Xanax, or alprazolam, is a sedative-hypnotic benzodiazepine tranquilizer drug used to treat anxiety, panic, and seizure disorders.

When taken as directed, Xanax is relatively safe. Available in pill form that is prescribed to be swallowed, Xanax can have toxic side effects when it is misused, however. The Drug Abuse Warning Network (DAWN) reports that in 2011, more than 100,000 Americans received emergency medical care for an adverse reaction to the abuse of alprazolam.

Benzodiazepines, or benzos, make up a class of drugs that act as central nervous system depressants. This means that they slow down things like blood pressure, respiration and heart rate, and they lower body temperature. Xanax helps to reduce anxiety and minimize seizures by increasing levels of the natural brain chemical GABA (gamma-aminobutyric acid) in the brain. GABA dampens the stress response and thus induces feelings of calm. As a result, benzodiazepines can be addictive, and their effects may make them desirable as drugs of abuse. Abusing Xanax, especially in large amounts, can lead to a possible overdose.

The National Survey on Drug Use and Health (NSDUH) publishes that close to 2 million people in the United States abused tranquilizer drugs at the time of the 2014 survey. When a person uses Xanax without a medical need, or outside of the parameters of a prescription, it is considered abuse.

The Drug Enforcement Administration (DEA) reports that Xanax is abused by swallowing the pills, or by crushing them to snort the drug for a rapid-onset “high.” Xanax is meant to be digested through the gastrointestinal system slowly, and by crushing and snorting the drug, the intended method of metabolism is bypassed. Instead, the drug quickly enters the bloodstream all at once. This method of abuse can increase the risk for overdose.

The Centers for Disease Control and Prevention (CDC) warns that drug overdoses in the United States are on the rise, as close to 50,000 people died from one in 2014. Taking more than one drug at a time greatly elevates the odds for a potentially fatal overdose. It is especially dangerous to mix central nervous system depressant drugs, such as Xanax, with other substances with similar methods of action, like opioids or alcohol. Benzos like Xanax are regularly abused with other substances. The Los Angeles Times reports that in more than three-quarters of benzodiazepine overdose deaths in 2010, the presence of an opioid drug was also found.

 

Recognizing and Treating Xanax Overdose

An overdose on Xanax can be potentially life-threatening without professional and medical intervention. The administration of a benzodiazepine antagonist drug like flumazenil can help to reverse Xanax overdose, per the prescribing information from the manufacturer Pfizer.

An overdose on Xanax may include the following symptoms:

    • Shallow breathing
    • Sluggish movements
    • Extreme drowsiness or sedation
    • Slowed pulse and heart rate
    • Cold, clammy skin
    • Mental confusion
    • Slurred speech
    • Loss of motor control and coordination
    • Loss of consciousness

 
 
 
 
The risk for Xanax overdose increases the more the drug is used. Regular use of the drug can lead to drug dependence and significant withdrawal symptoms when it wears off. In general, Xanax abuse, dependence, and addiction should be treated first with medical detox, as withdrawal can be intense and even life-threatening, including possible seizures, insomnia, depression, and anxiety. Xanax withdrawal can last between a week and a month, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports, and this drug should not be stopped “cold turkey.” Medical detox can help a person to wean off Xanax slowly by tapering the drug in a controlled manner over a set period of time.

Detox should be followed with an inpatient or outpatient addiction treatment program.


Treatment for Xanax abuse should include behavioral therapies and supportive care in conjunction with pharmacological management, and treatment programs generally last at least 90 days in order to ensure the most beneficial outcome.