How Does Xanax Work?

Xanax pronounced [zan-aks], is a benzodiazepine and a brand name for the anxiolytic Alprazolam, a central nervous system (CNS) depressant. CNS depressants slow brain activity and are frequently used as sedatives or tranquilizers which are often used to treat insomnia and anxiety. These drugs are generally prescribed for short-term use only because of their addiction and abuse potential.

Xanax Abuse
Like other prescription drugs, Xanax is often legally prescribed on a short-term basis for legitimate medical conditions including anxiety or sleep disorders. In the beginning, you use it as described and like the calming effects it produces. Unfortunately it’s tempting but also dangerous to try managing these conditions by overusing or taking Xanax in quantities and for longer periods of time other than how it was prescribed.

Tolerance & Self-Medication
Individuals may take higher doses or use it more frequently than recommended, particularly after they build a tolerance to the medication (the same dosage level is no longer as effective as the body becomes accustomed to its presence). Once an individual begins straying from prescription guidelines, it is considered abuse, and addiction can quickly form. Other people suffering from addiction may have originally attempted to self-medicate their anxiety by getting Xanax illicitly from a friend or acquaintance.

Dangers of Mixing Xanax
Mixing Xanax with other substances, either in an attempt to enhance/counteract effects of either drug, is considered abuse. Combining substances is dangerous and amplifies the risks and effects associated with both drugs, increasing the likelihood of health complications and overdose.

Effects of Xanax – Not Just Physical
Like with other addiction involving other drugs, Xanax use eventually affects every area of a person’s life, reaching far beyond simply damage to their health. Over time, Xanax addiction may become the sole focus of life, resulting in career, familial, financial, legal, criminal, and social issues. All other areas of life may become less important as substance abuse becomes the number one priority.

Warning Signs of Addiction
Mayo Clinic lists the following warning signs of addiction:

  • Stealing, forging prescriptions
  • Taking higher doses than prescribed
  • Sudden mood swings, unexplained hostility
  • Changes in sleep patterns, poor hygiene
  • Poor decision-making skills
  • Appearing unusually energetic or sedated
  • Claiming to lose prescriptions to get new ones
  • Seeking prescriptions from multiple doctors
  • Isolating oneself to use drugs, strained relationships
  • Lying about substance use
  • Declining performance at work/school
  • Weight loss or gain

Xanax & the Brain

Xanax affects the brain by acting on a neurotransmitter called gamma-aminobutyric acid (GABA). By increasing levels of GABA within the brain, Xanax can slow brain activity. This produces a drowsy, calming effect that makes it useful in the treatment of anxiety disorders; however, this sedative effect is also sought out by those who seek to abuse the drug.

Side Effects of Xanax
The National Library of Medicine lists common side effects of alprazolam:

  • Drowsiness, lightheadedness
  • Headaches, dizziness
  • Irritability
  • Talkativeness, difficulty concentrating
  • Dry mouth, nausea
  • Changes in sex drive
  • Constipation, difficulty urinating
  • Weight changes, changes in appetite
  • Joint pain

Harmful Reactions to Xanax
Occasionally, some people have more serious reactions, including:

  • Shortness of breath
  • Seizures, difficulty speaking
  • Hallucinations, balance/coordination problems
  • Skin rash, yellowed skin or eyes
  • Depression, suicidal thoughts
  • Difficulties with memory, confusion
  • Mood swings or unusual behavioral changes

Dangers of Overdose
If you’re taking Xanax and experience any of these effects or notice them in someone you love, contact 911 first and the prescribing doctor immediately. Taking Xanax other than how it is prescribed can lead to overdose symptoms:

  • Severe drowsiness
  • Confusion
  • Problems with coordination
  • Loss of consciousness

If overdose is suspected, call for emergency help immediately. Without proper care, Xanax overdose can lead to death.

Addiction & Dependence

Xanax becomes addictive in similar ways that other addictive substances do. According to the National Institute on Drug Abuse (NIDA), when Xanax increases levels of GABA within the brain, it causes a surge in dopamine, a chemical responsible for feelings of pleasure and reward. Repeatedly experiencing this surge in dopamine causes structural and chemical changes within the brain, which can lead to addiction.

Physical Dependence
Xanax addiction is often accompanied by physical dependence on the drug. Dependence occurs when the body adapts to the frequent presence of the drug and needs the drug in order to function. When decreasing or stopping use of Xanax, a withdrawal syndrome will occur. Symptoms of Xanax (benzodiazepine) withdrawal include:

  • Difficulty sleeping
  • Irritability, anxiety
  • Heart palpitations
  • Panic attacks, tremors
  • Sweating, headaches
  • Difficulty concentrating
  • Nausea, dry retching
  • Weight loss
  • Muscle pain and stiffness

Xanax Withdrawal
Because of the dangers of physical withdrawal from Xanax, medically-supervised detox for the patient is recommended. Like withdrawal from most benzodiazepines, Xanax withdrawal typically lasts 10-14 days due to unpleasant and potentially life-threatening physical symptoms that occur as the substance slowly exits the body.The National Institute on Drug Abuse (NIDA) advises that detox should not be attempted without medical supervision. Dosages of Xanax have to be gradually tapered to avoid more serious withdrawal symptoms.

Xanax & Opiates

Personalized Treatment
According to the Substance Abuse and Mental Health Services Administration (SAMHSA), the majority of individuals addicted to Xanax (or other benzodiazepines) may also also addicted to other drugs, usually opiates. It important that treatment addresses all drugs of abuse, as well as any co-occurring mental health disorders, such as depression or anxiety.

Effective Treatment Programs
Currently, there are no FDA-approved medications to successfully treat Xanax addiction. The best results for prescription medication addiction involves helping the patient get to the root of the addiction with peer support groups and by developing coping skills to replace the substance abuse with more positive behaviors. Various methods of therapy have been shown to be effective in treating addiction both in inpatient/residential settings, or outpatient programs. Most programs include individual therapy, group therapy, and family therapy and work with the individual in establishing treatment objectives and aftercare goals.

Behavioral Therapy
Common behavioral therapies used in the treatment of prescription drug addiction include:

  • Cognitive Behavioral Therapy (CBT) is a common therapy modality that has been shown to be effective in treating many mental health disorders, including addiction. This type of therapy helps the individual recognize how thoughts and behaviors contribute to addiction, and replace the problematic patterns with new ways of thinking and behaving. Coping skills are developed that will help prevent relapse in the future.
  • Contingency Management offer rewards when certain milestones are met. Vouchers or other tangible rewards are given when the individual remains sober for a certain length of time or participates in the treatment process. This helps the individual stay motivated to remain in treatment until a firm foundation in recovery is established.

Additional Treatment
Many other treatment methods may be used in the recovery process, including Motivational Enhancement Therapy, adventure therapy, arts therapy, and family therapy. The most effective method of treatment depends on individual preferences and needs. As a result, treatment plans should be individualized to each person in need of treatment and adjusted as needed as the individual progresses in recovery.