Xanax is the widely recognized brand name of alprazolam, a benzodiazepine medication prescribed as needed to treat anxiety symptoms. This medication, in both brand name and generic versions, is prescribed to treat generalized anxiety disorder (GAD), anxiety associated with depression, and panic disorder. Because it is a short-acting benzodiazepine drug, Xanax often is not prescribed for conditions such as insomnia or seizure disorders.
The medication was first approved by the U.S. Food and Drug Administration (FDA) in 1981 and comes in immediate-release (IR) and extended-release (XR) tablets, a liquid, and disintegrating tablets. Unfortunately, because some of the drug’s properties can lead to euphoria, Xanax is too often abused for nonmedical reasons.
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Why Is Xanax So Widely Abused?
Benzodiazepines like Xanax work by binding to the gamma-Aminobutyric acid (GABA) receptors in the brain, leaving more of the GABA neurotransmitter available. This neurotransmitter is important for slowing rapid neuron-firing, which can lead to anxiety, panic, insomnia, or, in very extreme cases, seizures.
The major effect of any benzodiazepine, including Xanax, is feeling calm, relaxed, pleasant, and sleepy. This action is similar to alcohol since alcohol also directly affects the GABA receptors to lead to a sense of calm. However, Xanax acts faster than most benzodiazepines, as well as alcohol, so it can lead to compulsive behaviors to take it and get a rapid high.
Xanax and other benzodiazepines also appear to weaken inhibitory interneurons found in the ventral tegmental area (VTA) of the brain. Typically, this cluster of brain cells prevents dopamine surges from becoming excessive when other neurotransmitters, like GABA, are naturally fired; when their response is weakened, however, the increased availability of GABA can lead to a surge in dopamine, triggering the brain’s reward system and leading to an intense, pleasurable high. As Xanax wears off, this experience goes away, leading to depression, cravings, and compulsive behaviors.
Typically, Xanax takes effect within 5 to 10 minutes after the dose is consumed. Because the action is so quick, alprazolam is considered a rapid-acting medication, which is part of the reason that it can cause addictive behaviors for some people. The drug has a half-life of about 11 hours, meaning it is completely out of the body within a day. Although the effects on the brain come and go quickly, metabolites of the drug will remain in the bloodstream, and these can potentially interact with other medications or recreational drugs, like alcohol, that one may consume.
If you or a loved one is considering how potentially dangerous Xanax is, then talk with your doctor. If you have a history of substance abuse, especially alcohol abuse or alcohol use disorder (AUD), benzodiazepines may be more likely to cause a relapse or addictive behaviors. Additionally, this medication will work differently on different people.
- Mental Health
People who struggle with anxiety truly benefit from access to benzodiazepines to reduce symptoms in the moment. However, they are at an increased risk of developing physical dependence on the drug and taking it compulsively because they may feel that Xanax is their only option to help them feel normal. Benzodiazepines, especially rapid-acting ones like Xanax, can quickly lead to physical tolerance, so people who take these drugs consistently for two weeks or more will need to up their dose to experience the original panic-reducing benefits.
When Xanax is abused, it can lead to a euphoria like being drunk. Some people report blacking out or missing memories after taking too much. Mixing Xanax with other CNS depressants, especially opioids and alcohol, can compound the intoxicating effects of all those drugs, leading to a more intense high but also causing serious side effects faster, including passing out or suffering an overdose.
Developing a physical dependence on the drug also will increase the risk of experiencing withdrawal symptoms when you try to stop taking the medication. This can happen even in people who take it as prescribed, but it is more likely to occur in people who abuse Xanax for nonmedical purposes.
If your doctor wants to prescribe Xanax to you, make the person aware if you are taking certain medications because these react poorly with benzodiazepines.
Some of these medications are:
- Hormonal birth control
- Antifungal drugs
- Heartburn drugs
- Opioid painkillers
These medications prevent Xanax from being eliminated in a normal fashion by blocking certain metabolic pathways.
The History of Benzodiazepines
Drugs in the benzodiazepine class were invented as safer, less addictive replacements for barbiturates, which were widely abused sedatives and muscle relaxants. Researchers experimented with benzodiazepines throughout the 1950s until viable prescription versions were finally made. Librium, the first FDA-approved benzodiazepine, became available in 1960, and Valium was approved in 1963.
Xanax is one of the most widely abused prescription medications today. It is reportedly involved in most emergency room admissions involving any central nervous system (CNS) depressant or a combination of these drugs since 2009. With the ever-rising popularity of new benzodiazepine drugs, more overdoses are reported. Between 1996 and 2013, prescriptions for all benzodiazepines have tripled, and reports of these drugs being involved in fatal overdoses have quadrupled.
However, it is rare for benzodiazepines to be the only drug involved in an overdose, especially a fatal one. Too often, people who abuse opioids, alcohol, or both add benzodiazepines like Xanax to the mix, creating a deadly cocktail. The problem has become so serious that Xanax and related medications are considered a “shadow epidemic,” contributing to the opioid abuse and overdose epidemic in the United States.
Between 2001 and 2013, opioid abuse quickly got worse, and benzodiazepine abuse grew alongside the opiate trend. According to the U.S. Centers for Disease Control and Prevention (CDC), alprazolam was one of the top five most dangerous drugs, being involved in thousands of overdose deaths between 2010 and 2014; however, it was rarely found alone.
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Even when you take Xanax as prescribed, it can cause side effects; however, you are more likely to experience side effects from this prescription drug if you take it daily for more than two weeks or if you take more of it than your doctor prescribes.
Side effects include:
- Impaired coordination
- Memory problems
- Slurred speech
- Changes to vision
- Respiratory depression
- Nausea, constipation, and stomach cramps
- Loss of appetite
- Dry Mouth
Very high doses of Xanax and other benzodiazepines can cause intense short-term symptoms, such as:
- Slowed reflexes
- Mood swings
- Erratic or hostile behavior
- Intense euphoria
- Disconnection from reality
- Drowsiness, leading to passing out
Long-term use or abuse of Xanax can lead to severe mental struggles, including depression, aggressive or impulsive behavior, and psychotic episodes. Some physical issues, like muscle weakness, slurred speech, and lack of coordination may become long-term problems, even during the withdrawal process and throughout rehabilitation.
Signs of Xanax Abuse and Addiction
Signs that someone you know and love is abusing Xanax will include the above side effects. They may appear drunk, sleepy, or disoriented much of the time. The person may also have chronic headaches, rebound anxiety, sleep disturbances, and problems at work, school, or with taking care of their family. Their eating, sleeping, and grooming habits will change.
There won’t be other signs of alcohol abuse, like empty bottles, but there may be a lot of extra prescription pill bottles around. They may lie about how much Xanax they take, how many doctors they see to get it, or about “losing” prescriptions and needing frequent refills.
- Increased confusion and disorientation
- Uncontrolled muscle movements
- Very poor coordination and frequent falling
- Slurred speech
- Slow reflexes
- Rapid heart rate
- Chest pain
- Trouble breathing
- Abnormal heart rhythm
Xanax has several overdose symptoms in common with other drugs, including alcohol and opioids; however, any of these symptoms can lead to worse physical reactions and eventual death without immediate medical treatment. There is no such thing as walking off or sleeping off a drug overdose.
It is crucial that you call 911 to get help for someone experiencing these symptoms.
Even if you do take Xanax as prescribed, you may become physically dependent on it because this process occurs rapidly with benzodiazepines. If you’re working with a physician, they will develop a plan to taper you off the drug; however, if you abuse Xanax without a physician’s oversight or take more than they prescribe, you may not have the help you need to safely stop taking the drug.
There are specific signs of withdrawal from Xanax:
- Returned anxiety
- Other sleep disturbances
- Trouble concentrating
- Suicidal ideation
- Panic attacks
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Since benzodiazepines like Xanax act on the GABA receptors, the brain is likely to get used to the presence of these drugs and stop producing GABA as readily. Alprazolam withdrawal is also associated with a higher risk of serious clinical symptoms like delirium and psychosis. In a study of 126 patients who took Xanax to relieve anxiety, 27 percent reported they had rebound anxiety that was more severe than pre-treatment anxiety, and 35 percent of patients reported new psychiatric symptoms during the withdrawal process, even after tapering for four weeks.
Withdrawal symptoms from Xanax will begin when the body has metabolized the last dose out of the bloodstream, so typically within one day. With medical oversight, Xanax withdrawal usually lasts about one week. However, there is the risk of protracted withdrawal, especially if you have abused large doses of Xanax for a long time. This reportedly occurs in about 15 percent of people who abuse Xanax. Symptoms include several weeks or even months of withdrawal symptoms like insomnia, muscle jerks, anxiety attacks, depression, and cognitive problems.
Get Help to Overcome Addiction
If you are worried about your habits around taking Xanax or concerned for a loved one, it is time to seek help. Addiction specialists can assess you for compulsive behaviors and psychological signs of dependence and addiction, and they can then recommend resources for detox and rehabilitation.
Detox is a medical program with supervision from clinicians that is designed to minimize withdrawal symptoms. While there are no replacement medications for benzodiazepine withdrawal, severe symptoms may lead a clinician to prescribe controlled doses of diazepam (Valium) because it is a longer-acting benzodiazepine and then design a taper around that medication.
Mild and some moderate withdrawal experiences may be safe enough that the person can live in their home and attend regular physicians’ visits to manage discomfort. Other symptoms, especially seizures or a high risk of relapse, mean that inpatient detox treatment at a residential facility is much safer.
After you have completed the detox process, rehabilitation programs will help you get behavioral therapy to change how you act around drugs, especially Xanax. Group therapy is the core component of rehabilitation, both inpatient and outpatient; however, many rehabilitation programs offer individual therapy.
The key part of any rehabilitation program is developing coping mechanisms for cravings and life stress to reduce the risk of relapse. With so many options for detox and rehabilitation, help is very available.
If you have used Xanax and developed an addiction, call Arete Recovery at (855) 781-9939 to find help today. We will tailor a treatment program to your needs and do our best to ensure a successful path to recovery.
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