Xanax Addiction: The Dark Throes of Prescription Drug Misuse

Written By Bobby Oerzen BS MA - April 4th, 2017
Xanax Addiction: The Dark Throes of Prescription Drug Misuse

Article Contents

During the dark throes of any addiction, there comes a point of no return wherein an individual develops a severe drug or substance dependency. They may continue to use, even though they are aware of the harm the drug causes. The acute cravings make it very difficult to quit using drugs, especially if the root causes aren’t fully addressed. So, how does this apply to Xanax addiction?

As is the case with many drugs, if you stop using abruptly after a period of regular use, or go “cold turkey,” you may experience unpleasant and even fatal withdrawal effects. Sadly, this can also become the reason for continued-use (or even overdose) amongst addicts, as the physical and mental burden of withdrawal becomes too much to bear. This is also true for Xanax, a commonly prescribed anti-anxiety medication.

Xanax Addiction 101

Alprazolam – available under the trade name Xanax – is a potent, intermediate-onset benzodiazepine. It is commonly used for the treatment of generalized anxiety disorder and panic disorder1.

Xanax works like any other benzodiazepine; by enhancing the effects of Gamma-Aminobutyric Acid (GABA), a chief inhibitory neurotransmitter in the brain. It plays a principal role in reducing neuronal excitability throughout the central nervous system via inhibition of postsynaptic neurons. GABA produces a calming effect on the brain, thereby decreasing anxiety5.

Alprazolam is the most commonly prescribed benzodiazepine and the most commonly prescribed psychiatric medication within the United States4. However, this does not mean that this is a safe medication. In fact, statistics show that alprazolam is the most common benzodiazepine responsible for drug-related emergency department visits7. Studies suggest that alprazolam causes a more severe withdrawal syndrome than other benzodiazepines3.

Short-Term Effects of Xanax

When taken properly and as prescribed by a doctor, the short-term effects of Xanax are highly beneficial to those whose everyday lives are negatively affected by anxiety. A multicenter trial showed efficacy in short-term treatment, whereby the following symptoms showed significant improvement while on alprazolam2:

  • Panic attacks
  • Phobias
  • Avoidance behavior
  • Anxiety

Xanax can, however, cause adverse effects even in a short period. O’Sullivan et al. demonstrated that, by eight weeks, patients using alprazolam developed depression, bed-wetting, aggression, sedation, slurred speech, irritability and impaired memory6.

The great dichotomy with Xanax is that, although it is effective in the short-term, it has a high misuse potential. All benzodiazepines, in susceptible patients, are liable to misuse. Xanax, however, is of particular importance due to its rapid absorption and short half-life. These pharmacokinetics increase its abuse liability1. It isn’t unusual for those under the effects of Xanax to have slurred speech and appear almost intoxicated.

When Xanax is taken in larger doses after a Xanax addiction has developed, the effects become even more dramatic. Confusion, memory impairments, cognitive impairments, and respiratory depression, or even coma may be induced at these high doses5.

Dangers of Xanax Withdrawal

There is no way of supposedly sugar-coating the pill or this following issue; going “cold turkey” or discontinuing the use of Xanax abruptly can cause severe withdrawal symptoms3. Any sustained-use of a benzodiazepine requires medical supervision for withdrawal. It is recommended that, if you have been using a benzodiazepine for a week or longer (especially at a higher dose), that you are adequately weaned off of the medication by a doctor1.

Xanax or alprazolam withdrawal syndrome causes rebound anxiety, insomnia, homicidal or suicidal ideation. It may even cause delirium and psychosis, and this is not a common occurrence with other benzodiazepine withdrawals. Seizures have also been reported on discontinuation1.

The symptoms of withdrawal are secondary to the body’s response to sudden changes in chemicals in the brain. When a patient abuses Xanax, the body becomes accustomed to the effect it causes (tolerance), and without the drug, the body goes into overdrive, trying to compensate for the loss of GABA activity5.

Kicking a Xanax Addiction Safely

There is only one recommended method for coming off Xanax, and that is to gradually reduce the dose under medical supervision; a process called weaning or tapering. In a medical setting, the withdrawal process is managed by slowly reducing the dose and transferring the patient to a longer acting form of the drug. This can take as long as six months (or even longer).

Severe withdrawal symptoms previously mentioned can importantly occur even if the dose is tapered or weaned1. The chance of them occurring is lower, but not altogether eliminated. That means that tapering the dose without the supervision of a medical professional is foolhardy at best. Always detox safely under the encouragement and supervision of trained professionals.



  1. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4-10.
  2. Ballenger, J.C., Burrows, G.D., DuPont, R.L., Lesser, I.M., Noyes, R., Pecknold, J.C., . . . Swinson, R.P (1988). Alprazolam in panic disorder and agoraphobia: Results from a multicenter trial: I. Efficacy in short-term treatment. Arch Gen Psychiatry, 45:413–422.
  3. Browne J. & Hauge, K. (1986). A review of alprazolam withdrawal. Drug Intelligence Clin Pharm, 20:837–841.
  4. Grohol J. (2016). Top 25 Psychiatric Medication Prescriptions for 2013. Retrieved March 17, 2019 from https://psychcentral.com/lib/top-25-psychiatric-medication-prescriptions-for-2013/
  5. Longo, L.P., & Johnson, B. (2000). Addiction: Part I. Benzodiazepines—Side Effects Abuse Risk and Alternatives. American Academy of Family Physicians, 61: 2121-8.
  6. O’Sullivan, G.H., Noshirvani, H., Başoğlu, M., Marks, I.M., Swinson, R., Kuch, K., . . . Kirby, M. (1994). Br J Psychiatry, 165(1):79-86.
  7. SAMHSA. (2013). Drug Abuse Warning Network, (2011): National Estimates of Drug-Related Emergency Department Visits. Subst Abuse Mental Health Serv Administr. 13:4760.

Medically Reviewed: September 25, 2019

Dr Ashley

Medical Reviewer

Chief Editor


All of the information on this page has been reviewed and verified by a certified addiction professional.

Dr Ashley Murray obtained her MBBCh Cum Laude in 2016. She currently practices in the public domain in South Africa. She has an interest in medical writing and has a keen interest in evidence-based medicine.

All of the information on this page has been reviewed and verified by a certified addiction professional.