Xanax (Alprazolam) addiction: symptoms, signs, side effects, and treatment
Xanax addiction is characterized by an individual’s physical or psychological dependence on the drug, necessitating increasingly high dosages to obtain the same effects. More precisely, in Xanax addiction, an individual continues using the drug or seeking more of it despite the harmful consequences it causes.
The symptoms of Xanax addiction are listed below. The symptoms of Xanax addiction include craving for Xanax, drowsiness, increased tolerance, blurred vision, withdrawal symptoms, slurred speech, loss of control, and difficulty concentrating.
The signs of Xanax addiction are doctor shopping, neglecting responsibilities, social withdrawal, financial problems, paraphernalia or hidden medication, risk-taking behaviors, and legal problems.
The side effects of Xanax addiction include weakness, impaired coordination, flattened mood, dry mouth, nausea and appetite loss, constipation, memory loss, and suicidal ideation.
Treatment options for Xanax addiction include medically supervised detoxification, cognitive behavioral therapy (CBT), gradual tapering, motivational interviewing (MI), inpatient treatment, 12-step programs, and outpatient treatment programs.
Is Xanax addictive?
Yes, Xanax is addictive. It is a member of the benzodiazepine class of drugs, which are well-known for their ability to calm people by boosting the effects of the neurotransmitter gamma-aminobutyric acid (GABA).
A continuing education activity by Tobin T. George and Jayson Tripp titled, “Alprazolam” last updated in April 2023 stated that like all benzodiazepines, the prolonged use of alprazolam results in clinically significant physical dependence. With chronic treatment of alprazolam for an extended period and at high daily dosages, the likelihood of dependence and withdrawal increases.
Anxiolytics like Xanax work by reducing nervous system activity, which in turn reduces anxiety. However, due to its fast-acting effects and the sense of relief it provides, it becomes highly addictive when used over extended periods.
In addition, abrupt cessation following long-term use results in withdrawal symptoms, therefore reinforcing the cycle of anxiolytic addiction. The risk of misuse is particularly pronounced when Xanax is used without proper medical supervision.
What is Xanax?
Xanax is a brand name for the drug alprazolam, a benzodiazepine mainly prescribed for the treatment of anxiety and panic disorders. The primary mechanism of action of this medication is the augmentation of gamma-aminobutyric acid (GABA), a neurotransmitter that suppresses specific brain signals to induce a calming response.
As a result, Xanax is useful in easing the symptoms of anxiety, nervousness, and panic attacks. However, because of its sedative qualities, it is frequently recommended for brief periods of time because extended usage results in addiction, tolerance, and dependency.
In fact, an article titled, “A Review of Alprazolam Use, Misuse, and Withdrawal” published in the January-February 2018 issue of the Journal of Addiction Medicine explained that its clinical application has been a topic of debate, as the majority of addiction specialists regard it as highly addictive due to its distinctive psychodynamic properties, which restrict its use in clinical settings. However, numerous primary care physicians continue to prescribe it for longer periods than recommended.
How addictive is Xanax?
Xanax is highly addictive, and its addictive nature is most pronounced when used for prolonged durations or in quantities above the prescribed requirements. Due to its quick-acting effects, which offer quick relief from anxiety, there’s a greater potential that users become more tolerant to it and need bigger dosages to get the same soothing effect.
The risk of both physical and psychological dependence rises with this escalation. The brain undergoes adaptation to the drug’s presence, and discontinuing or decreasing its use leads to withdrawal symptoms, therefore reinforcing the ongoing use.
What makes Xanax so addictive?
Xanax is particularly addictive because it is processed by the body quickly and has a short half-life, meaning it doesn’t stay in the system for long, as per a 2018 study by Ait-Daoud et al., titled, “A Review of Alprazolam Use, Misuse, and Withdrawal.”
This makes it more likely to be misused because its effects wear off faster. It gets absorbed into the body quickly but doesn’t spread through body fat much, which means it doesn’t last as long as other drugs like diazepam. This additionally means people are bound to experience withdrawal symptoms sooner, which highlights the impact of drugs on the brain.
The quick and immediate onset of calm elicits a powerful psychological compulsion to continue drug use, particularly for persons who are seeking instant alleviation from stress or anxiety.
Is it possible to take Xanax every day without becoming addicted?
No, it is not possible to take Xanax every day without the risk of becoming addicted. Xanax is intended for short-term use because of its high potential for dependence and addiction when taken regularly.
Even when taken as prescribed, the brain becomes reliant on the drug, making it difficult to stop without experiencing withdrawal symptoms. For this reason, medical professionals generally recommend limiting Xanax use to short-term treatment or occasional use under strict supervision.
Can you overdose on Xanax?
Yes, it is possible to overdose on Xanax, particularly when it is consumed in large quantities or when it is mixed with other substances, such as alcohol or opioids. Due to its central nervous system depressant effects, Xanax, when taken in excess, reduces the pace of breathing and heart rate, among other critical bodily functions.
Approximately one-third of deliberate drug overdose and suicide attempts are linked to benzodiazepines, according to a 2018 article from the Journal of Addiction Medicine titled, “A Review of Alprazolam Use, Misuse, and Withdrawal.”
The review added that a database analysis of poisoning admissions to a regional toxicology service showed that the median length of stay (LOS) for cases involving alprazolam was 19 hours, 1.27 times greater than for cases involving other benzodiazepines.
What are the symptoms of Xanax addiction?
Symptoms of Xanax addiction denote the indications that an individual has developed a dependence on the medication. The symptoms of Xanax addiction are listed below.
- Craving for Xanax: A person addicted to Xanax often experiences a strong, uncontrollable urge to use the drug. These cravings dominate their thoughts, making it difficult to focus on anything other than obtaining and consuming Xanax. Findings of a 2006 paper by Mol et al., titled, “The absence of benzodiazepine craving in a general practice benzodiazepine discontinuation trial” revealed that compared to patients who had effectively discontinued benzodiazepines, those who continued to use them throughout the 21-month study reported more severe cravings. This implies that cravings are potentially exacerbated by prolonged use, or vice versa.
- Drowsiness: Individuals addicted to Xanax frequently experience excessive drowsiness, even when not intending to sleep. The drug’s sedative effects leave them feeling constantly fatigued or sleepy, impairing their ability to stay alert during daily tasks. This persistent drowsiness interferes with responsibilities, such as work or driving, increasing the risk of accidents.
- Increased tolerance: As tolerance increases, individuals take more of the drug than prescribed or seek additional sources to maintain their desired effect. Tolerance to benzodiazepines develops with prolonged usage, particularly for their sedative and anticonvulsant properties. The gradual decrease in therapeutic efficacy due to tolerance is a major obstacle in clinical practice, according to a 2012 study by Christiaan H. Vinkers and Berend Olivier titled, “Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective GABAA Receptor Modulators?”
- Blurred vision: Blurred vision is another symptom of Xanax addiction, where individuals have difficulty seeing clearly. As visual perception is compromised, reading, driving, or other intricate tasks become more difficult. The medication’s effect on the central nervous system leads to disturbance of regular eye function, therefore contributing to certain visual impairments.
- Withdrawal symptoms: Withdrawal symptoms from alprazolam are more severe and distinct from those of other benzodiazepines; they include rebound anxiety, panic attacks, physical symptoms, and, in extreme circumstances, delirium and psychosis, as per a 2018 review by Ait-Daoud et al., titled, “A Review of Alprazolam Use, Misuse, and Withdrawal.” Experiencing these symptoms is possible even when following the manufacturer-recommended tapering schedule.
- Slurred speech: Slurred speech often occurs in people addicted to Xanax, as the drug slows down brain activity and impairs motor coordination. This makes communication difficult, with speech becoming unclear or difficult to understand. As the dosage increases or addiction worsens, slurred speech becomes more noticeable, affecting personal and professional interactions.
- Loss of control: A hallmark of Xanax addiction is the inability to control or limit use, even when trying to cut back. Individuals find themselves taking larger amounts or using Xanax more frequently than intended. This loss of control interferes with daily activities, work, and relationships.
- Difficulty concentrating: Xanax causes cognitive impairment, which leads to difficulties when it comes to focusing on tasks, solving problems, or retaining information, affecting their performance at work or school. In a 2018 study by Simon F. Crowe and Elizabeth K. Stranks titled, “The Residual Medium and Long-term Cognitive Effects of Benzodiazepine Use: An Updated Meta-analysis,” current benzodiazepine users showed significant adverse impacts in the cognitive domains of working memory, such as divided attention, processing speed, visuoconstruction, expressive language, and recent memory.
What are the signs of Xanax addiction?
Signs of Xanax addiction are identified by observable behaviors and emotional patterns that point to an individual experiencing Xanax dependence. The signs of Xanax addiction are listed below.
- Doctor shopping: Doctor shopping refers to the behavior of seeking prescriptions from multiple doctors to obtain more Xanax. Individuals addicted to Xanax engage in this practice to ensure a steady supply of the drug, often without disclosing their previous prescriptions. A 2010 study by Pradel et al., titled, “Assessment of Abuse Potential of Benzodiazepines from a Prescription Database Using ‘Doctor Shopping’ as an Indicator” found that approximately 12% of local residents had at least one prescription for a benzodiazepine during the year, and 3.6% of the total amount of these medications that were administered came from doctor shopping, or over 350,000 defined daily doses (DDD). The amount of medications acquired through doctor shopping was mostly attributed to more often prescribed benzodiazepines, such as Alprazolam.
- Neglecting responsibilities: People addicted to Xanax often begin to neglect their responsibilities at work, school, or home as their focus shifts to obtaining and using the drug. Important tasks are left incomplete, and personal relationships suffer due to their increasing preoccupation with Xanax.
- Social withdrawal: An addicted person often withdraws from social activities and isolates themselves from family and friends. Loved ones notice a lack of interest in spending time together, attending events, or engaging in hobbies they once enjoyed. This withdrawal often happens because the individual prioritizes drug use over social connections and feels ashamed or anxious in social settings.
- Financial problems: Xanax addiction leads to financial difficulties, as individuals spend large amounts of money to obtain the drug, either legally or illegally. Family members or friends are likely to notice unpaid bills, borrowing money frequently, or other signs of financial distress. The need to sustain their addiction results in the person prioritizing drug purchases over essential expenses.
- Paraphernalia or hidden medication: Those close to a person addicted to Xanax typically notice hidden pill bottles or empty medication containers around the home or car. The individual tries to hide their drug use by stashing medication in unusual places or keeping their supply secret from others. A 2019 study from the journal Psychiatric Services titled, “Benzodiazepine Use and Misuse Among Adults in the United States” revealed that the benzodiazepine most often misused was Alprazolam, and the primary suppliers of misused benzodiazepines were friends or relatives.
- Risk-taking behaviors: Individuals addicted to Xanax begin engaging in risky behaviors, such as driving under the influence, taking higher doses than prescribed, or mixing Xanax with other substances. They are more likely to make poor decisions, often without considering the potential dangers to themselves or others. These reckless actions stem from the drug’s impact on judgment and self-control, which becomes impaired as addiction deepens.
- Legal problems: Legal issues arise when someone addicted to Xanax engages in illegal activities, such as obtaining the drug through fraudulent prescriptions or possessing it without a valid prescription. Legal troubles are often a significant indicator that the person’s drug use has spiraled out of control.
What are the side effects of Xanax addiction?
Side effects of Xanax addiction are the outcomes of abusing the medication over an extended period of time. The side effects of Xanax addiction are listed below.
- Weakness: Prolonged Xanax addiction leads to a constant feeling of physical weakness or fatigue. Individuals struggle to perform everyday tasks or feel drained after minimal effort. This lack of strength often stems from the sedative effects of Xanax, which slow down physical activity and muscle function.
- Impaired coordination: One adverse effect of benzodiazepines, such as Xanax, is impaired motor coordination, which is more prevalent at higher dosages, according to a 2013 review from The Ochsner Journal titled, “Benzodiazepine Pharmacology and Central Nervous System–Mediated Effects.” This makes simple tasks such as walking or handling objects more difficult. People experience clumsiness or stumble often, which leads to accidents or injuries.
- Flattened mood: Addiction to Xanax results in a flattened or dulled emotional state, where the person experiences limited emotional responses. They appear indifferent or show little reaction to positive or negative situations. This emotional blunting is caused by the drug’s numbing effects on the brain’s emotional centers.
- Dry mouth: A common side effect of Xanax addiction is dry mouth, where there is a noticeable lack of saliva, causing discomfort. This leads to difficulty swallowing, bad breath, or an increased risk of dental issues like cavities. A 2003 article by C Scully CBE titled, “Drug effects on salivary glands: dry mouth” explained that benzodiazepines decrease excretion of fluid in the salivary glands, therefore contributing to the perception of oral dryness. This phenomenon is likely attributed to their influence on the GABA receptors, which are involved in the regulation of salivation.
- Nausea and appetite loss: Affected individuals feel queasy after eating or have difficulty maintaining a regular diet, leading to weight loss and nutritional deficiencies. This digestive discomfort results from the body’s reaction to prolonged drug use, as Xanax alters the body’s natural functions.
- Constipation: Chronic use of Xanax causes constipation, making bowel movements infrequent or difficult. This occurs because Xanax slows down the body’s overall functioning, including digestion, which results in discomfort and bloating.
- Memory loss: Memory impairment is a notable side effect where individuals struggle to recall recent events or important information. In fact, a 2023 review by Kameron Kaplan and Holly Christian Hunsberger titled, “Benzodiazepine-induced anterograde amnesia: detrimental side effect to novel study tool” confirmed that benzodiazepines have been shown to impair both short-term and long-term memory in humans and rodents, with an especially strong impact on verbal recall, recognition, working memory, and spatial memory.
- Suicidal ideation: Benzodiazepine use has been linked to depressive symptoms and, in certain situations, the emergence of suicidal thoughts, as per a 2000 article form the American Family Physician titled, “Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives.” The paper further stated that reducing the dosage or stopping medication possibly alleviates depressed symptoms, according to studies linking greater benzodiazepine dosages to a higher risk of depression. The mechanism of this action is not entirely clear; however, benzodiazepine-related depression is potentially a physiological consequence of a decrease in central monoamine activity.
How to recognize Xanax addiction?
To recognize Xanax addiction, observe both behavioral and physical changes in the individual. Symptoms include increased drowsiness, slurred speech, impaired coordination, and frequent mood swings.
They additionally exhibit risk-taking behaviors, such as driving under the influence or seeking multiple prescriptions from different doctors (doctor shopping). Pay attention to social withdrawal, neglect of responsibilities, and sudden financial problems as further indicators.
Furthermore, the individual is likely to express a need for higher doses to achieve the same effect or display withdrawal symptoms like anxiety and agitation when they stop using the drug.
How to help someone with Xanax addiction?
To help someone with Xanax addiction, begin by adopting a compassionate and understanding attitude towards the person. Refrain from passing judgment and instead show non-confrontational concern for their well-being.
Advocate for their engagement of professional assistance, such as seeking guidance from a medical practitioner or addiction specialist who possesses the necessary knowledge to direct them towards detoxification programs or therapeutic alternatives such as cognitive behavioral therapy (CBT).
Offer support by assisting with finding treatment resources and providing emotional encouragement throughout the recovery process. Additionally, avoid enabling their behavior by refusing to assist with obtaining more Xanax or ignoring the problem, as this is guaranteed to further perpetuate the addiction.
What are the Xanax addiction treatment options?
Xanax addiction treatment options pertain to the therapeutic methodologies employed to assist persons in overcoming their reliance on Xanax. The most significant Xanax addiction treatment options are listed below.
- Medically supervised detoxification: This process involves gradually reducing Xanax use under the supervision of a healthcare professional to manage withdrawal symptoms safely. Drug detoxification takes place in a hospital or specialized treatment facility, where doctors monitor the individual’s physical and mental state. Medication is often provided to alleviate withdrawal effects and ensure a more comfortable experience. Detoxification is often the first step in a comprehensive treatment plan for Xanax addiction.
- Cognitive behavioral therapy (CBT): In CBT, individuals work with a counselor to develop healthier coping mechanisms for anxiety and stress, which are often triggers for Xanax misuse. According to a 2021 review by Chapoutot et al., titled, “Cognitive Behavioral Therapy and Acceptance and Commitment Therapy for the Discontinuation of Long-Term Benzodiazepine Use in Insomnia and Anxiety Disorders,” RCTs, or randomized controlled trials, have demonstrated that CBT considerably raises the likelihood of a successful benzodiazepine (BZD) cessation. For example, a study conducted on insomnia patients demonstrated a success rate of 85% with CBT and 48% without CBT following the completion of treatment.
- Gradual tapering: This involves slowly reducing the dosage of Xanax over time under medical supervision to minimize withdrawal symptoms. This method helps the body adjust to lower levels of the drug, preventing the shock that occurs with abrupt cessation. In their 2015 article titled, “Management of benzodiazepine misuse and dependence,” Jonathan Brett and Bridin Murnion asserted that the tapering procedure is crucial for mitigating the risk of withdrawal symptoms, which include life-threatening seizures. Starting with a more rapid taper, patients who are taking higher doses of diazepam equivalents (greater than 10 mg) can transition to a slower taper as they reach lower doses.
- Motivational interviewing (MI): Motivational interviewing is a therapeutic approach that helps individuals explore their ambivalence about quitting Xanax and encourages self-motivation for change. The therapist works collaboratively with the individual to identify their personal reasons for recovery and strengthen their commitment to the process.
- Inpatient treatment: Inpatient drug rehab provides a structured, intensive treatment environment where individuals stay at a facility for a designated period. They participate in therapy sessions, receive round-the-clock medical attention, and acquire coping mechanisms for their addiction while they are inside. People who receive inpatient therapy are freed from the distractions and triggers of everyday life, allowing them to concentrate entirely on their recovery.
- 12-step programs: 12-step programs provide a structured approach to overcoming addiction through a series of spiritual and personal steps. Participants work through the steps at their own pace, often with the guidance of a sponsor, while attending regular meetings. Greater self-efficacy, better psychosocial functioning, and higher rates of abstinence are all linked to 12-step program participation, as per a 2013 study from the journal Social Work in Public Health titled, “12-Step Interventions and Mutual Support Programs for Substance Use Disorders: An Overview.” Several participants claim years of sobriety, demonstrating the possibility of achieving long-term abstinence.
- Outpatient treatment programs: Outpatient treatment allows individuals to live at home while attending regular therapy sessions and treatment appointments. With this flexible alternative, people are able to receive treatment for their addiction while still working or taking care of their families. Outpatient programs are frequently implemented subsequent to inpatient care and provide an assortment of services, including counseling and group therapy.
Is rehab effective for Xanax addiction?
Yes, rehab is effective for Xanax addiction, most notably when it is customized to the individual’s needs and accompanied by comprehensive treatment methods. Inpatient and outpatient rehabilitation programs in particular offer controlled settings where individuals with addiction receive the medical treatment, counseling, and coping mechanisms they need to overcome their drug habit.
People in these programs are taken away from daily stresses and triggers, which lets them focus on recovery while learning how to control their cravings. Detoxification, therapy, and ongoing support considerably raise the likelihood of a successful Xanax addiction recovery.
The efficacy of rehab is further contingent upon the quality of the program, the individual’s dedication, and the ongoing support provided after treatment.
Does Xanax cause a withdrawal effect?
Yes, Xanax causes a withdrawal effect, particularly when used over an extended period or in high doses. As a benzodiazepine, Xanax alters the brain’s chemistry, and sudden discontinuation leads to what is known as “benzo withdrawal.”
Symptoms of benzo withdrawal include tremors, anxiety, sleeplessness, irritability, and, in severe cases, seizures. The intensity of these symptoms depends on the duration of use, the dosage, and whether the individual stops abruptly or gradually. To mitigate withdrawal effects, it is often recommended that individuals taper off the drug under medical supervision.
How long does Xanax withdrawal last?
Xanax withdrawal lasts for about 28 days in general. It is worth noting, however, that the duration of Xanax (alprazolam) withdrawal varies widely depending on several factors, including the dose, duration of use, individual metabolism, and whether the patient tapered off the drug gradually or discontinued it abruptly.
Typically, withdrawal symptoms begin within a few hours to a day after the last dose, as Xanax has a short half-life of about 11 hours in healthy adults. Benzodiazepine withdrawal usually involves an acute phase that lasts five to 28 days, according to a 2012 study by Hood et al., titled, “Benzodiazepine dependence and its treatment with low dose flumazenil.”
The paper further explained that people go through a variety of symptoms during the acute phase, such as tremors, anxiety, panic attacks, sleep disturbances, and muscular spasms. More serious events, such as seizures or the start of psychosis, are possible in severe situations.
Following the acute phase, there is a protracted withdrawal phase that typically lasts for a year or more. Protracted withdrawal symptoms, which include psychological and physical symptoms such as ongoing anxiety, depression, and cognitive impairments, affect between 10 and 25% of long-term benzodiazepine users.
