Xanax Addiction, Overdose, & Treatment Options
Xanax is the brand name for the anti-anxiety medication generically referred to as alprazolam. When used correctly in the short-term, Xanax treatment for anxiety can be helpful in most cases. However, long-term or improper use can lead to dependence and addiction, with potentially dangerous effects.1
According to the National Survey on Drug Abuse and Health from 2015, as many as 17.6 million people in the US use alprazolam products, including Xanax, which makes it the most commonly used benzodiazepine in the country. The high rate of prescriptions for this drug does have an effect on the number of people who may be likely to abuse it or develop addiction related to it based on the development of tolerance through long-term use or misuse.2
In the same year, more than 4.1 million people abused alprazolam. This represents about 1.6% of the population, and it is approaching one-quarter of the number of prescriptions given.2
Of course, not everyone who abuses Xanax has a prescription. For people who are at risk of becoming addicted to this medication or who are already struggling with addiction, professional treatment for Xanax addiction can be a lifeline to help with recovery and management of both the anxiety and the addiction.
Xanax: A Short-Term Benzodiazepine
Alprazolam is a type of many benzodiazepine drugs. These drugs are commonly prescribed to manage a host of nervous system and mental health conditions, such as:3
- Panic disorders.
Like other prescription benzodiazepines such as Klonopin, Xanax works by increasing the activity of certain neurochemicals in the brain, including gamma-aminobutyric acid, or GABA. This means that Xanax treatment for anxiety consists of relaxing the signals traveling through the brain and nerves, resulting in a calming effect.3
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 and seek professional treatment for Xanax addiction should it develop.1
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, 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.1
Because of tolerance, legitimate medical use of Xanax can lead to abuse. Most often, people may begin to abuse Xanax because it seems like the drug is no longer working 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.4
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 purpose, building up tolerance in a similar manner.5
How to Know If Someone Is Abusing Xanax?
Usually, the signs of Xanax abuse can be spotted fairly easily. Since 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:6
- 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.
Behavioral Signs Someone Is Abusing Xanax
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:7
- A focus on seeking out the drug, using it, and recovering from the 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.
Cognitive and Emotional Effects of Xanax Abuse
Xanax and other benzodiazepines can have negative effects on both short-term and long-term health.8 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:8
- 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, the cognitive effects of benzo use, including memory loss, can persist for six months or longer after stopping the drugs. Obtaining treatment for Xanax addiction as early as possible for abuse or addiction can help to prevent or minimize these symptoms.9
What Happens if You Overdose on Xanax?
As with many drugs of abuse, overdose is a major risk with Xanax and other benzodiazepines. As reported by the National Institutes on Drug Abuse, 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.10
Symptoms of Xanax overdose include:11
- Severely slowed or stopped breathing.
- Low heart rate and blood pressure.
If a person overdoses with Xanax, they need to receive emergency medical help immediately. With appropriate Xanax overdose treatment, many of the symptoms are reversible.11
What Are the Withdrawal Symptoms of Xanax?
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 can be uncomfortable enough to cause the person to continue using the drug instead of making effort to get treatment for Xanax addiction. However, when it comes to benzodiazepines, this is not the only risk during withdrawal.12
Stopping benzos use abruptly can send the neurological systems affected by the drug into a severe reaction, which may include the following symptoms:13
- Tension and anxiety
- Panic attacks
In some cases, these symptoms can be severe enough to be life-threatening. For this reason, quitting cold turkey is never advisable with these drugs. It is important to get appropriate treatments for Xanax addiction that include supervision and support of medical professionals.14
Xanax Addiction Treatment
Like any addiction treatment, treatments for Xanax addiction start with detoxification, the purpose of which is to remove the harmful substance from the body. This may happen after the person has overdosed, so they need immediate Xanax overdose treatment, or the person may look for treatment when they realize that they have an addiction issue.
To avoid severe withdrawal symptoms that can occur during detoxification, the drug is typically discontinued gradually over a period of several weeks. It is possible to carry out outpatient detoxification, but inpatient treatment is advised in cases when the patient is going through withdrawal from very high doses.15
In cases when a person uses multiple drugs, the best option may be to switch to only one slow-acting benzodiazepine during detoxification, namely diazepam.15
Psychological treatment makes recovery from Xanax addiction more effective. Treatment options for Xanax addiction that combine psychotherapy with tapering give better results than the treatment that only reduces the drug dose.12 Psychotherapy has three main goals:8
- To facilitate withdrawal
- To support further abstinence
- To treat the mental health issues that underlie addiction
The forms of psychotherapy can vary but the purpose is the same: to help the patient modify their patterns of thinking and behavior, and enhance their ability to deal with stressors so as to avoid using addictive drugs as a way of coping.16
Frequently Asked Questions
- Since Xanax can be habit-forming, it is important that it is used exactly as prescribed, i.e. not in larger doses, more frequently, or for a longer period of time.17 Xanax should be used primarily in its extended-release formulation for a short period of time. In addition, it should generally not be prescribed to patients with substance use history.15
- The dose of Xanax is slowly reduced to avoid severe withdrawal. For most patients, this period of detoxification is 4 to 8 weeks long. In order to prevent relapse, patients are encouraged to continue with therapy. This may involve treating co-occurring mental health issues or group or family therapy. Generally, longer treatment retention tends to result in better outcomes.18
- Treatment seekers can either first contact their physician or immediately look for an addiction treatment facility. A helpful tool may be the treatment locator of the Substance Abuse and Mental Health Services Administration (SAMHSA) as it provides information on licensed treatment providers, including the facilities that provide treatments for Xanax addiction.19
1. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of addiction medicine, 12(1), 4–10.
2. Substance Abuse and Mental Health Service Administration. (2016). Prescription Drug Use and Misuse in the United States: Results from the 2015 National Survey on Drug Use and Health.
3. George T. T., Tripp J. (2020) Alprazolam. StatPearls.
4. Vinkers, C. H., & Olivier, B. (2012). Mechanisms Underlying Tolerance after Long-Term Benzodiazepine Use: A Future for Subtype-Selective GABA(A) Receptor Modulators?. Advances in pharmacological sciences, 2012, 416864.
5. Reissig, C. J., Harrison, J. A., Carter, L. P., & Griffiths, R. R. (2015). Inhaled vs. oral alprazolam: subjective, behavioral and cognitive effects, and modestly increased abuse potential. Psychopharmacology, 232(5), 871–883.
6. WebMD. Benzodiazepine Abuse.
7. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders.
8. Ashton, C. H. (2002). Benzodiazepines: How They Work & How to Withdraw. Newcastle University, The Institute of Neuroscience.
9. Barker, M. J., Greenwood, K. M., Jackson, M., Crowe, S. F. (2004). Persistence of cognitive effects after withdrawal from long-term benzodiazepine use: a meta-analysis.Archives of Clinical Neuropsychology, 19(3), 437-454.
10. National Institute on Drug Abuse. (2021). Overdose Death Rates.
11. Medical News Today. (2020). Xanax overdose: Symptoms, dangers, and what to do.
12. Brett, J., & Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian prescriber, 38(5), 152–155.
13. Pétursson H. (1994). The benzodiazepine withdrawal syndrome.Addiction.89(11), 1455-1459.
14.Medical News Today. (2020). Benzo withdrawal: Timeline and symptoms.
15.Soyka, M. (2017). Treatment of Benzodiazepine Dependence.New England Journal of Medicine, 376, 1147-1157.
16. National Institute on Drug Abuse. (2021). How can prescription drug addiction be treated?
17. Medline Plus. Alprazolam.
18.National Institute on Drug Abuse. (2018). Principles of Effective Treatment.
19. Substance Abuse and Mental Health Service Administration. FindTreatment.gov.