Xanax (Alprazolam) addiction: recognition and treatment

Xanax addiction is a type of substance use disorder wherein a person has developed a tolerance to Xanax, which leads to dependence and withdrawal symptoms when they stop using it. More precisely, in Xanax addiction, an individual continues using the drug or seeking more of it despite the harmful consequences it causes.

Xanax, also referred to as alprazolam in its generic equivalent, is a medication that belongs to the class of drugs called benzodiazepines. It is a US Food and Drug Administration-approved medication as a fast-acting tranquilizer that acts on neurotransmitters in the brain to treat anxiety, panic disorder, and anxiety linked to depression.

The main causes of Xanax addiction are the impact of the drug on the brain’s reward system, but various factors contribute to the development of the addiction, such as genetics, underlying mental health problems, and the environment according to a 2016 review of Benzodiazepine use, misuse, and abuse from the Mental Health Clinician.

The most pronounced symptoms of Xanax addiction include withdrawal symptoms when a person stops, needs to keep taking the drug, and engages in risky behaviors to obtain it as stated in A Review of Alprazolam Use, Misuse, and Withdrawal published in the Journal of Addiction Medicine in 2018.

The main misconception about Xanax addiction is that a person can just stop taking the drug, and their problem will be solved. Xanax has a strong addiction potential, which is why the person needs a well-structured treatment.

How addictive is Xanax?

Xanax is highly addictive due to its unique psychodynamic properties, which limit its clinical usefulness. The medication is only recommended for short-term treatment, a 2018 review from the Journal of Addiction Medicine reports. The question is: why is Xanax so addictive? The fast-acting nature is what makes Xanax highly addictive; the drug reaches its peak in one to two hours. Since it’s fast-acting, Xanax induces a major change in the brain in a short timeframe.

The effects of Xanax on the brain can be short- and long-term. Short-term effects are changes in GABA (gamma-aminobutyric acid) and the triggering of the brain’s reward system. Long-term effects are the development of tolerance which leads to dependency and later addiction. Some people can develop these problems even if they adhere to all the instructions.

Tolerance means the prescribed dosage isn’t working anymore. But, is Xanax addictive in low doses? It can be, especially when it’s misused and induced over a long period.

People receive Xanax prescriptions to manage a specific problem, mostly anxiety—symptoms of anxiety return. A patient starts taking more of the drug to experience relief. During this process, the brain becomes more reliant on the drug. The cycle of tolerance and increased intake continues to the point until a person becomes addicted.

How much Xanax does it take to be addicted?

The precise dosage of Xanax that may lead to addiction is unclear. Not every person who takes Xanax will develop an addiction. Many factors are involved, including using high doses, mixing Xanax with other drugs, and using the drug for a long period of time. Younger age and lower level of education are also risk factors for developing Xanax addiction, according to a study by Kan et al., published in the Comprehensive Psychiatry journal.

Generally speaking, the recommended daily dose of Xanax in the acute treatment of anxiety is 0.25mg to 0.5mg three times a day as advised by the U.S National Library of Medicine. The maximum daily dosage doctors recommend is 4mg a day in divided doses. These doses are considered relatively safe. However, every person is different, so they may respond to the specific amount of Xanax in a different manner. Someone can develop Xanax addiction symptoms even when taking the drug as prescribed.

How long does it take to get addicted to Xanax (Alprazolam)?

How long it takes to get addicted to Xanax (alprazolam) may vary from one person to another. It is recommended that benzodiazepines shouldn’t be used for more than four weeks, a 2014 paper by Professor Malcolm Lader of the Institute of Psychiatry published in the British Journal of Addiction suggests.

Benzodiazepine drugs, such as Xanax are potentially addictive drugs, psychological and physical dependence can occur within a few weeks to a few months of continuous or regular use according to The Ashton Manual by Professor Heather Hashton of Newcastle University’s Institute of Neuroscience. The prolonged and consistent medication increases the likelihood of becoming dependent. Risks such as high doses for short periods, previous history of substance dependence, and passive dependent personalities are among the factors for developing dependence on benzodiazepines.

When discussing how long it takes to get addicted to Xanax, it is important to emphasize once again that not every person who takes Xanax will become addicted. While many clinicians imply addiction is unpredictable, research shows that genetic, situational, and psychological factors are involved and make a person more prone to addiction. An individual’s personality profile also plays a role. For instance, persons who become addicted to Xanax tend to cope in more emotional ways than their counterparts who use Xanax without becoming addicted to it. Due to the severity of the problem, well-structured Xanax addiction treatment is necessary.

What are the signs and symptoms of Xanax addiction?

The signs and symptoms of Xanax addiction can range from mild to severe and can vary from individual to individual, as defined by Professor Heather Ashton of the University of Newcastle in an article published in the Psychiatric Annals. Some common indicators may include:

• Inability to reduce or stop taking the medication, needing to use more and more
• Excessive drowsiness and/or lightheadedness
• Sleeping for extended periods of time
• Blurry vision
• Spending most time or money on thinking about, obtaining, and using Xanax
• Engaging in risky behaviors under effects of Xanax, e.g., driving
• Buying Xanax on the street
• Relying on deception to get more Xanax from healthcare providers, family, or friends
• Impaired coordination, slurred speech, or difficulty walking
• Cognitive impairment
• Nausea and/or vomiting
• Delirium
• Dry mouth
• Weakness
• Lack of interest in other activities a person used to enjoy
• Social isolation and problems at school or work

What are the dangers of Xanax addiction?

The most common dangers associated with Xanax addiction include depression, delirium, psychosis, impulsivity, aggression, cognitive impairment, increased risk of dementia, and death.

A 2016 review by Allison Schmitz, a clinical pharmacy specialist from Fargo VA Health Care System, published in The Mental Health Clinicians, reports that benzodiazepine abuse is often accompanied by the use of other drugs. The most commonly abused substances along with benzodiazepine are opioids and alcohol. These are frequently taken in conjunction to enhance euphoric effects, counterbalance unpleasant side effects like insomnia caused by stimulants, and alleviate withdrawal symptoms while consuming larger doses than recommended.

On account of that, the biggest danger of Xanax addiction is overdose and death. Opioids and benzodiazepines are the predominant prescription drugs that are linked to overdose fatalities.

What are the stories of the dangers of Xanax addiction?

Stories of the dangers of Xanax addiction show just how severe this problem truly is. The Guardian published an article in 2018 about a London teenager who developed Xanax addiction after he obtained it illegally with his friend. The teenager explains tolerance to Xanax develops quickly, and his personality changed to the point he had no emotions. After having tried to sell Xanax to an off-duty police officer, the teenager was arrested, after which he went through detox. He described withdrawal symptoms as strong, and the whole process seemed a lot longer than it actually was. The teenager also added that Xanax addiction had a negative impact on his and his family’s life.

A different story, published in Healthline in 2018, speaks about Xanax addiction from a different aspect. In this case, the female patient received a prescription to treat her anxiety, despite having a history of addiction (alcoholism). Addiction to benzodiazepines changed her personality until she became a shell of the person she used to be. She abandoned many activities in favor of plotting ways to get more pills. For example, she would call a doctor to say she needs a prescription early because she’s going on vacation. Her addiction was so serious doctors put her on instant withdrawal without medications because she also developed an addiction to heroin.

These two Xanax addiction stories paint a scary picture of how dangerous it can be to develop an addiction to Xanax. The whole personality is changed. Addiction doesn’t only affect the person who takes drugs, but their family and friends too.

How to recognize Xanax addiction?

A person addicted to Xanax appears very tired and has low energy levels. They usually don’t have the motivation to socialize or engage in normal daily activities.

You may also recognize something is wrong by changes in a person’s behavior, mood, appearance, or performance at school or work. These changes can be attributed to other factors, not just Xanax addiction. However, they’re telltale signs someone’s struggling with serious problems like drug abuse.

If you recognize signs associated with Xanax addiction symptoms from this post, you can encourage the addicted person to seek professional help. Laboratory tests can detect the presence of medications, including Xanax. However, these tests can’t diagnose addiction.

Addiction to Xanax is diagnosed when the affected person meets the criteria described in the DSM-5 Criteria for Substance Use Disorders. Basically, a Xanax diagnosis is established when a person meets at least two of 11 criteria within a one-year period. These include using the drug in a harmful manner, neglecting duties due to drug use, social and relationship problems due to Xanax, developing drug tolerance, withdrawal symptoms, using higher amounts or taking the drug more frequently, inability to decrease or stop drug use, investing a lot of time to obtain or use the drug, experiencing side effects, cravings, and avoiding normal activities in favor of Xanax.

Upon diagnosis of Xanax addiction, the healthcare professional also determines the severity of the problem. Addiction can be mild, moderate, or severe. Mild addiction refers to cases where a person meets two to three criteria, moderate if four to five criteria are met. Severe addiction occurs when a person meets six or more criteria.

It is of extreme importance for the addicted person to participate in the diagnostic process. Remember, you can’t diagnose Xanax addiction on your own. When you recognize signs of Xanax use, you can set up a support system that would motivate or encourage the person to get help.

What are the treatment options for Xanax addiction?

Treatment options for Xanax addiction normally involve medications and therapy. In most cases, a patient receives a combination of these two approaches according to a 2014 research-based guide on the Principles of Drug Addiction Treatment from the National Institute on Drug Abuse. The main objective of the treatment is to help a patient avoid using Xanax, but it also works to address their underlying conditions such as depression and anxiety.

Medications for Xanax addiction work to manage withdrawal symptoms. They may also serve as a long-term treatment for anxiety. To avoid further problems, doctors usually prescribe non-addictive alternatives to Xanax. The use of medications doesn’t necessarily remain in detoxification, which is the first stage of addiction treatment. Detox in Xanax addiction treatment tends to last longer than detoxification for other drugs. The reason is simple: Xanax is highly addictive and causes serious withdrawal symptoms, so the dose has to be tapered slowly and gradually. As a result, treatment can overlap with other stages of the treatment process.

Therapy is an integral component of Xanax addiction treatment. The goal of the therapy is to treat underlying mental health problems, help patients adopt healthy coping mechanisms, and adopt a more positive mindset to replace negative thoughts and behaviors. The most effective approach is cognitive-behavioral therapy (CBT), according to a 2017 review article by Michael Soyka, M.D. on the Treatment of Benzodiazepine Dependence published in the New England Journal of Medicine. This type of therapy could help patients learn to resist triggers that lead to drug abuse.

Patients also receive education, cue exposure, and take part in self-management training. Education is particularly important primarily because most patients don’t know how is Xanax addictive primarily because they regard medications as safe solutions to symptoms they experience. To address the growing severity of drug abuse, organizations including the American College of Physicians, Substance Abuse and Mental Health Services Administration, and the American Psychiatric Association, created treatment guidelines and policy statements on physician prescription, patient education, and the use of Prescription Drug Monitoring Programs to aid in the prevention and reduction of prescription misuse such as Xanax addiction, as reported by A Systematic Review of Opioid and Benzodiazepine Misuse in Older Adults published in The American Journal of Geriatric Psychiatry in 2016.

Alternative treatment options for Xanax addiction include motivational interviewing and contingency management. Counseling in Xanax addiction treatment can be done individually or in groups. Family and marital therapies are also available.

Support groups are also an important aspect of Xanax addiction treatment. Regular meetings allow persons with addiction to share their experiences, and offer and receive support. All this can help an addicted individual stay on the right track as explained in detail by the research-based guide on the Principles of Drug Addiction Treatment from the National Institute on Drug Abuse.

How to find a treatment center for Xanax addiction?

You can find a treatment center for Xanax addiction treatment by asking your healthcare provider or other health professionals for a recommendation since they are knowledgeable of treatment resources as noted by a guide from the Substance Abuse and Mental Health Services Administration of the U.S. Department of Health and Human Services. Additionally, contacting different treatment centers to see how they can help and what kinds of treatments they offer is also useful. Compare their approaches to see what works best. Persons with Xanax addiction, or their family members, can also connect with other individuals who overcame this problem and learn more about the treatment center where they received treatment.

Keep in mind the addiction treatment center is a center that provides a well-structured treatment for persons who are struggling with different substance use disorders. The treatment plan may vary from one center to another. Some provide both inpatient and outpatient programs, whereas others focus on one of them only. The severity of addiction should also play a role in choosing treatment centers and the program they offer. For that reason, it’s practical to set up an appointment with an addiction specialist from a specific center to learn as much as possible.

Is rehabilitation effective for Xanax addiction?

Rehabilitation is effective for Xanax addiction treatment. The main purpose of rehabilitation is to help a person start their recovery in a safe manner. An addicted individual shouldn’t quit taking Xanax cold turkey because this move can cause serious withdrawal symptoms such as aches and pains, anxiety, aggression, dizziness, paranoia, difficulty breathing, and tremors. Rehabilitation starts with a medically supervised detoxification or tapering program during which they slowly wean off the medication. The inpatient rehabilitation program is suitable for persons with moderate to severe addiction, whereas an outpatient program is useful for individuals with mild addiction. According to a 2021 qualitative study on people who use drugs in rehabilitation published in PLOS ONE, rehabilitation provides a stable environment to prevent relapse through an emphasis on pharmacotherapy and psychotherapy; and secondly by imposing a structured routine to recover normal lifestyle practices.

What are the drugs like Xanax that are not addictive?

Drugs like Xanax that are not addictive include classes of medications such as SSRIs, SNRIs, beta-blockers, Vistaril (hydroxyzine), and Buspar (buspirone). These medications act as non-addictive alternatives to benzodiazepines.

In a nutshell, the most common substitute for Xanax is a class of drugs called selective serotonin reuptake inhibitors (SSRIs), which are formulated primarily to treat depression but are also effective for the management of anxiety. These drugs work to increase serotonin concentration in the brain. Serotonin is a feel-good chemical. Common SSRIs include fluoxetine (Prozac), citalopram (Celexa), and escitalopram (Lexapro). According to a 2014 paper entitled “Abuse and misuse of antidepressants” published in Substance Abuse and Rehabilitation, most people prescribed with antidepressants don’t misuse them, and these drugs have low addictive potential. That means these medications are a safer alternative to Xanax, but the prescription is still necessary.

The term SNRIs refers to serotonin and norepinephrine reuptake inhibitors usually prescribed for generalized anxiety disorder and panic disorder. These medications are similar to SSRIs because they regulate serotonin, but they also control norepinephrine, a neurotransmitter associated with concentration and alertness. Common examples of SNRIs include duloxetine (Cymbalta) and venlafaxine (Effexor).

As far as buspirone and hydroxyzine are concerned, the latter is a fast-acting drug for temporary anxiety treatment that works by blocking histamine receptors to balance out neurotransmitters. On the other hand, buspirone is similar to SSRIs because it increases serotonin but only targets one subtype of the serotonin receptor.

Beta-blockers are medications that control the body’s fight-or-flight response and decrease its impact on the heart. These medications can be prescribed for different health problems ranging from high blood pressure to irregular heartbeat. Doctors can also prescribe beta-blockers to manage anxiety because they prevent adrenaline from getting into contact with beta receptors of the heart. As a result, the heart doesn’t pump faster or harder. Unlike benzodiazepines, beta-blockers don’t cause drug addiction.