Xanax is the brand name for a medication generically referred to as alprazolam – an anti-anxiety medication that is one of the most commonly prescribed drugs in the country. When used correctly in the short-term, Xanax can be helpful in controlling anxiety for many people. However, long-term or improper use can lead to dependence and addiction, with potentially dangerous effects.
For people who are at risk of becoming addicted or who are already struggling with Xanax addiction, professional support and treatment can be a lifeline to help with recovery and management of both the anxiety and the addiction.
Xanax: A Short-Term Benzodiazepine
Alprazolam is one of many benzodiazepine drugs. These drugs are commonly prescribed to manage a host of nervous system and mental health conditions, such as:
- Panic disorders
According to Medical News Today, Xanax is typically used for anxiety, anxiety-based depression, and panic disorders. Like other benzodiazepines, Xanax works by increasing the action of certain neurochemicals in the brain, including gamma-aminobutyric acid, or GABA. This causes a relaxation of signals travelling through the brain and nerves, resulting in a calming effect.
Because of how Xanax acts on the brain, using it for a long period of time can cause long-term changes in the brain, including the potential for addiction. For this reason, it is recommended to be used only in the short-term.
The brain changes that occur from Xanax use can result in the individual developing tolerance for the drug. This means that, over time, more of the drug is needed to produce the original effect. Caused by repeated use of the drug over time, as described in Merck Manuals, tolerance often results from the brain trying to compensate for the drug’s action on the nervous system by adjusting the production of the neurochemical that is affected by the drug.
Because of tolerance, legitimate medical use of Xanax can lead to abuse. Most often, people begin to abuse Xanax because it seems like the drug isn’t working as well. This is a sign that tolerance has started to develop. If the individual then increases the dose or frequency of drug use, tolerance can develop at the higher dose, leading to a spiraling cycle that becomes drug abuse.
There are instances where individuals use Xanax specifically to experience the “high” that it creates, without having a medical prescription for it. In this case, addiction can develop if the drug is used regularly for this reason, building up tolerance in a similar manner.
Benzos like Xanax have become some of the most prescribed drugs in the country. For example, in 2015, 17.6 million people used alprazolam products, including Xanax, according to the National Survey on Drug Abuse and Health. This makes it the most commonly used benzodiazepine in the country.
In the same year, more than 4.1 million people abused alprazolam; this represents about 1.6 percent of the population, and it is approaching one-quarter of the number of prescriptions given.
Of course, not everyone who abuses Xanax has a prescription. The high rate of prescriptions for this drug does have an effect on the number of people likely to abuse it or develop addiction related to it based on the development of tolerance through long-term use or misuse.
Signs of Abuse
Usually, the signs of Xanax abuse can be spotted fairly easily. Because Xanax is a nervous system depressant, use of the drug results in a general slowing of bodily functions and more lethargic, fatigued physical and mental symptoms. These can include:
- Slowed reflexes
- Difficulty concentrating
- Slurred speech
- Slowed breathing and heart rate
If a person is abusing Xanax through a legitimate medical prescription, another sign may be missing pills from the bottle, running out of the medication sooner than expected, or obtaining multiple prescriptions from multiple doctors or pharmacies.
In addition to these signs, there are some behavioral cues from the individual that can indicate Xanax abuse is occurring, as defined by the Diagnostic and Statistical Manual of Mental Disorders. These include:
- A focus on seeking out the drug, using it, and recovering from use of the drug
- Difficulties in relationships, responsibilities, and other activities based on drug use
- Not being able to control or stop drug use
- Participating in risky behaviors while using the drug
- Experiencing withdrawal symptoms upon stopping use
This last sign is perhaps the most important one to pay attention to because one of the chief dangers of Xanax use and abuse is a severe and dangerous withdrawal syndrome.
Dangers of Xanax Abuse
There are a number of risks that come from abusing Xanax. These include:
- Negative short-term and long-term health effects
- Addiction to Xanax
- Severe withdrawal syndrome and symptoms
Each of these dangers is further discussed below.
Xanax Effects on Health
As researched and studied, and reported through The Ashton Manual, Xanax and other benzodiazepines can have negative effects on both short-term and long-term health. In the short-term, the symptoms and signs described above may occur, including sleepiness or insomnia, decreased reflexes, inability to concentrate, and so on. However, over time, these effects can be magnified, leading to more severe effects, including:
- Loss of memory
- Poor cognition
- Loss of emotional variation
- Increased anxiety
While a number of these mental symptoms begin to resolve when use is stopped, they may persist for months or even years after quitting Xanax use. In fact, a study from Archives of Clinical Neuropsychology indicates that the cognitive effects of benzo use, including memory loss, can persist for six months or longer after stopping the drugs. Obtaining treatment as early as possible for abuse or addiction can help to prevent or minimize these symptoms.
Xanax Dependence and Addiction
The process of tolerance can quickly lead to addiction to Xanax. Addiction manifests as physical dependence on the drug, coupled with the inability to control use. When Xanax is used for a long time, there is often damage to the brain systems it affects, resulting in the body’s inability to function properly without having the drug.
While it might be argued that the drug was taken because these brain systems weren’t working properly to begin with, there is an added dimension to addiction related to the individual’s inability to control or stop use of the drug. In addiction, the person feels compelled to continue using the drug even when negative health effects, behaviors, or other consequences occur.
As mentioned above, Xanax withdrawal can be dangerous if undertaken alone. As with many other drugs of abuse, one major risk is that the withdrawal symptoms will be uncomfortable enough to cause the person to continue using the drug instead of making efforts to get help with stopping use. However, when it comes to benzodiazepines, this isn’t the only risk during withdrawal.
Stopping benzo use abruptly can send the neurological systems affected by the drug into a severe reaction, which may include symptoms described in a study from Addiction as:
- Tension and anxiety
- Panic attacks
In some cases, these symptoms can be severe enough to lead to death.
While with many drugs, the severity of withdrawal increases based on the high dosage of the drug being abused, this is not necessarily the case with benzos. In fact, short-acting benzos like Xanax can cause severe withdrawal because it can be difficult to taper off them. For this reason, quitting cold turkey is never advisable with these drugs; it is important to get the help of medical professionals to avoid a severe withdrawal reaction.
As with many drugs of abuse, overdose is a major risk with Xanax and other benzodiazepines. As reported by the National Institutes of Health, 8,700 people died of a benzodiazepine overdose in 2015. Such overdose deaths are on the rise, as the 2015 figure is more than four times the number of people who died of a benzo overdose in 2002. In addition, the risk of overdose and death can be increased when benzos are used with other substances that also depress the nervous system, like alcohol and opioids.
Symptoms of Xanax overdose include:
- Severely slowed or stopped breathing
- Low heart rate and blood pressure
Medical attention should be obtained immediately in case of an overdose to avoid complicating the issue with severe withdrawal symptoms that can also be risks to the person’s life.
If the person receives medical help, many of the symptoms are likely reversible. However, with slowed or stopped breathing and poor circulation, there may be lack of oxygen to the brain, which can cause permanent brain damage.
Treatment for Xanax Abuse and Addiction
The risks of Xanax abuse and addiction can be reduced through treatment. When provided by the experienced, certified medical and addiction treatment specialists in a research-based treatment program, cognitive and physical therapies can help an individual begin to recover from the addiction and learn to manage it into the future. These therapies include:
- Education to help the person understand addiction and its effects
- Behavioral therapy to develop skills in altering behavior patterns
- Family therapy to manage relationship dynamics that may contribute to drug abuse
- Nutrition and fitness programs to help the body recover from health effects
- Group therapy and 12-Step or peer groups to provide motivation and social support
- Alumni and post-treatment programs to help the person reintegrate into society and practice recovery skills
With these treatments and others supported through addiction research, the individual has a higher chance of achieving long-term recovery than with no support, enabling the person to move forward into a more positive, productive future.