Xanax (Alprazolam) Addiction: Side Effects of Xanax Abuse

Xanax (alprazolam) is a benzodiazepine that is used to treat conditions such as generalized anxiety disorder (GAD) and panic disorder.1

Benzodiazepines are some of the most commonly prescribed medications in the United States.1 Abuse of and addiction to benzodiazepines like Xanax has dramatically increased in the last 20 years: Deaths due to overdose in women between 30 and 64 years of age increased 260% between 1999 and 2017, largely due to benzodiazepines and other opioids.2

In this article you’ll find information about:

  • What Xanax is and how it and other benzodiazepines work.
  • The short- and long-term side effects of Xanax use and abuse.
  • How to identify a Xanax addiction.
  • Treatment for a Xanax substance use disorder.

What Is Xanax?

bottle of alprazolam, otherwise known as xanax, on a shelfXanax, the brand name for alprazolam, is one of several medications classified as benzodiazepines or benzos.

You may be wondering what Xanax is used for. Its legal, clinical use is to treat conditions including generalized anxiety disorder (GAD) and panic disorder.1 Like all benzodiazepines, Xanax helps to decrease abnormal brain activity, promoting a sense of calm, relaxation, and even sedation.3

However, Xanax is sometimes taken illegally or in a way not approved by a medical professional. Some people abuse Xanax for the sedating effects and euphoric high, which can result in some unexpected or challenging side effects.

Sometimes Xanax is used in combination with other sedating drugs, particularly opioids and alcohol. This is known as polydrug abuse and can speed up the onset of addiction, increase its severity, and intensify side effects—particularly the risk of respiratory problems and death.

How Long Xanax Lasts

According to the Food and Drug Administration (FDA), the average half-life of Xanax is 11.2 hours. This means that after this time, half of the dose will have been metabolized and eliminated from the body.4

This can lead to intense cravings that materialize faster than cravings from benzodiazepines with a longer half-life, such as diazepam. Tolerance to Xanax can develop faster than tolerance to other benzodiazepines because of the drug’s short half-life.5

Side Effects of Xanax Use

As we mentioned earlier, Xanax reduces excessive brain activity associated with anxiety and panic and induces feelings of calm. It does this by increasing the availability of a brain chemical called GABA, an important neurotransmitter in the brain inhibits other neurotransmitters related to abnormal brain excitation and anxiety.6

Because of this action, the drug also causes some less-than-desirable side effects, some of which can interfere with the individual’s ability to function normally. These side effects include:3

  • Irritability.
  • Fatigue.
  • Dizziness.
  • Inability to concentrate.
  • Sleep problems.

Although Xanax treats mental health disorders rather than physical ones, its action on the brain can also affect other organs and in turn, your physical health.

Some of the physical short-term side effects of Xanax include:3

  • Sleepiness.
  • Feeling lightheaded.
  • Headaches.
  • Dizziness.
  • Dry mouth or increased salivation.
  • shifts in sex drive or performance.
  • Upset stomach and nausea.
  • Constipation.
  • Changes in appetite.
  • Increases or decreases in weight.
  • Difficulty urinating.
  • Joint pain.

These side effects can range from mild to severe, varying between individuals.

Serious Side Effects of Xanax Use

People who take benzodiazepines like Xanax on a long-term basis may have a higher risk of developing dementia, including Alzheimer’s disease, than those who don’t take them.

Other serious issues include:3

  • Trouble breathing.
  • Seizures.
  • Hallucinating.
  • Skin rash.
  • Yellow discoloration in the skin or eyes.
  • Feeling depressed.
  • Problems with memory.
  • Confusion.
  • Difficulty speaking.
  • Unusual changes in behavior or mood.
  • Harmful or suicidal thoughts.
  • Difficulties with coordination or balance.

Due to the risks of Xanax, it is recommended only for short-term use. The FDA recommends use of Xanax for anxiety disorder for no more than 4 months and for panic disorder, 4 to 10 weeks.4 The risks of Xanax are not limited to the above side effects. Xanax also has a known potential for abuse and dependence.4

What Causes Xanax Dependence and Addiction?

xanax tablets in their packagingDependence on a drug like Xanax can form if the drug is used too often, for an extended period of time, or in higher doses than prescribed.

Dependence doesn’t constitute addiction. Instead, it is a physical adaptation of the body to a drug. It is normal for even those people who are prescribed medications and using them correctly to develop physical dependence. However, it often happens alongside addiction and is one of the diagnostic criteria for a substance use disorder.Dependence on Xanax is indicated by withdrawal symptoms arising when a person tries to cut back or stop their use of the medication. You can read more about Xanax withdrawal symptoms below.

Addiction is distinct from physical dependence. It is a disease that can cause a user’s brain chemistry to change, making self-control more difficult. A combination of factors contribute to a person becoming addicted to a substance, including their biology and environment. However, there is no one definitive cause for addiction.9

People who abuse Xanax may develop problems like dependence and addiction at a faster rate. Xanax abuse can take many forms. For example, a person may self-medicate with Xanax for conditions other than those it has been prescribed to treat (for example, using the drug as a sleep aid, when its intended use is to ease anxiety). Other may individuals take it illicitly to experience a high. Others may just continually increase their dose without consulting their doctor first.

Xanax Withdrawal Symptoms

Stopping using Xanax suddenly can cause withdrawal symptoms, such as:10

  • Increased anxiety and depression.
  • Irritability.
  • Panic attacks.
  • Tremors.
  • Trouble concentrating.
  • Nausea.
  • Weight loss.
  • Headaches.
  • Muscular pain and stiffness.

Can I Quit Xanax Cold Turkey?

Every instance of Xanax abuse or addiction is different.

It can be helpful to get medical support when detoxing from benzodiazepines. A medical professional can help you either taper your dose to avoid health risks.12

In some cases, users may be advised to taper off the drug using a longer-acting benzodiazepine such as diazepam. This can make withdrawal symptoms easier to manage.12

What are the Signs of Xanax Addiction?

As with any potentially habit-forming drug, the symptoms of Xanax addiction vary between patients. However, common warning signs can include:11

  • Unusual drowsiness.
  • Confusion.
  • Memory problems.
  • A general feeling of not being “with it”.
  • Loss of interest in activities the user once enjoyed.
  • Using increasing amounts of Xanax.
  • Obsessing about Xanax.
  • “Doctor shopping” for multiple prescriptions.
  • Anger and mood swings (especially if the user is unable to obtain the drug).
  • New or increased instances of depression.
  • Appearance of withdrawal symptoms when use is stopped.

Xanax Addiction Treatment

When you’re suffering from Xanax dependence or addiction, it’s a good idea to find a reputable, research-based addiction treatment facility. Xanax is a difficult drug to stop taking safely, and a professional program can help you find effective medically supported detox to stay safe as you overcome your dependence on the drug. It can also provide support, treatments, and therapy that enable you to gain control over your Xanax use.

Treatments should be evidence-based and may include:

  • Individual or group cognitive behavioral therapy—also known as talk therapy— sessions.
  • Family or interpersonal therapy.
  • Peer support groups, such as 12-Step programs.
  • Exercise and nutritional support.
  • Other programs to provide recovery support.

With these and other treatments, you can learn to enjoy life again without Xanax and learn ways to manage the symptoms that might result in relapse.

Helping a Loved One with a Xanax Addiction

If you’re worried that a loved one is abusing Xanax, and want to encourage them to seek treatment, it’s important to take the right approach.

A confrontational “intervention” like those you see on TV is likely to upset or anger your loved one, and they are less likely to admit they have a problem, or to accept help.

It can be hard to stay calm when someone you care about is causing themselves harm. However, it’s important to remember that they didn’t choose this addiction, and that to overcome it, they’re going to need your support—not your judgement.

Let your loved one know that they can trust you, and approach them with a plan that can help them overcome their addiction. The disease of addiction is manageable, and recovery is possible.

 

References:

  1. American Chemical Society. (2014). Alprazolam.
  2. VanHouten, J.P., Rudd, R.A., Ballesteros, M.F., & Mack, K.A. (2019). Drug overdose deaths among women aged 30-64 years—United States, 1999-2017. Morbidity and Mortality Weekly Report 68(1), 1-5.
  3. Medline Plus. (2017). Alprazolam.
  4. Food and Drug Administration. (2011). Xanax.
  5. Vinkers, C.H. & Olivier, B. (2012). Mechanisms underlying tolerance after long-term benzodiazepine use: a future for subtype-selective GABAa receptor modulators? Advances in Pharmacological Sciences 2012, 416864.
  6. Lydiard, R.B. The role of GABA in anxiety disorders. The Journal of Clinical Psychiatry 64(Suppl 3), 21-27.
  7. Billioti de Gage, S., Begaud, B., Bazin, F., Verdoux, H., Dartigues, J., Peres, K., Kurth, T., & Pariente, A. (2012). Benzodiazepine use and risk of dementia: prospective population based study. BMJ 345, e6231.
  8. National Institute on Drug Abuse. (2018). Is there a difference between physical dependence and addiction?
  9. National Institute on Drug Abuse. (2018). Understanding drug use and addiction.
  10. Schmitz A. (2016). Benzodiazepine use, misuse, and abuse: A review. The Mental Health Clinician, 6(3), 120–126.
  11. Ohio Hospital for Psychiatry. (n.d.). Benzodiazepine addiction symptoms, signs & effects.
  12. Center for Substance Abuse Treatment, Detoxification and Substance Abuse Treatment. (2006). Treatment Improvement Protocol (TIP) Series, No. 45. Rockville, MD: Center for Substance Abuse Treatment.