Non-Proprietary Medicine Prescription Bottle and Spilled Pills Isolated on a White Background

The anti-anxiety medication Xanax became so popular in America that the name became a catch-all term for any kind of feel-good drug, says Forbes magazine. People loved the idea of a pill that would take care of their stress and tension, but there was scant understanding of what the long-term effects of Xanax were, which include both physical and psychological elements.

How Xanax Works

Xanax is the brand name of the drug alprazolam, which is a potent benzodiazepine that is prescribed for no more than six weeks. Benzodiazepines work by boosting the GABA neurotransmitter in the brain, which is responsible for regulating the electrical excitation in the central nervous system. Reduced GABA levels leave people feeling anxious and restless; they might have muscle tension, insomnia, difficulty controlling their temper, and trouble concentrating. Benzodiazepines induce the brain into producing more of the GABA neurotransmitter throughout the central nervous system, and users feel calmer and more relaxed.

Alprazolam (Xanax) is prescribed primarily for the treatment of anxiety, but there are many other conditions for which the sedative properties of the medication are effective. They include:

  • Muscle spasms
  • Agitation
  • Seizures
  • Trouble sleeping
  • Alcohol withdrawal

There are many drugs that address these problems, but The Fix explains that Xanax’s effects are felt relatively quickly, in just 25 minutes, but they fade away in a matter of hours. This compels some users to take more Xanax to try and escape the return of their anxiety or because they found the chemical tranquility desirable and wanted to continue the experience. Either way, there is a problem of individuals taking Xanax for longer than the six-week limit or consuming more tablets at a time.

Drug Tolerance

The primary danger of this is drug tolerance. Tolerance is the state of a user’s reduced response to a drug; this happens when the drug or medication is used to the point where the body simply gets accustomed to the continued presence and effects of the substance. Larger and larger doses have to be taken in order to produce the same initial effect. While the potency of the effect does not significantly change, the user becomes increasingly dependent on the drug to simply feel normal. In the case of Xanax, being on the drug becomes the new default way of being normal, to the point that trying to go off Xanax results in anxiety and other symptoms returning, often returning even stronger than before. Tolerance is not the same as dependence or addiction, but it is a big step in that direction.

As a user continues to take Xanax for longer than the safe six-week period, the brain eventually cannot regulate GABA without the presence of Xanax and soon cannot even function normally without the chemical boost. Because of the neurotransmitter regulation, the constant influx of Xanax controls not only emotions and mood, but also memory, thought processes, and muscular coordination. The longer the consumption of Xanax, the harder it will be for a person to get off the drug.

Weight and Fatigue Problems

Continued use of Xanax also carries the possibility of reducing appetite. This is a standard concern even when the medication is taken according to treatment guidelines, but consuming alprazolam at length can lead to a loss of appetite, such that the user experiences weight loss. Users also tend to feel fatigued with prolonged exposure to benzodiazepines. GABA stimulation does give users more energy and zest, but without proper periods of rest, they can feel more worn out and exhausted than normal. Without adequate regulation or exercise because they are simply too tired, there might be a paradoxical weight gain associated with long-term Xanax use.

The relentless stimulation of the brain to produce GABA can also affect muscle, motor, and speech coordination in the long-term.

This should not be a problem with proper care, but if a person takes too much Xanax or takes it for too long, they will have trouble keeping their balance, multitasking, or even speaking. Work and academic performance will suffer as a result of an inability to concentrate in addition to the constant feeling of lethargy. If Xanax use persists for months, there is the danger of alprazolam even damaging brain cells. Psychology Today warns that in extreme cases, this can lead to clinical depression and suicidal thoughts.

Xanax Effects in Female and Older Patients

Close up image of woman putting white round pill in mouth.

The risks of long-term use of Xanax are particularly of note for female and older patients, since these groups tend to be prescribed Xanax to a greater degree than younger and male patients. In “Popping Xanax Is More Harmful than You Think,” the co-chairman of the medical scientific subcommittee of the National Council on Alcoholism and Drug Dependence told Fox Health that the danger of physical and psychological dependence on Xanax is a serious problem for young women. Overall, women tend to be at a higher risk for developing stress and anxiety-related disorders than men, which might require more Xanax prescriptions and a greater likelihood of those disorders compelling consumption of Xanax beyond treatment limitations. In 1982, researchers writing in the Postgraduate Medicine journal noted that family physicians tended to prescribe Xanax and other benzodiazepines to middle-aged women at higher rates because of “reported life stress” in that population.

As for senior citizens, they are more likely to develop insomnia and anxiety as a result of their advanced years due to everything from losing touch with family members and friends to suffering injuries from falling. Even though professional associations have cautioned against prescribing benzodiazepines to older patients, data suggests that alprazolam prescriptions are up for this demographic. Since older individuals metabolize their medications at a slower rate, there is a risk that they may be taking new doses of Xanax even though their previous dose is still in their system, effectively and unwittingly extending the length of their time on Xanax.

More On Long-Term Effects:

Dependence and Addiction to Xanax

As the tolerance of Xanax increases, and the user needs more and more of the medication to simply feel at ease, the next step of this effect of long-term consumption of alprazolam is the development of physical and psychological dependence. Tolerance is not dependence, but the progression is almost inevitable if the user does not seek help for Xanax abuse.

Prolonged consumption of Xanax alters the brain’s reward pathways, meaning the brain not only expects constant stimulation from the Xanax and its effects, but also comes to rely on that stimulation to the point where discontinuing Xanax is often more damaging than continuing to be on it. If consumption is stopped or even lowered, the brain struggles to return to normal functioning. The central nervous system is flooded with confused and panicked signals, causing distressing physical and psychological effects. These are known as withdrawal symptoms, which are a sign that the Xanax use has gone on too long.

The Addiction journal explained that these effects are characterized by:

  • Insomnia and disruptions to sleep
  • Irritability and agitation
  • Tension and anxiety
  • Panic attacks
  • Trembling in the hands
  • Sweating and cold sweats
  • Nausea, dry retching, and vomiting
  • Intense cravings for more Xanax

For people who have been taking Xanax for too long, and if there are other factors involved, “more serious developments such as seizures and psychotic reactions” are also known to take place.

There is also the danger of “rebound anxiety and insomnia” if a user stops taking Xanax after developing a tolerance to the drug. This is usually the precursor to full-on withdrawal symptoms, and it can be distressing enough that it compels users to go back on Xanax. However, people in this situation tend to increase their Xanax doses because the return of the anxiety feels more intense due to their growing dependence on alprazolam, and this is what precipitates the more comprehensive dependence and then addiction to the medication.

Xanax Withdrawal

Young women standing in a park with hands over arms

Because of what dependence and addiction do to the body, those struggling with overusing Xanax, any other benzodiazepine, or any drug in general should not attempt to discontinue their intake without medical supervision. The bone-deep need to take Xanax again is very hard to resist when a host of physical and psychological symptoms of withdrawal are taking place, and the resumption of alprazolam use is often done to a greater degree than the use before the attempted discontinuation.

The length of Xanax withdrawal depends on a number of factors, including how long the Xanax has been consumed, the dosage, the presence of other drugs or alcohol, the user’s mental health, and environmental and lifestyle risk factors that might complicate the process. At its worst, Xanax withdrawal can last as long as two weeks. By the end of this time, the user will not be physically dependent on the Xanax, but the process is still distressing enough that it will require medical care and intervention, if necessary, to ensure that body systems are not significantly damaged by the decoupling from alprazolam.

This care be given at a drug treatment and rehabilitation center, where the individual’s vital signs will be monitored to ensure that the gradual draining of the Xanax from the system is as complete and safe as possible. Doctors can also administer other drugs to calm the worst of the withdrawal symptoms, such as insomnia or anxiety. Since competing medications can cause complications to the process, especially medications that set out to treat the problems that the Xanax itself was initially prescribed for, it is vitally important that individuals are forthcoming about the length and extent of their Xanax use, so doctors know the right kind and amount of medications to administer to make withdrawal less stressful.

Therapy for Psychological Effects of Xanax Use

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Even when medical detox is complete, psychological dependence due to long-term Xanax use and its effects needs to be addressed. Without this step, recovery is incomplete, and relapse is all but certain. For this reason, detox should be followed by counseling and therapy. A psychologist will help the individual address the mental health damage caused by Xanax abuse and develop coping mechanisms and skills for when the temptation to use Xanax or another benzodiazepine presents itself. There are many triggers for such a temptation in everyday life, – everything from work-related stress to a bad night’s sleep, and the familiar GABA boost will seem very alluring. Coping skills might include meditation, mindfulness, checking in with trusted friend or family member, breathing exercises, or any other kind of measure to control and redirect the thought process away from reaching for a Xanax or reacting negatively and into something healthier and more productive.

Xanax is an undeniably popular and effective medication, and it has helped millions of people overcome their anxiety and feel less stressed. But for many other people, that Xanax prescription came with an unforeseen price tag: a long-term habit with serious physical and psychological health effects that was hard to stop. However, with time and treatment, it is entirely possible to put a Xanax abuse problem in the past and reclaim a life of happiness and recovery.