Xanax Addiction and Abuse

Xanax is the brand name of alprazolam, a prescription sedative that falls under the category of benzodiazepine. This medication is generally prescribed for the treatment of anxiety, panic attacks, and insomnia. Xanax is a highly regulated schedule IV-controlled substance with a high potential to cause physical dependence with prolonged use. Xanax is the most heavily prescribed psychiatric medication in the US.

Xanax is available in strengths and colors of 0.25 mg (white), 0.5 mg (orange), 1 mg (blue), and 2 mg (white, green, and yellow). The most potent dosage (2 mg) is referred to as a Xanax bar due to its distinctive rectangular shape, compared to the smaller doses that are of oval shape. When taken according to a doctor’s prescription, Xanax is a safe and effective drug for mental health care.

Xanax is a CNS depressant that affects the brain and central nervous system (CNS) by increasing the production of gamma-aminobutyric acid (GABA), a chemical that helps decrease nerve cell activity in the brain. Xanax induces a sense of a calm, relaxed state upon its users when consumed.

Consuming more than the prescribed dose or using Xanax without a prescription is regarded as abuse. Xanax is generally prescribed by doctors as a short term (2–6 weeks) solution due to its high potential to cause dependence, tolerance, and addiction. American Family Physicians have found benzodiazepines, such as Xanax, to have a significant potential for abuse, particularly in certain at-risk populations.

Xanax is commonly abused due to its ability to induce an extreme feeling of relaxation in a patient. What makes Xanax so highly addictive is that its effects are experienced as quickly as 25 minutes after ingestion, but dissipate after only a few hours. This leaves patients wanting more of Xanax, even though it violates the boundaries of their prescriptions.

Common street names of Xanax are:

• Xannies or zannies
• Handlebars
• Bars
• Blue footballs
• Benzos
• French fries
• Ladders
• Sticks

The New York Times notes that Xanax’s illicit use is so extreme that in 2011, a clinic in Louisville put an end to both Xanax and alprazolam prescriptions with a proposal to wean pre-prescribed patients off the drugs by the end of the year.

Xanax may be abused in the following ways:

• Taking multiple tablets or pills
• Injecting the drug
• Snorting the drug
• Taking the drug through a blotter paper
• Taking the drug with other drugs or alcohol

The formation of tolerance can grow rapidly within a short period. This results in patients requiring higher and higher doses to achieve the desired effects, as the body grows accustomed to the previous doses. During the stage of physical dependence, patients will no longer be able to function on a regular basis without the use of Xanax. Patients will experience severe withdrawal symptoms if they cease consumption during this stage.

Individuals who are addicted to Xanax generally abuse the drug by crushing, snorting, and injecting the substance to instantly activate their effects. They are generally abused in its most potent form, known as Xanax bars. Drug abuse through injecting may cause bacterial skin infections and spread diseases such as HIV and Hepatitis C.

Most individuals experience the effects of the medication within 20 minutes after oral consumption. However, when the pill is crushed and snorted, patients may experience its effects much faster. According to a study about the disparity between snorting Xanax and taking it orally, the average duration of symptoms decreased to about 2 minutes from the time it was inhaled. Most study participants indicated that the peak of the drug effects’ was similar between the two methods of administration. As such, most researchers find snorting Xanax to be just as dangerous as regularly abusing the drug by consuming excessive quantities or consuming more than recommended.

When inhaled through the nose, Xanax causes high irritation around the tissues surrounding the nose, which can cause nosebleeds over time. Prolonged Xanax snorting can also create a hole through the nasal septum (the wall between the nostrils). Individuals who snort Xanax may also inhale more than just alprazolam as drug trafficking organizations often make fake Xanax by combining many potent and hazardous drugs such as fentanyl. This has resulted in severe and adverse consequences for many users.

The most popular approach to misusing Xanax bars is orally or sublingually, allowing the pill to dissolve under the tongue. These techniques allow the largest amount of Xanax to get into a person’s body. Individuals who have developed tolerance to a quarter of a Xanax bar often double their dosage. Those who consume an entire Xanax bar may experience severe and adverse consequences due to its high potency.

The effects of abusing Xanax bars may include:

• Irritability
• Aggression
• Low blood pressure
• Chest pain
• Trembling
• Panic attacks
• Drowsiness
• Overdose

Xanax is widely used in conjunction with alcohol or other opioids to heighten its effects. It is also the drug of choice for those who are addicted to heroin and methadone. Nearly 40 percent of alcoholics routinely misuse Xanax. However, consuming Xanax with other forms of CNS depressants can be highly lethal as it can result in an overdose or respiratory failure. Crushing and chewing Xanax can also increase the risk of an overdose as the medication is only intended as a time-release medication.

The signs of a Xanax overdose may include:

• Confusion
• Slowed heart rate
• Extreme drowsiness
• Difficulties in breathing
• Fainting
• Loss of co-ordination
• Muscle weakness
• Coma

• Emergency room visits related to Xanax’s recreational use more than doubled from 57,419 in 2005 to 124,902 in 2010.
• Fifty million Xanax prescriptions were issued in 2013.
• Prescription rates for Xanax have been growing at a rate of 9 percent since 2008.
• In 2012, twice as many women had active Xanax prescriptions compared to men.
• Seventy percent of teenagers who are addicted to Xanax acquired the drug from their homes.
• In 2018, 5.4 million individuals under the age of 12 misused Xanax.

There is a difference between abuse and addiction. Addiction takes time to develop, and drug abuse is the initial stage of its formation. Not all who abuse drugs form an addiction, but the line is easily crossed. Patients who abuse Xanax are able to stop consumption for a long period, unlike patients who form an addiction.

A few signs of Xanax abuse are:

• Drowsiness
• Lightheadedness
• Sleeping for an unusually extended period
• Cognitive impairment
• Sluggishness
• Nausea
• Vomiting
• Headache
• Dry mouth
• Slurred speech
• Vertigo
• Impaired co-ordination
• The weakness of the body

An individual addicted to Xanax will exhibit certain physical, psychological, and behavioral symptoms such as:

• The development of tolerance
• Encountering withdrawal symptoms
• Memory loss
• Difficulties in concentration
• Lack of motivation
• Loss of interest in regular daily activities
• Intense cravings for the drug
• Avoiding activities or tasks that demand sustained attention and concentration
• Estranged relationships with family and friends
• Running into financial problems due to spending too much on the drug
• Taking part in risky activities, such as driving while under the influence of Xanax
• Facing legal problems due to Xanax use
• Losing control over the amount of Xanax consumed
• Unable to quit Xanax use despite the desire to do so

Other than the formation of dependence and tolerance, prolonged use of Xanax can also cause adverse and sometimes permanent psychological impairments in patients.

Psychological effects caused by prolonged Xanax addiction may include:

• Delirium
• Depression
• Cognitive impairment
• Psychosis
• Heightened risk of dementia
• Aggression

A 2016 study states that approximately 70 percent of teenagers experimented with drugs and alcohol by or before the age of 15. Xanax is popular among adolescents as it helps them cope with the stressors, depressions, and anxieties of teenage life. The use of Xanax by adolescents increases the probability of life-long dependence, a growing concern around the world. Prolonged use of Xanax in teens can cause adverse implications for their physical and psychological health and wellbeing. The easy access to Xanax at homes and schools leaves young adults vulnerable to form addictions. Kids who abuse Xanax are also more open to experimenting with other forms of potent drugs.

Xanax continues to be one of the most commonly used drugs among college students, with 31 percent of drug overdoses caused by Xanax or other forms of benzodiazepines involve this age group. Xanax is generally abused by college students to help them cope with the stress of adulthood and college life. Xanax is also widely abused in party cultures that are prevalent on most campuses as they induce the same effects as alcohol. The presence of other drugs on college campuses may encourage students to combine Xanax with other drugs such as alcohol, marijuana, and opioids. Combining drugs in such a manner increases the risk of a fatal overdose.

Expectant mothers who use Xanax can cause disruptions in fetal development in their unborn child. Xanax is known to directly impact birth defects as well as cause acute withdrawal symptoms that can be highly dangerous to a newborn child. Contrary to the dangers it holds, Xanax is widely prescribed to expectant mothers to treat anxiety and muscle cramps. Although prescribed for short-term relief, its capacity to form dependence within a short period creates the risk of addiction among expectant mothers.

Prolonged use of Xanax can cause the development of dependence among its users. During this stage, patients are no longer able to function on a daily basis without the influence of the drug as their body has grown accustomed to its effects. Abrupt cessation of consumption or reduction of dosage can cause physical and psychological effects that can be severe and intense. The intensity and duration of withdrawal symptoms may depend on the severity of one’s addiction.

Factors that contribute to the severity of an addiction:

• The length of Xanax use
• The general dosage consumed
• Duration of addiction
• Existence of polydrug abuse
• Mental health and medical history of the user
• Method of consumption

Xanax withdrawal symptoms may appear within a few hours since the last dose.

Withdrawal symptoms may include:

• Increased anxiety
• Panic attacks
• Insomnia
• Irritability
• Sweating
• Weight loss
• Suicidal thoughts
• Seizures
• Heart palpitations
• Uncontrollable shaking
• Nausea
• Vomiting
• Headaches
• Difficulty concentrating
• Muscle pain and stiffness
• Rebound Symptoms
• Hallucinations

Those who have been prescribed Xanax for generalized anxiety disorder, panic disorder, or insomnia may experience relapse symptoms during withdrawal. Rebound effects are enhanced symptoms of a pre-existing psychological disorder that was initially treated with Xanax. Although rebound symptoms usually disappear after a week, the underlying disorder will require treatment to avoid a relapse.

Certain Xanax’s withdrawal symptoms may persist up to two years in some individuals. This phenomenon is known as post-acute withdrawal syndrome (PAWS) or long-term withdrawal. Symptoms of PAWS are evident for up to 18 – 24 months after detoxification.

Common symptoms of PAWS may include:

• Chronic insomnia
• Aches and pains
• Persistent anxiety
• Sexual dysfunction
• Difficulty performing complex tasks
• Poor concentration
• Depression
• Nerve Pain
• Disorientation
• Short-term memory loss
• Lethargy
• Exhaustion

Xanax detoxification can be a long and intense process. Considering the severity of Xanax withdrawal, patients are not recommended to abruptly cease consumption, also known as going ‘cold turkey.’ Tapering down usage is the safest and most effective way to detox from Xanax as it helps reduce the intensity of withdrawal symptoms.

Tapering off Xanax involves the gradual reduction of the doses over a certain period. In some cases, a doctor may recommend switching to a less active benzodiazepine with a longer half-life, such as Klonopin. This helps patients wean off of Xanax dependence. Xanax withdrawal should always be performed under the supervision of a medical practitioner. Medically-assisted withdrawal is the most successful way to effectively and securely detox from Xanax as they decrease the chances of relapse.

Recovering from a Xanax addiction also involves learning how to cope with anxiety and difficult situations without the use of the drug. Hence finding the right treatment program is imperative to a patient’s long-term recovery. After the completion of detoxification, patients must undergo further treatment at an inpatient rehabilitation. For patient’s with a milder form of addiction to Xanax may find treatment at an outpatient rehabilitation center.

Inpatient rehabilitation is one of the most effective treatment options for Xanax addiction. This program offers the highest level of care, support, and structure, while also providing medically supervised detox programs. Inpatient treatment centers provide patients with residential facilities void of all temptation and distractions so they could solely focus on their recovery. Inpatient treatment programs may last from 28 days to several months, depending on the requirements of each patient.

After successful detoxification, the psychological aspects of Xanax addiction are addressed through treatments such as therapy and counseling. These programs help patients address any underlying issue that developed before and after addiction.

Inpatient rehab offers many different treatment therapies and options, such as:

• Group counseling
• Individual counseling
• 12-step program
• Art, music, and equine therapy
• Yoga
• Meditation
• Neurofeedback
• Biofeedback
• Cognitive-behavioral therapy (CBT)

Cognitive-behavioral therapy (CBT) is, by far, the most common form of benzodiazepine addiction therapy. CBT helps patients develop positive coping strategies against triggers and urges. Research has indicated that CBT is efficient in lowering benzodiazepine use over three months when incorporated in conjunction with tapering.

Outpatient treatment plans are an ideal choice for patients diagnosed with a mild form of addiction. This program provides patients with the flexibility to receive the treatment they require and return back to their lives outside. This is an ideal choice for patients with unavoidable obligations and responsibilities at home, work, or school. Outpatient services may consist of family therapy, counseling, continuing education, relapse prevention, and support groups. This program is also recommended for patients who complete inpatient rehabilitation as it provides them the essential support they need while gradually integrating back into society.

Outpatient rehab options:

• Partial Hospitalization Program (PHP) – This program may involve approximately 30 hours of treatment per week with a blend of individual and group therapy services.
• Intensive outpatient programs (IOPs) –This program provides an average of 6-9 hours of care a week.
• Standard outpatient – Depending on the requirements of a patient, this program provides individual and group therapy along with counseling services.

Receiving treatment after the completion of rehab is a vital component of addiction recovery. Addiction is a chronic disease that will require a patient to receive life long support and guidance through ongoing treatment plans or aftercare programs. These programs will provide patients with the support they require, along with essential education on relapse prevention strategies.

A few tips to avoid relapse are: