Xanax, the brand name for a benzodiazepine named alprazolam, is a short-acting, potent sedative prescribed to treat anxiety and panic attacks. Unlike other benzodiazepines, it is not prescribed to treat more serious nervous conditions, including insomnia, sleep disorders like narcolepsy, or seizure disorders. However, Xanax works on the same part of the brain as other drugs in its class, bringing about a sense of relaxation, pleasure, and sleepiness by decreasing abnormal levels of excitement.

The effects associated with Xanaxdepend on the dose, but the body rapidly builds up a tolerance to benzodiazepines in just a few weeks. If the first dose relieves a panic attack and makes you feel sleepy, a week later, this likely won’t be the effect anymore.  Xanax is so potent and hits the brain quickly, so doctors tend to prescribe it on an as-needed basis.

Unfortunately, too many people abuse the drug almost as soon as they receive a prescription. In 2009, according to the National Institute on Drug Abuse (NIDA), Xanax and other benzodiazepines were responsible for the most emergency room visits related to central nervous system (CNS) depressants. These drugs are too often mixed with other CNS depressants, like opioids and alcohol.

What is Xanax?

If you feel like you need more Xanax to manage your anxiety or panic disorder, you are advised to speak with your doctor first. There are likely safer, long-term approaches to manage anxiety or panic that do not involve increases in medication. Your doctor may also determine that a different medication could benefit you more if the original dose of Xanax no longer helps.

Typical Doses of Xanax that May Be Prescribed Include:

  • 0.25 mg
  • 0.5 mg
  • 1 mg
  • 2 mg

Your doctor will place you on the lowest possible dose first. If you need more from there, the two of you can work together to adjust your Xanax dose. You may take one pill once a day, a pill as needed, or half a pill twice a day.

Xanax can induce a sense of calm, relaxation, and pleasant sleepiness even in people who do not have an anxiety or panic disorder. This is because this drug and other benzodiazepines act on certain brain receptors called gamma-Aminobutyric acid (GABA) receptors to manage neurotransmitters. It can affect the brain’s reward system, releasing dopamine and serotonin, which are chemicals both associated with being in a good mood. Once the reward system is triggered, the person may feel like Xanax is the best way to feel happy or normal; that, in turn, may lead to compulsive behaviors around the drug.

Xanax is especially risky because it is a short-acting benzodiazepine, meaning it takes effect within one to three hours. The effects peak quickly, and it is rapidly metabolized out of the body. Fast-acting drugs can be good for people whose symptoms are immediate and intense, but they also lead to compulsive behaviors faster because the euphoria from taking the drug comes on so quickly. With drugs like crystal meth and cocaine, this pattern of abuse is called a binge.

Signs of Abuse

Benzodiazepines such as Xanax can cause many side effects, some of which are pleasant, others of which are not. Some of these side effects are:

  • Loss of motor coordination
  • Slurred speech
  • Drowsiness, fatigue, or lethargy
  • Confusion
  • Depression
  • Changes to vision
  • Vertigo
  • Physical tremors
  • Respiratory depression
  • Nausea, vomiting, constipation, and abdominal cramps
  • Dry mouth
  • Changes to appetite

When someone takes a lot of Xanax, the effects are much like being extremely drunk.

  • Blackouts or memory loss
  • Hostile or erratic behavior
  • Euphoria
  • Mood swings
  • Slowed reflexes

One of the most common signs of Xanax addiction is appearing drunk without drinking a lot of alcohol. The person may also display other behavioral or emotional changes, including:

  • Being unable to quit taking the drug, leading to several relapses
  • Having intense urges or thoughts about Xanax
  • Feeling like you need more Xanax to get the original effect
  • Maintaining a supply of the drug despite financial issues
  • Doing dangerous things to get the drug, such as stealing
  • Spending more time taking the drug than participating in work, school, or social activities
  • Experiencing changes to mental or physical health from too much Xanax, but continuing to take it anyway
  • Hurting relationships with friends and family but continuing to take the drug anyway
  • Lying to doctors or loved ones about taking it
  • Doctor shopping to get more of the drug
  • Feeling sick from taking too much Xanax
  • Experiencing withdrawal symptoms when you do stop taking it

There are outward signs of Xanax addiction that loved ones may notice, which include:

  • Changes in personality, including increased depression, anxiety, or insomnia
  • Multiple empty pill bottles
  • Denial or anger when asked about the drug
  • Problems at school or work
  • Refusal to attend social events
  • Suddenly having a different group of friends
  • Changes to sleep patterns
  • Changes in eating habits
  • Changes in personal grooming or hygiene
  • Asking for money or stealing money
  • Financial or legal problems
  • Health problems

People who struggle with Xanax abuse may take a lot of pills, or they may find other ways to abuse the drug, including crushing and snorting it, smoking it, buying illicit powdered versions of it online, injecting it intravenously, or mixing it with other benzodiazepines, opioids, alcohol, muscle relaxants, or other sedatives to increase the euphoria associated with the substance.

All of the above practices are extremely dangerous. Not only do they increase the risk of addiction and physical tolerance to and dependence on the drug, but they also radically increase the risk of overdose and death. The main symptom of CNS depressant overdose, including on Xanax, is depressed or stopped breathing. Eventually, oxygen deprivation will lead to the brain to shut down various organ systems until ultimately, the brain dies.

If you see someone experiencing a Xanax overdose or an overdose involving another sedative, then immediately call 911. They require emergency medical attention.

Why Do Some People Abuse Xanax and Others Do Not?

There are many reasons someone may suffer an addiction to Xanax. The primary three are:

  • Genetics
  • Environment
  • Family history

If people in your family struggle with addiction or mental illness, especially close relatives, you are more likely to suffer from one or both of these conditions yourself. Some genetic markers have been linked to addiction. Environmental factors may activate these markers and increase your risk of struggling with addiction to any drug, including Xanax. If you have certain mental health conditions—and anxiety disorders are one group of those conditions—then you are at a higher risk for developing an addiction to drugs or alcohol. If you are in a stressful environment, you may begin to abuse drugs in an attempt to reduce your stress.


Most people who struggle with addiction have some combination of these factors. People who receive a prescription drug like Xanax for anxiety may take a lot of it to feel normal, and they may not want to take it short-term or as-needed because they may feel like it is the only way they can feel normal enough to function in their daily lives.

Similarly, a stressful environment can trigger short-term anxiety in someone who does not normally suffer from anxiety. If the person knows someone who has a Xanax prescription, they may get one of those pills and take it to feel better just once. However, the drug’s potent relaxing effects may lead them to start taking it regularly and eventually become addicted to it. If you have a history of any other drug abuse, especially addiction to alcohol, opioids, or muscle relaxants, you are at greater risk for developing an addiction to another drug you receive, even if it is a prescription medication.

If you struggle with Xanax abuse and you have never received a prescription for this drug, you have no appropriate oversight for your dose. You are at greater risk of mixing the drug with other recreational substances, like alcohol or opiates, which puts you at risk of having an overdose. Abusing Xanax can lead to long-term cognitive problems as well along with legal issues from driving while intoxicated or financial issues from losing a job.

Get help overcoming Xanax addiction before any severe, life-limiting side effects occur.

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