When most people think about addictions to prescription medications, they think about painkillers. Opioid drugs like Vicodin and OxyContin dominate the news on the subject, and they are increasingly sold illicitly on the streets to meet the demand of people who want to get high.
But there is another class of medications that has been associated with prescription drug abuse: benzodiazepines. Xanax is one of the most common of these medications, and while it has therapeutic value, when abused, it can also be 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 prescribed to treat symptoms associated with anxiety disorders and are classified as Schedule IV substances under the Controlled Substances Act due to their low-to-moderate potential for abuse.
The brand name Xanax represents the drug alprazolam, which is a short-acting benzodiazepine. It is most often prescribed to alleviate moderate to severe anxiety and panic attacks. It is also used as an adjunct treatment for the kind of anxiety that is associated with moderate depression, and the kind connected to sleeping disorders.
The medication comes in immediate-release and extended-release (Xanax XR) formats, with tablets available in 0.25 to 3 milligrams.
Legitimate and illicit routes of Xanax administration include:
- Swallowing the pill whole.
People who take Xanax may experience the following short-term effects:
- Pain relief
- Feelings of relaxation
- Respiratory depression
- Papillary constriction
- Impaired coordination
- Impaired memory
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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 a limited time, typically 2–4 weeks. So, when people use the drugs for longer periods of time, it becomes more likely that they’ll develop an addiction. This study assessed data from people who use benzodiazepines to treat a medical condition, so those who do not have a therapeutic need for Xanax (such as people who abuse the drug recreationally) might have very different results than the ones presented in this study.
Another factor in the addiction capability of benzodiazepines is the speed at which the drug takes effect, which is measured by its onset of action. In other words, the sooner the drug works, the quicker it causes dopamine flooding and the more the brain experiences this, the stronger it remembers the drug because of the positive effects it creates. What makes Xanax more likely to lead to addiction is this chemical series of actions.
How Xanax Is Abused
In an article published by American Family Physician, researchers report that benzos are rarely the primary subject of a person’s abuse. They found that nearly 80% of people who abuse benzos also abuse other drugs, such as alcohol and opioids.
However, for some people with addictions to other substances, Xanax can act as a withdrawal medication to ease symptoms associated with weaning off a drug. For example, people addicted to alcohol may struggle to get through the day without it and may find it difficult to sleep through the night while detoxing. In these cases, Xanax mimics the effects alcohol has on the brain, so people can move through the day and night without experiencing significant withdrawal symptoms.
Other people with addictions use Xanax to augment a high. People who abuse painkillers and heroin, for example, use those drugs to boost the dopamine levels in their brains, which contributes to feeling high. Since Xanax causes a similar dopamine boost, when these users take a Xanax in combination with their other drug of choice, they can experience a stronger high.
When someone has a full-blown addiction, they have developed a tolerance to the effects of Xanax. This means they have to take larger amounts of the drug to feel the impact that they once felt with a small dose. People with an active addiction can consume as much as 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, which results in withdrawal symptoms if they try to stop using it. Some of the more serious symptoms related to Xanax withdrawal are 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, most 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 prevented them from successfully quitting—they returned to their drug use to avoid the uncomfortable symptoms.
As previously mentioned, withdrawal from Xanax can be more than uncomfortable, but truly dangerous. Brain cells long inhibited by the constant presence of Xanax can rebound with abnormal excitatory signaling, which can cause those cells to erupt with activity that jumps from cell to cell to cell—a spreading wave of nerve cell excitation that may result in seizures. Further, repeated attempts to quit Xanax increases the risk of seizures with each additional withdrawal process, which is known as “kindling”. In kindling, each withdrawal episode causes the cells to become even more excitable in the absence of Xanax, and as the cells become more reactive, the risk of seizures increases.
When people take Xanax or other benzodiazepines alone and as prescribed, the risk of overdose is low. While the drugs have the potential to be powerful, they are unlikely to lead to an overdose or death in the course of normal use.
But all of that can change when people mix benzodiazepines with other drugs. Combining the power of benzos with the strength of painkillers can cause an additive effect that is much more likely to result in an overdose.
People who are in the midst of an overdose caused by combining drugs might exhibit the following symptoms:
- Cool skin temperature
- Shallow breathing
- Slow, rapid, or weak pulse
- Shallow breathing
- Impaired coordination
With quick medical attention, these people can avoid death by overdose and be brought back to a normal level of functioning.
Signs of Abuse
People who abuse Xanax may also experience behavioral changes that families often spot. Those changes frequently involve something researchers call “flat affect”, which refers to a tendency to speak without vocal inflections or exhibit the normal range of of emotion. Part of the reason for this is that Xanax dampens the electrical activity in the brain, which makes expressing a normal range of emotional more difficult.
Another tell-tale sign of abuse is suddenly needing more money than they usually do. Sometimes, they may steal or borrow to get it. Xanax can be quite expensive to buy on the street, so people can resort to questionable tactics to get the funds to support their addiction.
Xanax Addiction Recovery
People who want to recover from a Xanax addiction do best working with a trained professional in a qualified treatment program. As an article in the journal Addiction states, 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 have completely weaned off it. However, due to the potential for life-threatening withdrawal symptoms such as seizures, this should always been done under the direction and supervision of a physician trained in addiction treatment.
When medical detox is complete, a treatment team can begin the counseling process in an extended rehab program. Anyone with an addiction needs to learn how to develop healthy and protective habits so they can avoid the temptation to relapse back into drug use. Ongoing counseling is especially important for people who have abused painkillers in addition to Xanax. According to research from MedicalResearch.com, people who abused these 2 types of drugs together were more likely to relapse when compared to people who did not use these drugs together.
Rehab typically involves a combination of types of counseling, including individual sessions, during which people have the opportunity to dive deep into their reasons for abusing Xanax. Group counseling is also an important component of a treatment program because people beginning their recovery process can learn together new sober skills and how to use them in everyday life. Many people also find it helpful 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 benefits, including spa amenities, gorgeous grounds, and outside activities. And the freedom that comes with sobriety is hard to beat.
If you’re ready to live a life free of Xanax addiction, you can make the choice to start today.