Xanax (Alprazolam): Effects, risks, addiction and treatment (2024)

By Edmund Murphy

Last updated: 23 January 2024 & medically reviewed by Hailey Shafir

Xanax is the brand name for alprazolam, a powerful prescription benzodiazepine used to treat generalized anxiety disorder (GAD), as well as panic attacks and insomnia. Xanax is the most prescribed psychiatric medication in the United States and unfortunately, one of the most commonly abused prescription drugs. For this reason, Xanax is classified as a controlled substance, meaning it has a high risk for abuse and addiction.

Key takeaways:

  • Xanax is a regulated schedule IV controlled substance, meaning it has a high potential for abuse and addiction. In large doses, it is possible to overdose on Xanax, especially when taking the drug with alcohol or other substances
  • The treatment for a Xanax overdose will depend on how much of the drug was taken, by what means, how long ago it was taken, and if any poly-drug use occurred (taking with other drugs or alcohol)
  • Rebound anxiety can occur when someone who has been prescribed Xanax to treat GAD, insomnia, or panic attacks stops taking the drug

Xanax (Alprazolam): Effects, risks, addiction and treatment (1)

Table of contents

Toggle table of contents

  • Understanding Xanax (Alprazolam)→
  • Side effects of Alprazolam abuse→
  • Xanax overdose→
  • Addiction to Xanax →
  • Xanax withdrawal symptoms→
  • Xanax detox→
  • Xanax addiction treatment→
  • Xanax FAQ→

Table of contents:

  • Understanding Xanax (Alprazolam)
  • Side effects of Alprazolam abuse
  • Xanax overdose
  • Addiction to Xanax
  • Xanax withdrawal symptoms
  • Xanax detox
  • Xanax addiction treatment
  • Xanax FAQ

Understanding Xanax (Alprazolam)

Xanax affects the brain's central nervous system (CNS) by helping the brain produce more GABA, a natural brain chemical that helps to deactivate the nervous system and reduce stress and anxiety. Xanax is often prescribed to help people struggling with anxiety disorders or panic disorders and results in an immediate calm and relaxed feeling. As it is a CNS depressant, it can cause a lack of coordination, slurred speech, and drowsiness.[1][2]

Even those who are prescribed Xanax can become addicted to the medication when taking it long-term, even when taking it as prescribed. Once addicted, it is dangerous to withdraw from Xanax without medically supervised detox, as many people experience serious and even fatal withdrawals, including seizures.[2][3]

Common street names for Xanax include Xannies (zan-knees), Handlebars, Bars, Blue footballs, Benzos, French fries, sticks, and ladders.

Xanax tablets

Alprazolam or Xanax pills are dispensed in 0.25 mg, 0.5 mg, 1 mg and 2 mg strengths. The pills come in different shapes and colors depending on strength. The 2 mg tablets are white, green, or yellow in color and rectangular in shape, often called a "Xanax bar".

The rest are oval-shaped and colored white (0.25 mg), orange (0.5 mg), or blue (1 mg). Xanax will typically stay in the system for 12 to 15 hours.[1]

Side effects of Alprazolam abuse

Xanax is a regulated schedule IV controlled substance, meaning it has a high potential for abuse and addiction. Alprazolam is commonly abused because of its relaxing and pleasurable effects. Taking Xanax without a prescription, taking it with other substances, or taking it more often, or in higher doses is considered abuse. Xanax is highly addictive and even those who take the recommended amount can eventually become addicted.[2][3]

Alprazolam can be taken in multiple ways, most commonly though it is taken in its Xanax pill form. When more than the recommended dose is taken it elevates the calming effect of the drug.

Forms of Xanax abuse include:

  • Injecting it

  • Snorting it

  • Taking it via blotter paper

  • Taking it with other drugs or alcohol

Xanax is often combined with other substances, such as alcohol or stimulants, in order to elevate the effects of one another or to, in theory, cancel out any negative side effects or come down.

Related blog: Mixing Xanax And Alcohol

If you are worried about someone's alprazolam abuse then there are some Xanax side effects to look out for:

  • Drowsiness

  • Light-headedness

  • Cognitive impairment

  • Sluggishness

  • Nausea or vomiting

  • Headache

  • Dry mouth

  • Delirium

  • Slurred speech

  • Vertigo

  • Impaired coordination

Because of the addictive potential, overdose risk, and risk of withdrawals, Xanax abuse is highly dangerous. Even those with anxiety disorders are not advised to use the medication long-term, as addiction can occur. [2][3]

Xanax overdose

A Xanax overdose can be fatal, especially if taken in conjunction with other drugs. The risk of overdose also becomes greater if the person ingests the drugs by snorting, injecting, or chewing them as they remove the time-release delivery process of the drug, meaning the drug affects the brain faster.[3]

Some common symptoms of Xanax overdose include: [4]

  • Confusion

  • Slowed heart rate

  • Extreme drowsiness

  • Difficulty breathing

  • Fainting

  • Loss of balance

  • Muscle weakness

  • Coma

The treatment for a Xanax overdose will depend on how much of the drug was taken, by what means, how long ago it was taken, if any polysubstance use occurred (taking with other drugs or alcohol), and if they have taken counterfeit Xanax. If you suspect that you or a loved one has overdosed on Xanax, seek emergency medical care. It’s vital to give the medical professionals any information you have on what has been taken, how much was taken, and when it was taken. Being accurate with this information could save someone's life.

While emergency medical care can help to save a person’s life in the event of an overdose, subsequent treatment at an inpatient or outpatient addiction rehab is also needed to help the person overcome their addiction.

Addiction to Xanax

Someone who abuses Xanax can develop a tolerance quickly, meaning they need to increase their dose to get the desired effects. This can lead to physical dependence forming, which if left unchecked can develop into an addiction. Someone with a severe Xanax addiction can need up to thirty pills a day which can cost a considerable amount.

Still, a person addicted to Xanax cannot simply stop taking the medication on their own because of the risk of withdrawal and seizures. Often, detox and withdrawal need to be done in an inpatient facility under the close supervision of medical professionals, who can help to ensure the person is stable and detoxes safely.

Like most forms of addiction, a person with a Xanax use disorder will be diagnosed by a licensed professional using the 11 criteria of addiction, as outlined in the DSM-5.[1] Some of these criteria include:

  • Social or interpersonal problems related to Xanax use: Substance use has caused relationship problems or conflicts with others.

  • Neglected major roles to use Xanax: You have failed to meet your responsibilities at work, school, or home because of substance use.

  • Xanax withdrawal symptoms: When you stop using the substance, you experience withdrawal symptoms.

  • Physical or psychological problems related to use: Your substance use has led to physical health problems, such as liver damage or lung cancer, or psychological issues, such as depression or anxiety.

  • Activities are given up to use Xanax: You have skipped activities or stopped doing activities you once enjoyed in order to use the substance.

  • Craving Xanax: You have experienced an intense craving for the substance.

Xanax withdrawal symptoms

Xanax addiction can form quickly, even after only a few weeks and even on the recommended dose, making it one of the most addictive forms of benzodiazepine. One of the warning signs of addiction is the onset of withdrawal symptoms when a person cuts down or misses a dose.

For Xanax, withdrawal symptoms may be mild at first, but the severity increases with a longer duration of abuse, as well as the dose size being taken and how much Xanax is in the person's system. Xanax withdrawal symptoms appear suddenly and can present themselves as little as three hours after the last dose. The most common and severe Xanax withdrawal symptoms include:[3][4]

  • Seizures

  • Shakiness or trembling

  • “Rebound” anxiety, which can include panic attacks

  • Agitation and irritability

  • Insomnia or restlessness

  • Overactive reflexes or tics

  • increased heart rate and blood pressure

  • Hot and cold chills, sweating, or fever

  • Hallucinations

  • Severe cravings or urges to use

Rebound anxiety

Rebound anxiety can occur when someone who has been prescribed Xanax to treat GAD, insomnia, or panic attacks stops taking the drug. Many people who experience rebound anxiety find that when they cut back or stop using Xanax, their anxiety intensifies, sometimes even to a more severe level than what they experienced before. They may experience extreme nervousness, worry, insomnia, and panic attacks.

Most of the time, these symptoms will fade on their own after about a week of stopping Xanax, but some people will experience residual anxiety for weeks or sometimes even months after stopping. Rebound anxiety makes it difficult for people with Xanax addiction to avoid relapse, especially because they know that taking a dose will help to alleviate their anxiety.

Xanax detox

Detoxing from Xanax can be a long and arduous process. The withdrawal symptoms can be very uncomfortable and quitting cold turkey is not recommended. Instead, tapering the use of the drug by having gradually smaller doses over time is the best way to detox from Xanax and reduce harsh withdrawal symptoms. This should only be done under the supervision of a dedicated treatment facility and the recommendation of a medical doctor, who can help to ensure you do not cut back on your dose too quickly.[3]

While it is possible to detox from Xanax alone, it is always advised that detox be overseen by a medical professional to ensure the process is handled comfortably and safely. For example, under a medically assisted treatment program, a doctor may prescribe a less potent benzodiazepine, such as Klonopin, to help with the tapering process and avoid withdrawal symptoms. Medically assisted detox is proven to be the most effective way of combating Xanax addiction and beginning the road to recovery.

Xanax addiction treatment

Xanax pills are incredibly addictive drugs and overcoming an addiction can be difficult. With a safe and controlled medical detox and subsequent treatment program, conquering a Xanax addiction is possible and can pave the way to long-term sobriety. If you or someone you know is suffering from a Xanax addiction, contact a treatment provider today to see what help is available.

Xanax FAQ

These are some commonly asked questions about Xanax (Alprazolam):

Can you buy Xanax illegally?

Xanax is an incredibly addictive and popular drug and is only available legally through prescription. This means there are many drug dealers who sell Xanax illegally for a high price.

What are fake Xanax?

There has been a growing trend of fake Xanax being sold on streets across America. This increases the availability of the drug to those who do not have a prescription and increases the risk of abuse, dependence, addiction, and fatal overdose.

How long does Xanax stay in your system?

Xanax normally has a half-life of around 11.5 hours, though the amount of time it is in your system can vary from person to person based on numerous factors. It is also detectable in toxicology drug tests.

Is Xanax a controlled substance?

Like most prescription drugs, Xanax is regulated by the DEA. This means that it must be classified under the Controlled Substance Act.

Are there different types of Xanax?

Yes, there are many different types of Xanax and alprazolam on the market. They are mostly in pill form ranging from .25mg to 3mg of alprazolam. There are also other versions of alprazolam, such as Farmapram from Mexico, which can have different strengths and effects to Xanax.

Xanax (Alprazolam): Effects, risks, addiction and treatment (2024)

FAQs

Xanax (Alprazolam): Effects, risks, addiction and treatment? ›

Alprazolam has a risk for abuse and addiction, which can lead to overdose and death. Taking this medication with alcohol or other drugs that can cause drowsiness or breathing problems (especially opioid medications such as codeine, hydrocodone) may cause very serious side effects, including death.

Is Xanax a high risk drug? ›

When used as directed, alprazolam is generally considered safe. However, misuse increases the risk of adverse effects, including overdose. Though many cases of overdose toxicity involve the concurrent use of other substances, benzodiazepine overdose is a risk with high dose misuse.

What should you avoid while taking alprazolam? ›

Do not drive, use machinery, or do anything that needs mental alertness until you know how this medication affects you. To reduce the risk of dizzy and fainting spells, do not stand or sit up quickly, especially if you are an older patient. Alcohol may increase dizziness and drowsiness. Avoid alcoholic drinks.

Why is alprazolam banned? ›

There is a risk of misuse and dependence in both patients and non-medical users of alprazolam; alprazolam's high affinity binding, high potency, and rapid onset increase its abuse potential. The physical dependence and withdrawal syndrome of alprazolam also add to its addictive nature.

Do alprazolam side effects go away? ›

Some side effects of alprazolam may occur that usually do not need medical attention. These side effects may go away during treatment as your body adjusts to the medicine. Also, your health care professional may be able to tell you about ways to prevent or reduce some of these side effects.

Is it bad to take alprazolam every night? ›

If you use alprazolam frequently — even if only as a sleep aid — and suddenly stop, you may experience symptoms like anxiety, difficulty concentrating, poor memory, sleep issues and others.

Does Xanax affect your kidneys? ›

Long-term benzodiazepine misuse is associated with potential cardiac problems, including blood pressure issues, heartbeat irregularities, and an increased potential for heart attack and stroke. Other organ systems, such as the liver and kidneys, can be damaged by chronic misuse of Xanax and polysubstance misuse.

Does Xanax help with overthinking? ›

Xanax can be effective in reducing excessive worry and anxious thoughts, but it's important to remember that it's not a permanent solution for overthinking. However, because Xanax has the potential for dependence and withdrawal, it is typically prescribed for short-term use.

Who should avoid Xanax? ›

Before using this medication, tell your doctor or pharmacist your medical history, especially of: lung/breathing problems (such as COPD, sleep apnea), liver disease, kidney disease, personal or family history of a substance use disorder (such as overuse of or addiction to drugs/alcohol), glaucoma.

What is Xanax illegal? ›

Xanax is a Class C controlled substance, which means it's illegal to buy or supply. If you're caught, you could be sentenced up to 2 years for possession, 14 years for supply as well as possibly receiving an unlimited fine.

Is alprazolam a narcotic? ›

No, Xanax is not a narcotic. Xanax is a type of drug called a benzodiazepine. Narcotics are opioids, which are drugs related to the opium poppy. Examples include strong prescription pain relievers, such as morphine (MS Contin) and oxycodone (OxyContin, Xtampza ER, Oxaydo, others).

Is Benadryl the same as Xanax? ›

However, OTC antihistamines (i.e., Benadryl/diphenhydramine) have been recommended as a short-term solution for anxiety symptoms. While there is likely not any harm in taking an occasional OTC antihistamine as an over-the-counter Xanax alternative, the sedating side effects are not ideal for regular use.

Why can't I sleep after taking alprazolam? ›

According to the National Institute of Health (NIH), benzodiazepines like Xanax with a short half-life can worsen sleep quality in the long term. People who take Xanax routinely over the course of a few months might experience a condition known as “rebound insomnia” when they discontinue the medication.

Is 1 mg of Xanax a lot? ›

Is 1 mg of Xanax a Lot? A normal starting dose of Xanax is 0.25 mg to 0.5 mg, but it may be up to 1 mg depending on what it is being used for. In unusual cases, people may be increased to doses as high as 10 mg per day, although this is not taken all at once.

Is it good to take alprazolam daily? ›

Alprazolam may be habit forming. Do not take a larger dose, take it more often, or for a longer time than your doctor tells you to. Tell your doctor if you have ever drunk large amounts of alcohol, if you use or have ever used street drugs, or have overused prescription medications.

Is Xanax and alprazolam the same thing? ›

Alprazolam is a prescription medicine that's used to treat anxiety disorders and panic disorder. It's in a class of drugs called benzodiazepines and works by lessening abnormal excitement in the brain. The U.S. Food and Drug Administration (FDA) approved alprazolam in 1981. It's sold under the brand name Xanax.

How long can you take alprazolam for anxiety? ›

Your doctor will typically prescribe it for as short a time as possible. It's not known whether it's safe or effective to take Xanax for longer than 10 weeks for panic disorder. And it's not known whether it's safe or effective to take the medication for longer than 4 months for generalized anxiety disorder.

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