Xanax is a brand name of alprazolam, a prescription drug primarily used to treat anxiety disorders. Alprazolam may also be prescribed to treat anxiety associated with depression, panic disorder, or insomnia, as reported by the Substance and Mental Health Services Administration (SAMHSA). According to the National Library of Medicine, this drug is a benzodiazepine, part of a group of drugs that fall within the category of central nervous system (CNS) depressants. CNS depressants slow down the nervous system, thereby alleviating symptoms of anxiety.
Xanax can be a very effective anti-anxiety medication, but it can often lead to dependence. It is also more toxic than other benzodiazepines, according to SAMHSA. Taking larger amounts than prescribed can have serious health consequences. Combining the drug with other CNS depressants like narcotics can also be extremely dangerous. If a dependence on Xanax is formed, stopping or lessening use of the drug can lead to withdrawal.
Withdrawal from Xanax
A study published by the National Library of Medicine reports that Xanax withdrawal often involves the following symptoms:
- Sleep disturbance
- Increased tension and anxiety
- Panic attacks
- Hand tremors
- Muscular pain and stiffness
Withdrawal syndrome is fairly common, and it usually lasts 5-7 days, though it can extend 10-14 days in some cases. Different people become dependent on Xanax at different rates. Higher doses of the drug may increase the risk of dependence. The National Library of Medicine reports that in addition to withdrawal symptoms, a recurrence of anxiety or insomnia is a common response to stopping use of Xanax. Symptoms of the original disorder for which Xanax was prescribed – whether anxiety, depression, or insomnia – can persist until another form of treatment is instituted. Recurrence typically begins 1-4 days after stopping use of the drug.
The National Institute on Drug Abuse (NIDA) recommends that people addicted to benzodiazepines do not attempt to stop taking the drug on their own. Withdrawal from Xanax and similar drugs can be severe and may involve medical complications. Because of these risks, medically supervised detox is encouraged.
While detox is necessary, more comprehensive therapeutic treatment must follow. Cognitive Behavioral Therapy (CBT) can assist throughout this process, as the person experiencing withdrawal adapts to life without the medication. CBT helps the individual learn how to reframe thoughts and behaviors in a healthier manner to avoid substance abuse of any kind.
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Medical Supervision and Assistance
Medical complications experienced during withdrawal can include the following, according to the Center for Substance Abuse Treatment:
- Distortions in taste, smell, or other perceptions
Dosages of Xanax and other benzodiazepines are tapered gradually during medically supervised detox, in order to avoid or lessen these complications. The person experiencing withdrawal will sometimes be given small doses of other benzodiazepines that are less addictive, in order to lessen symptoms of withdrawal. The Center for Substance Abuse treatment reports that chlordiazepoxide and clonazepam are often used for this purpose because they are longer-lasting medications.
Substitution with other medications can also be used during the withdrawal process, including phenobarbital. Hospitalization is commonly recommended in these instances. For less serious withdrawal symptoms, anticonvulsants like carbamazepine or valproate, or antidepressants like trazodone or imipramine, may be used to assist in detoxification. Even with proper medical treatment, medical complications can occur, so most people should avoid driving or operating machinery for several weeks after detoxification.
Detoxification from Xanax should begin when the person experiencing dependence on the drug is in a stable and non-stressful situation.
Difficult life circumstances can make withdrawal more challenging and can increase withdrawal symptoms like anxiety and panic. Plans should be made to manage underlying disorders that were being treated by Xanax, to prevent or lessen reoccurrence of those disorders. Frequent contact and monitoring are vital throughout the withdrawal process.
Unsupervised detox is more likely to result in medical complications, uncomfortable withdrawal symptoms, and a relapse to Xanax use. Relapse during detox is particularly dangerous since a return to use after any period of abstinence is more likely to result in overdose. In cases of benzodiazepine withdrawal, medical detox is always recommended. The best and safest option is for individuals to undergo medical detox in a professional facility.