When most people think about addictions to prescription medications, they think about painkillers. Drugs like Vicodin, methadone, and OxyContin dominate news programs that discuss addiction, and these are drugs that dealers might hawk on the streets when people talk about wanting to get high.
But there is another class of medications that has been associated with addictions: benzodiazepines. Of that class, Xanax is very common and also very dangerous.
What Is Xanax?
The Center for Substance Abuse Research reports that there are more than 15 types of benzodiazepines available in the United States today. These medications are used to help people deal with anxiety concerns, and since they can be sedating, they are classified as Schedule IV substances under the Controlled Substances Act.
Alprazolam (trade name Xanax, among others) is a short-acting benzodiazepine. Xanax comes in the form of elongated white pills, which can be oval. It is generally used to address moderate to severe anxiety and panic attacks. It is also used as an adjunctive treatment for anxiety associated with moderate depression. Xanax can also assist with anxiety and sleeping disorders.
The medication comes in instant-release and extended-release (Xanax XR) formats. Tablets are available from 0.25 to 2 milligrams in strength.
Routes of Xanax administration include:
People who take Xanax may experience these short-term effects:
- Feelings of relaxation
- Respiratory depression
- Papillary constriction
- Cough suppression
Xanax and Addiction
When Xanax is used properly, it can be considered a safe and effective drug. For example, research published in the journal Addiction suggests that the benefits of benzodiazepines outweigh the risks when the drugs are used for about 2-4 weeks. When people use the drugs for longer periods of time, addictions become more likely. This study is assessing data from people who are using benzodiazepines to treat a medical condition. Those who do not have a therapeutic need for Xanax, such as people who are abusing the drug recreationally, might have very different results.
Xanax can cause addictions, according to research published in the journal Nature, by creating a chain reaction of responses. The drug excites so-called GABA cells, and those cells entice the brain to release more of a chemical known as dopamine. This chemical is used by the brain to signal an event that is somehow positive and/or rewarding. The more dopamine, the better the brain feels about the experience, and the more the brain pays attention to that experience. It is that chemical reaction that makes Xanax, along with all benzodiazepines, addictive.
The addiction capability of benzodiazepines is determined by the speed at which the drug takes effect. That is measured by the drug’s half life. The sooner the drug works, the more likely it is to overwhelm the brain with in-depth chemical changes that cause dopamine flooding. The more flooding the brain experiences, the more the brain remembers the drug. Xanax is dangerous due to its short half-life. That short number makes Xanax one of the more addictive benzos.
How Xanax Is Abused
In an overview article published by American Family Physician, researchers report that benzos are rarely the primary subject of a person’s abuse. In fact, researchers say, some 80 percent of people who abuse benzos also abuse other drugs, including alcohol and painkillers.
For some people with addictions, Xanax works to smooth out the withdrawal process. People addicted to alcohol, for example, may struggle to access alcohol during the day, and they may find it hard to sleep through the night without alcohol. Xanax helps to mimic the impact of alcohol, so people can move through the day and night without experiencing withdrawal.
Other people with addictions use Xanax to augment a high. People who abuse painkillers and heroin, for example, use those drugs to boost a dopamine level inside the cells of the brain. Since Xanax causes that same dopamine boost, these users can take a Xanax in concert with a hit of drugs and feel an overwhelming response.
When an addiction is in full force, people can develop a tolerance to the effects of Xanax. That might mean people will be required to take huge amounts of the drug to feel the impact that they once felt with a small dose. People with an active addiction can consume up to 14 mg of Xanax per day.
When people develop a tolerance for Xanax, their bodies have become accustomed to the constant presence of the drug. That can mean the body will protest when there is no more Xanax available. A protest can take the form of a withdrawal, with effects that include psychosis and epileptic-type seizures.
In a study published in BMC Psychiatry, researchers asked people who had been addicted to benzodiazepines to describe what it felt like when they tried to stop taking these drugs. Of the 41 people they interviewed, people said that withdrawal could be considered difficult, complicated, and highly unpredictable. These users wanted to quit their use, but the difficulties they had with the withdrawal process served to keep their addictions alive.
Withdrawal from Xanax can be more than uncomfortable too. An unsupervised withdrawal can trigger life-threatening seizures. Brain cells long sedated by the constant presence of Xanax can spring into action when the drug is removed, and during that spring to life, those cells can erupt with activity that jumps from cell to cell to cell. Researchers call this “kindling,” and it can trigger seizures.
When people take Xanax or other benzodiazepines alone, the risk of overdose is slight. The drugs are powerful, but they do not seem to have the capacity to overwhelm the brain and cause an overdose or a death.
But all of that can change when people mix benzodiazepines with other drugs. Mixing the power of benzos with the power of painkillers can cause an additive effect, and that could very well cause an overdose.
People who are in the midst of an overdose like this might display:
- Cool skin temperature
- Slow pulse
- Shallow breathing
With quick medical attention, these people can be brought back to a normal level of functioning, and they could avoid death due to overdose. But without that attention, the overdose could cause death.
Signs of Abuse
People who abuse Xanax may also experience behavioral changes families can spot. Often, those changes involve something researchers call a “flat affect.” This means benzo abusers tend to speak without vocal inflections, and they tend to resist big sweeps of emotion. The Xanax is dampening electrical activity in the brain, and that makes sudden emotional shifts hard to accomplish.
Also, people who abuse this drug may have a sudden need for a great deal of money, and they may steal or borrow to get it. Xanax can be quite expensive to buy on the street, so people may need to work hard to get enough funds to keep a habit alive.
People who want to recover from a Xanax addiction will need to work with a trained professional in a qualified treatment program. As an article in the journal Addiction pointed out all the way back in 1994, benzodiazepine recovery begins with a slow taper of the drug. People take smaller and smaller doses of the drugs they are addicted to, until they are taking no drugs at all. This is work that should be directed by a physician who has the ability to prescribe benzodiazepines and who has a willingness to supervise and intervene should serious side effects take hold.
When medical detox is well underway, the team can begin the counseling process. People with these addictions need to learn how to develop healthy and protective habits, so they can avoid the temptation to relapse back into drug use. That counseling is especially important for people who have abused painkillers in addition to Xanax. According to research quoted by MedicalResearch.com, people who abused these two types of drugs together were more likely to relapse, when compared to people who did not use these drugs together.
Therapy typically involves individual counseling, in which people have an opportunity to dive deep into their reasons for using and abusing Xanax. Then, people can head into group counseling sessions and learn more about how to build up sober skills. They can use support group sessions to learn about how others have handled their relapse challenges.
There is a great deal of work involved in rehab, but it can also be a wonderful experience. Many facilities offer fun and pleasant benefits, including spa amenities and gorgeous grounds. The freedom that comes with sobriety can be hard to match or beat. People who want to recover should take this step today.