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3 Xanax Addiction Treatment Options You Should Know

By Lan Pham, Kristen Gasnick
Quitting an addiction to Xanax can be challenging due to unpleasant withdrawal side effects. Find out how different Xanax addiction treatments can help.

Xanax, or alprazolam, is a common benzodiazepine medication used to treat anxiety. Because of its specific characteristics, it can become very addictive. While your Xanax addiction treatment should be tailored to your medical specifics, there are some recognized methods that your doctor may recommend for you. Read on to find out more about three key options for Xanax detox.

1. Use of Other Medications

Xanax is a benzodiazepine that is rapidly absorbed by the body. While its effects start quickly, they also wear off quickly. Because of this, Xanax can cause severe withdrawal symptoms when you stop using it, even if you've only used it for a short period of time.

So, how does being off a Xanax feel? If your body has become dependent on the drug, you could experience a number of uncomfortable symptoms while withdrawing. “Many patients suffer from something called PAWS (post-acute withdrawal syndrome) that leaves them feeling anxious—creating sleep problems and altering their cognitive function for months after full detox,” Adi Jaffe, PhD, author of The Abstinence Myth and founder of IGNTD, a virtual addiction recovery program, tells WebMD Connect to Care. 

The Seminal Institute for Neuroscience and Human Behavior at UCLA defines post-acute withdrawal syndrome (PAWS) as a set of impairments, potentially lasting for weeks or months, that a person experiences when they stop taking a specific substance. This syndrome most commonly appears in those who have stopped using alcohol, benzodiazepines, or opioids. Common symptoms include:

  • Mood swings
  • Insomnia
  • Increased anxiety without apparent cause
  • Memory, learning, or problem-solving difficulties
  • Depressed mood
  • Obsessive-compulsive behaviors
  • Social difficulties
  • Cravings for the substance
  • Sleep disturbances
  • Increased sensitivity to stress

“Medications like gabapentin and other similar lower-level neuro-depressants can sometimes be used during this process," Jaffe explains.

Additionally, American Addiction Centers reports that some patients are switched to a relatively longer-acting benzodiazepine during the Xanax tapering process. While your program will be determined according to the specifics of your case, you could potentially be put on one of the following benzodiazepines in order to ease the withdrawal process:

  • Chlordiazepoxide
  • Clonazepam
  • Diazepam

Additionally, studies have shown that certain anticonvulsants, antidepressants, and beta blockers can successfully treat benzodiazepine withdrawal symptoms. There is also preliminary scientific evidence that the medication flumazenil can provide some relief for both acute and longer-term benzodiazepine withdrawal. Flumazenil is a GABA receptor antagonist, meaning that it blocks benzodiazepines from acting on particular receptors.

2. Medication Tapering

Another treatment option for Xanax addiction is tapering your Xanax dose. Tapering means gradually reducing dosage over time—in contrast to withdrawing from drug use entirely and all at once, also known as quitting “cold turkey”. 

“The long-action of a medication like Xanax (alprazolam) creates tolerance that is very difficult to overcome and can take months of careful titration to fully eliminate,” Jaffe says. With titration tapering, your doctor will dilute the medication to stretch out the tapering process and decrease your dosage by very small degrees over time. 

Tapering the medication gradually can help decrease unpleasant withdrawal symptoms and ease the process of ending Xanax abuse.  To begin, doctors lessen the dosage in small steps. By slowly decreasing the dosage, the body has time to adjust to this change in medication.

Xanax is known to cause intense withdrawal symptoms. Medical management while tapering off Xanax in pre-determined doses that decrease over an 8-week minimum is highly recommended. It’s also important that you have simultaneous psychological support during this process, such as individual or group therapy. To prevent relapse, you’ll need to understand addiction and have the knowledge and support to cope with your withdrawal symptoms.

Does gabapentin help with benzodiazepine tapering? There is scientific evidence that gabapentin can be used to help patients withdraw from benzodiazepines successfully. In fact, a 2015 case report published by the Journal of Addiction and Dependence describes its efficacy for this purpose in several patients. The study reports that the experiences of patients using gabapentin during their benzodiazepine withdrawal included the following:

  • The absence of cravings or significant discomfort during withdrawal
  • The cessation or reduction of anxiety symptoms 
  • The absence of insomnia and irritability 
  • The absence of measurable symptoms of benzodiazepine withdrawal
  • The reduction of hallucinations and cognitive disturbance

It’s important to note that each of these cases were unique and involved distinct medication and treatment regimens. The safety and efficacy of gabapentin for your Xanax withdrawal will depend on the specifics of your case, but it’s an option worth discussing with your doctor. 

Does gabapentin cancel out Xanax? The answer to this question is no. As reported in a 2018 review published by Therapeutic Advances in Psychopharmacology, the purpose of taking gabapentin during Xanax detox is not to cancel out Xanax. Instead, gabapentin calms the nervous system in a manner similar to Xanax, but is a much less potent drug. Therefore, gabapentin doesn’t cancel Xanax out–instead, it can replicate some of the calming effects of Xanax while your body is adjusting to withdrawal.

3. Therapy and Support Groups

Overcoming Xanax addiction can be challenging when proceeding through it alone. Having support from a therapist or others going through similar challenges can help make the process of eliminating the drug from your life smoother and easier. 

“Therapy support and potentially even peer-group support can be important to help prevent relapse to the medication and the potential transfer of the dependency to other depressants like alcohol,” Jaffe says.

In group therapy, you work with a therapist and a group of peers who may be facing similar challenges to yours. Social support and reinforcement can be a great help during recovery. This form of treatment can also help you build communication and conflict resolution skills. 

Individual therapy sessions involve direct discussions with a therapist. These sessions can be done either in person or online, which can be especially helpful if you cannot make it to your counselor’s office. They’ll use evidence-based techniques to help you through your problems and manage issues.

What types of therapy might be used? A 2021 article published by the International Journal of Environmental Research and Public Health  reports that cognitive behavioral therapy (CBT) has been shown to increase abstinence success to 70-80% in those being treated for benzodiazepine addiction. This type of therapy is typically divided into three stages:

  1. Regulating the causes of benzodiazepine use by providing treatment for insomnia and anxiety
  2. Applying the knowledge gleaned from the first stage to enhance the patient’s compliance with their benzodiazepine taper program and the management of their withdrawal symptoms
  3. Preventing relapse through the practice of regulatory behaviors and cognitive strategies, which serve as substitutes for problematic substance use

The article also reports that acceptance and commitment therapy, a specific form of CBT, can be successfully used to help end long-term benzodiazepine use. This form of therapy encourages the acceptance of inner experiences such as thoughts, emotions, or sensations–rather than avoidance or regulation of these experiences. 

Since taking benzodiazepines often helps people avoid experiences of stress, anxiety, insomnia, or panic attacks, this form of therapy is uniquely equipped to help patients displace negative patterns associated with benzodiazepine use and replace these patterns with psychologically healthy analysis and coping skills.

Acceptance and commitment therapy centers around six processes:

  1. Contact with the present moment (mindfulness)
  2. Acceptance (making space for unpleasant feelings)
  3. Defusion (creating distance from troublesome thought patterns)
  4. Values (focusing on what is important)
  5. Committed action (aligning choices with what is important)
  6. Context (using the viewpoint of an observer of your own experience)

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