicit street drugs. 

The five drug schedules include the following:

  • Schedule I: This includes illegal drugs that are not approved for medical use. They are deemed highly abused and addictive.
  • Schedule II: This includes prescription drugs that have a higher potential of being abused and could lead to addiction.
  • Schedule III: This includes prescription drugs that have a moderate potential of being abused and could lead to addiction.
  • Schedule IV: This includes prescription drugs with a low potential for abuse and less likely to lead to addiction.

Schedule V: This includes drugs with a smaller abuse potential than Schedule IV substances that can only be obtained with a prescription or from behind-the-counter.

controlled-substance-xanax

Why Is Xanax a Controlled Substance?

As was mentioned above, Xanax is used to treat anxiety and panic disorders. It works because it has a short onset of action, meaning it takes effect quickly. This is helpful for someone who may become stricken with panic. Unfortunately, despite the relief it offers, this is the same reason many people will abuse the drug.

Since Xanax is a short-acting benzodiazepine, it won’t stay in the system for very long. Many people will experience rebound anxiety between their doses, causing them to use Xanax more frequently.  Rebound anxiety is often worse than the initial a person sets out to treat with the medication. 

Benzodiazepines start to lose their effectiveness over time because most who use the drug quickly develop a tolerance. If someone continues increasing the frequency and their dosage of Xanax, the risk of developing physical dependence and addiction increases significantly. 

Xanax is especially deadly when mixed with alcohol or other central nervous system (CNS) depressants like opioids. Abusing Xanax by itself elevates the chances of a deadly overdose, but using it in conjunction with opioids is fatal 16 percent of the time. If you’re using opioids and a doctor suggests Xanax to treat anxiety, you must be transparent about your opiate use. 

For all of the reasons listed above, the U.S. Drug Enforcement Administration (DEA) has classified Xanax as a controlled substance. 

The Difference Between Controlled Substances and Prescription Drugs

Not all prescription drugs are considered controlled substances. For example, you can only obtain antibiotics with a prescription, but it’s not regulated like Xanax. Controlled substances are drugs that lead to dependence and addiction, which you aren’t going to find with antibiotics or other specific prescriptions. 

An amendment to the Federal Food, Drug, and Cosmetic Act was passed in 1951, and it defined which drugs need a doctors’ approval and which don’t. In 1970, The Controlled Substances Act determined which substances would come with criminal charges if they were used outside of prescription guidelines. 

Xanax and Prescription Drug Monitoring

In most stages, controlled drugs like Xanax are part of the prescription drug monitoring programs (PDMPs). The programs require the participating physician to enter a prescription like Xanax into a database that can be accessed by other healthcare providers. It has been extremely beneficial as a deterrent for those abusing prescription drugs. 

Keeping these records transparent prevents doctor shopping, otherwise known as individuals who get prescriptions from multiple doctors. It will raise a red flag for an individual abusing Xanax so their doctor can either taper them off the substance or switch to a longer-acting benzo. 

Although these programs have been effective in limiting the number of controlled prescriptions going out, prescriptions aren’t the only way to get drugs. Xanax can be purchased through the black market online without a prescription and imported from other countries. This is even riskier because you can’t be confident about what you’re getting, which is why the consequences of illegal trafficking are far more significant. 

Consequences of Xanax Use Without a Prescription

If you’re found with Xanax in your possession without a prescription, you’re going to face criminal charges. Depending on the state, the severity of your punishment will be based on previous offenses you’ve encountered. Some of the consequences you could face include:

  • Fines that range from hundreds to thousands of dollars
  • Suspension of your driver’s license
  • Prison time from a few months to years
  • Diversion (rehab programs or drug classes)
  • Court-ordered drug rehab
  • Probation

Possessing the drug with intent to sell poses a more severe threat. Fines for trafficking a Schedule IV substance can be costly and range from hundreds to thousands of dollars. An individual could spend up to five years in prison for their first offense and ten years for a second. Because Xanax can be deadly, courts take sales seriously. 

How to Dispose of Controlled Substances Like Xanax Safely

If you’re prescribed Xanax and don’t finish the prescription, you should dispose of the drug so that it doesn’t become a danger to others. The excess pills should never be given away or sold, even to someone with a Xanax prescription. Your doctor monitors how much Xanax is used to keep you safe, so giving someone more can be deadly. 

When Xanax is left around the house, there’s a chance teenagers or others around the house could access it and abuse it. You should mix the drugs with something inedible like coffee grounds or dirt, seal them in plastic, and then throw it in the trash. Especially dangerous drugs may require you to flush them immediately. 

Local police departments offer drug-take-back programs to encourage the safe disposal of your drugs. The DEA provides periodic take-back events around the country, and medical facilities offer safe disposal as well. By disposing of the drug properly, you can prevent drug abuse.

Treatment Options for Xanax Addiction

If you’re abusing Xanax or you’ve become addicted and fear the legal consequences, you might benefit from getting help. Despite its classification as a Schedule IV drug, it’s possible to become addicted. Xanax withdrawal is just as dangerous as using the medicine, so seeking proper help can ensure your safety during the detox phase. 

Xanax addiction treatment will start in medical detox to deal with the dangerous withdrawal symptoms. Once you’ve cleared the drug from your system, it’ll be up to the treating physician and addiction experts to determine the next course of action. Don’t let addiction dictate your life another day. 

Sources

ADAA (N.D.) Facts and Statistics. from https://adaa.org/about-adaa/press-room/facts-statistics

NCBI (March 2018) A Review of Alprazolam Use, Misuse, and Withdrawal. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/

DEA (February 2021) The Controlled Substances Act. from https://www.dea.gov/controlled-substances-act

NIDA (February 2021) Benzodiazepines and Opioids. from https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids

NIH (November 1994) The Benzodiazepine Withdrawal Syndrome. from https://pubmed.ncbi.nlm.nih.gov/7841856/

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