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Xanax Addiction: 6 Facts You Should Know

By Will Solomon, Kyle Kirkland
Xanax can treat anxiety and panic disorders, but you must use it correctly to prevent addiction. Here’s what you need to know.

Xanax, also known as alprazolam, is used to treat anxiety and panic disorders, according to Mayo Clinic. The medication has some particular characteristics that you should keep in mind if you're using it. For example, dependence on the drug can develop in just a few weeks, and withdrawal from it can result in uncomfortable symptoms. Both of these factors should be considered in order to avoid becoming addicted to the medication. Read on for six key facts about Xanax addiction. 

1. Dependence can happen fast.

Some people who take Xanax think that only using the drug for a few weeks means they cannot become addicted. But that's not necessarily true. “Xanax dependence occurs very rapidly relative to other benzodiazepines,” Allen Masry, MD and medical director of All In Solutions Counseling Center tells WebMD Connect to Care.

Benzodiazepines are drugs that raise the level of a specific neurotransmitter called GABA, according to the National Institute on Drug Abuse. This results in a more calm, relaxed state of mind.

Among benzodiazepines, Xanax is uniquely addictive. "As with any other controlled substance, Xanax leads toward chemical dependence—meaning that it follows a typical tolerance and withdrawal cycle," Matt Glowiak, PhD, LCPC at Choosing Therapy tells WebMD Connect to Care. "Though this does not necessarily mean it will lead toward addiction, for many, its effects are strong and desirable enough that resistance is difficult"

Given that the cycle of tolerance and withdrawal is especially pronounced with Xanax, those with a prior history of addiction, among other risk factors, are especially at risk," Glowiak says.

It’s also important to note that Xanax can never be considered 100% safe and non-addictive. “Even when taken as prescribed, studies show that between 15 and 44% of people will experience moderate to severe withdrawal symptoms that can last months, even after taking the drug for just 3 to 6 weeks,” Masry says.

Drug withdrawal can result in complications. In fact, a 2018 article published by the Journal of Addiction notes that alprazolam withdrawal symptoms can include:

  • Rebound anxiety
  • Body weakness
  • Insomnia
  • Suicidal ideation

Depending on duration and degree of addiction, certain withdrawal symptoms can be fairly severe, and long-lasting.

2. You can’t just quit.

Some people addicted to Xanax—as with other drugs—may seek to quit "cold turkey." But that is not recommended when stopping Xanax.

“You can not safely stop using Xanax without medical assistance,” Cali Estes, PhD and Clinical Director of The Addictions Academy tells WebMD Connect to Care.

“Xanax is a very powerful benzodiazepine, and you can have a seizure if you stop without a proper detox protocol overseen by a medical doctor,” Estes says.

It’s not always clear that addiction to Xanax has developed, but it is important to be aware of the signs. According to American Addiction Centers, signs of addiction may include:

  • Fatigue
  • Speech and/or vision impairment
  • An obsession with finding Xanax — whether from doctors, friends, family, or colleagues
  • Engaging in dangerous activities while impaired by Xanax, like driving or using machinery

For some users, there may be additional signs that indicate a Xanax addiction has developed. Remember, the only safe way to use Xanax is under a doctor's supervision, which should include regular check-ins.

3. Mixing alcohol and Xanax can be deadly.

Xanax on its own can be dangerous, and an overdose is possible. But Xanax mixed with alcohol is even more dangerous.

Like alcohol, Xanax depresses the central nervous system—and in some ways, the two substances produce similar effects or sensations, according to the Mayo clinic. But the combination of the two depressants can be life-threatening.

“Mixing Xanax with alcohol is a deadly cocktail that can result in your respiratory system shutting down and your heart stopping. Your body will literally forget to breathe, and you will be so intoxicated that you won't notice,” Estes says.

Other depressants can produce a similarly dangerous combination with Xanax, including tranquilizers, sleeping medicines, and antihistamines, among others. It is important to check with your prescribing doctor about what substances to avoid using simultaneously with Xanax.

 

4. Addiction risk may vary depending on the type of Xanax taken. 

There are multiple types of Xanax on the market—and the risk of addiction may be different for each type.

According to Mayo Clinic, standard Xanax (for adults) is generally started at .25 to .5 mg taken daily, and then increased as needed, with a typical maximum dose of less than 4 mg daily. However, Xanax also comes in an extended-release (XR) formula, which is sometimes prescribed for panic disorder. This type of Xanax is taken only once daily, generally starting at .5 to 1 mg, with a maximum of 10 mg daily.

Propensity for addiction may change depending on which form of Xanax is taken. “The intention behind Xanax XR… is to minimize the risk of addiction, and this does work in many cases,” Glowiak says. “Extended release means that the drug absorbs in the bloodstream over a more extended period of time—minimizing the likelihood of a euphoric experience. In this case, it works more so as intended—to reduce anxiety while maintaining a healthier baseline mood." 

Also, Xanax XR continues to act over an extended period. In theory, then, it requires taking fewer pills—so long as it is ingested as prescribed by a doctor.

Xanax is also sometimes prescribed in low-dose forms. “Lower dose Xanax works the same as traditional Xanax but impacts the tolerance and withdrawal cycle less dramatically, as there is less of the substance present to influence physiology,” Glowiak says.

However, just because you are using low-dose or extended-release Xanax does not mean addiction is no longer a risk. “[In] either case, when abused, individuals may manipulate the pills to ingest in a manner to achieve desired results and/or take more than prescribed. Doing this defeats the purpose,” Glowiak says.

In other words, while low-dose Xanax and Xanax XR may help to mitigate the risk of addiction, they are not foolproof approaches—and for some individuals, addiction can still develop

5. There are ways to lessen the risk of Xanax addiction.

As noted, there is no perfect solution to avoiding addiction to Xanax if you are taking it, as its unique properties can lead to addiction. However, there are steps you can take to reduce the risk of addiction.

The simplest way to lessen the risk? Seek other treatment methods. “The best way to avoid becoming addicted to Xanax is by not taking it,” Glowiak says. “There are other options toward reducing anxiety that include less invasive medications, supplements, talk therapy, healthy coping skills, exercise, and otherwise.”

However, sometimes avoidance simply is not possible. “In cases where anxiety has reached a point where Xanax is the best intervention, it is important to take as prescribed,” Glowiak says.

Understanding the risks of Xanax addiction—and staying on the lookout for signs of addiction and abuse—are also important. “Understand the drug, its effects on physiology, and potential side effects,” Glowiak says. “If one is still struggling with the prescribed dose, it should still be taken as prescribed but communicated with the prescribing physician.”

It is especially important to keep in communication with your doctor when taking Xanax. Ensuring your doctor is aware of your medical history—including past struggles with addiction—as well as your experience taking Xanax, and any medications you may be taking alongside Xanax, can help ensure you avoid dependency and take the drug safely.

6. Detox is challenging but worth it.

Getting over Xanax addiction is difficult and may feel impossible. Indeed, it can involve a long process, and fully healing from addiction can sometimes take months.

“Even when a patient is tapered down by their prescribing physician over several weeks, they are likely going to experience symptoms of withdrawal,” Masry says.

“Tapering” is when a person is slowly weaned off of a drug, and contrasts with a "cold turkey" approach, which is when you stop using a substance all at once. While tapering is often a safer method of quitting—and this is particularly true with Xanax—it can also be hard.

“Xanax is just a particularly difficult drug to detox from—there's no way to guarantee a pain-free detox,” Masry says. Even with a potentially challenging detox and recovery, speaking with your doctor and having a clear plan can help reduce and eventually eliminate your dependency on the drug.

Ultimately, with organized care, getting over a Xanax addiction can be achieved. It’s important to formulate a holistic treatment plan–not only for detox, but for sustained abstinence and recovery. Knowing what could happen during your detox and recovery process, as well as the medical and psychological interventions available to mitigate symptoms, will better prepare you for successful treatment

Don’t Wait. Get Help Now.

If you or a loved one are struggling with addiction, WebMD Connect to Care Advisors are standing by to help.