Xanax Addiction: Signs, Effects, and Treatment

Benzodiazepines are a class of drugs known as central nervous system depressants, commonly prescribed to treat anxiety and insomnia.¹ Xanax is the brand name version of alprazolam, one of the most prescribed types of benzodiazepines.¹

This article will discuss how Xanax works, the side effects, the signs of Xanax addiction, withdrawal symptoms, and how to find treatment.

What Is Xanax?

Xanax is the brand name for the benzodiazepine alprazolam, which is prescribed to treat certain types of anxiety disorders.^{2, 3, 9} It may also be prescribed to treat insomnia and alcohol withdrawal.³

Benzodiazepines are Schedule IV drugs under the Controlled Substances Act.¹ Schedule IV drugs are defined as having a lower potential for misuse and dependence compared to Schedule I, II, and III drugs.⁴ However, dependence can still occur even when used as prescribed and there are growing concerns among prescribers about its risk for misuse.^{1, 5} Alprazolam, in particular, has been shown to have more severe withdrawal symptoms compared to other benzodiazepines, even when tapered according to manufacturer’s guidelines.⁵

How Does Xanax Work?

Central nervous system (CNS) depressants work by increasing the activity of gamma-aminobutyric acid (GABA), an inhibitory neurotransmitter in the brain that is responsible for a calming effect on the mind and body, making Xanax useful for treating anxiety and sleep disorders.⁷

Side Effects of Xanax

Short-term desired effects like drowsiness and relaxation are reasons they may be prescribed to help someone manage anxiety or insomnia.⁷

However, there are some potential unwanted side effects of using benzodiazepines like Xanax, which may include:⁷

• Slurred speech
• Confusion
• Headache
• Dizziness
• Problems with coordination and memory
• Dry mouth
• Decreased blood pressure
• Slowed breathing

Potentially serious side effects may include:³

• Shortness of breath
• Unconsciousness
• Increased heart rate
• Restlessness
• Depression
• Thoughts of suicide

Is Xanax Addictive?

Despite being classified as a Schedule IV drug, which signifies a lower potential for misuse compared to many other drugs, there have been increased concerns about the potential for misuse of Xanax and other benzodiazepines.⁶ More than 90 million prescriptions for benzodiazepines were dispensed from U.S. pharmacies in 2019, with alprazolam being the most common at nearly 40% of those prescriptions.⁶

From 2019 to 2020 there was a 23% increase in emergency department visits for benzodiazepine overdoses.⁸ Both prescription and illicit benzodiazepine-related overdose deaths also saw a dramatic increase in the same year.⁸

In 2019, the FDA required labeling changes for benzodiazepines to be updated to include misuse, addiction, and other serious risks.⁶ While benzodiazepines can be important and effective medications for many people, they are not without risks and should be taken with precaution.⁶

Alprazolam’s misuse potential stems from several factors, including its high potency, rapid absorption, and short half-life.⁵

Benzodiazepines with a rapid onset, like Xanax, are often used to quickly experience the euphoric effects of the drug.¹

Signs of Xanax Addiction

Addiction often involves compulsive, drug-seeking behaviors despite negative or harmful consequences in a person’s life.¹¹

Benzodiazepine addiction falls under the category of sedative, hypnotic, and anxiolytic use disorder in the Diagnostic and Statistical Manual of Mental Disorders, 5^th edition (DSM-5).⁸

There are 11 diagnostic criteria, of which at least 2 must cause clinically significant impairment in 12 months to determine a sedative, hypnotic, and anxiolytic use disorder. Some of the criteria include the following:⁸

• Taking benzodiazepines in larger amounts or for a longer period than intended.
• Unsuccessful efforts to control use.
• Recurrent use results in failure to fulfill obligations at work, school, or home.
• Continued use despite persistent social and interpersonal problems related to use.
• Continued use despite knowing recurrent physical or psychological problems related to use.
• Experiencing withdrawal symptoms.

These are just some of the criteria a licensed medical professional will assess to determine a diagnosis of sedative, hypnotic, and anxiolytic use disorder, which can range from mild to severe.⁸

Xanax Withdrawal Symptoms

Even when taken as directed for the short-term treatment of anxiety and panic disorders (0.75-4.0 mg per day), there is a risk of dependence.⁹ Dependence is a physiological adaptation of the body to a substance, wherein the body gets so used to the drug being present in the system that when you cut back or stop use, withdrawal symptoms emerge. With significant levels of physiological dependence, a person may continue to compulsively drink or use drugs to avoid unwanted withdrawal symptoms.¹

The severity of withdrawal symptoms depends on the dose of benzos, how long a person has been using them, and the specific substance used.¹

Symptoms of withdrawal from benzodiazepines may include:^1,9

• Sweating or increased pulse rate (more than 100 bpm)
• Hand tremors
• Insomnia
• Nausea or vomiting
• Increased anxiety
• Psychomotor agitation
• Transient visual, tactile, or auditory hallucinations
• Grand mal seizures

More specifically, withdrawal from Xanax has been shown to involve more complicated rebound anxiety than withdrawal from other benzodiazapines.⁵

Xanax Overdose

If you suspect someone is experiencing a benzodiazepine overdose, or any other substance overdose, call 911 immediately.

A person can overdose on benzodiazepines like Xanax; however, the risk of overdose increases when a person combines benzos with other substances, particularly other central nervous system depressants like alcohol, opioids, and other benzodiazepines.^{9, 10, 15}

Both opioids and benzodiazepines cause sedation, slowed breathing, and impair cognitive function.¹⁰ Some studies have shown that overdose death rates were 10 times higher in people who were prescribed opioids and benzodiazepines than in those only prescribed opioids.¹⁰

Alcohol is also a CNS depressant and should not be used with benzodiazepines.⁹

Signs of a Xanax overdose include:²

• Extreme drowsiness
• Decreased reflexes
• Respiratory depression
• Coma
• Death

If you are taking other medications or substances, it’s important to speak with your doctor to avoid potentially harmful effects or overdose.

Treatment for Xanax Addiction

Effective treatment for Xanax addiction may include several interventions, the first of which is typically detox.¹² Supervised detox can help safely manage the acute symptoms of Xanax withdrawal and prevent potentially life-threatening complications of withdrawal.¹²

Quitting Xanax cold turkey is not recommended as it can be extremely dangerous and even life-threatening. Stopping or drastically reducing Xanax can lead to seizures and therefore it is advised to consult professional medical treatment to safely withdrawal from Xanax and other benzodiazepines.⁹

After detox, it’s often recommended that people continue treatment to support positive outcomes and develop healthy coping skills.¹³ Treatment should address the individual needs of each person and the underlying triggers associated with the addiction.¹³ During treatment a person is continually assessed physically and psychologically.¹² Any co-occurring mental health or medical conditions should be addressed, as well as any social, vocational, and legal issues.¹³

Treatment settings may include inpatient/residential or outpatient facilities, which can involve the use of a combination of therapy, medication, support groups, and other amenities to help a person recover from Xanax addiction.

Find Xanax Addiction Treatment

If you or a loved one are struggling with Xanax misuse or any other substance addiction, find help by exploring qualified rehab facilities near you.