Did you know that one of the most commonly prescribed drugs in the United States has a dark side? The opioid crisis has hit the country hard, and the problem is only growing. With opioids taking center stage in the addiction epidemic, it is at the forefront of most people’s minds when they think about problem drugs. But other substances are quietly causing more and more damage with limited media attention. Xanax is one of the most popular brands among a class of drug called benzodiazepines, a prescription sleep-aid and anxiety treatment.
Since the late 1800s to today, doctors and researchers have been looking for pharmaceutical remedies to two of America’s most widespread disorders: anxiety and sleep problems.
There are about 80 different sleep disorders that can make it difficult for you to fall asleep, wake you up in the middle of the night, or cause sleepiness in the middle of the day. It’s estimated that around 35 percent to 40 percent of adults in the U.S. are affected by a sleep disorder. Plus, an estimated 19 percent of adult Americans had an anxiety disorder in 2017.
Benzodiazepines like Xanax have properties that make them useful in promoting sleep and relieving anxiety, but they also come with some serious side effects like a high dependence and addiction liability.
Learn more about how Xanax works and what you can do if you develop a substance use disorder involving a benzodiazepine.
Xanax is the prescription name for a psychoactive compound called alprazolam, which is in the benzodiazepine class of drugs. Benzodiazepines (or benzos) are in the central nervous system (CNS) depressant category, which means they suppress excitability in the nervous system. In other words, they make you feel relaxed, sleepy, and they can relieve anxieties. Xanax can be used for various medicinal purposes, including treatment for anxiety, panic disorders, and social anxiety disorders. It’s short-acting compared to other benzodiazepines, which makes it less useful as a sleep aid.
Xanax works similarly to other depressants but increasing the efficiency of a neurotransmitter called gamma-Aminobutyric acid, of GABA. This chemical is the primary reason why your nervous system controls and manages excitability. In people with anxiety and sleep disorders, there may be an imbalance that affects the way your brain communicates by making it harder to calm down.
Xanax binds to GABA receptors and modulates its function to be more efficient when activated. The result is sedation, anxiety suppression, a loss of inhibitions, muscle relaxation, and other dizziness. The drug has the potential to cause intoxication that’s similar to alcohol, especially when it’s abused. Some people use it recreationally, which can lead to cognitive euphoria. However, it also can cause, memory loss, loss of coordination, respiratory depression, slurred speech, and confusion.
Using Xanax consistently for too long or abusing it can cause you to become dependent on the drug. As euphoria triggers the reward center of the brain, you also may start to become addicted, leading to long-term consequences.
Addiction often comes with several warning signs. It’s worth pointing out that dependence and addiction are closely related, but they refer to different consequences of substance abuse. Dependence is a common risk associated with benzodiazepine use, and it occurs when the drug alters the chemical communication pathways in your nervous system. As you use or abuse Xanax, your brain will start to adapt to the presence of the drug. If you use it longer than directed or in heavy doses, your risk of a dependence developing is increased.
Dependence will feel like you are taking Xanax to maintain normalcy rather than as a therapeutic medication or a recreational drug. As tolerance builds, you may feel like the drug is getting weaker or that you need heavier doses of it to achieve the same effects. As your brain gets used to Xanax, it may stop producing its own inhibitory chemicals and start producing excitatory chemicals to balance brain chemistry. But the drug will continue to suppress the brain’s natural neurochemistry. If you stop using Xanax, you’ll feel uncomfortable withdrawal symptoms, which can actually be dangerous.
Addiction is when your limbic system, also called the reward center, starts to mistake the rewarding euphoria that comes with Xanax intoxication with a life-sustaining necessity like eating and sleeping. To someone that’s developing an addiction, it will feel like an impulsive need for the drug. According to the American Psychiatric Association, addiction is characterized by the impulsive use of a drug despite the consequences. If you lose your job because of because of your substance use, and you continue to use, that could point to addiction.
Addiction treatment is a process that begins with an in-depth assessment of your needs. Most people entering treatment for a substance use disorder involving benzodiazepines start by going to medical detoxification because withdrawal symptoms can be dangerous.
In medical detox, you will be monitored 24 hours every day by medical professionals. Your withdrawal symptoms may be treated with medications to help avoid serious complications and alleviate symptoms as much as possible. Doctors may use anticonvulsants, antidepressants, and melatonin supplements to manage your symptoms while you go through detox.
After the detox process, you most likely need to attend some level of addiction treatment. Detox is an important part of the treatment process, but it’s not enough to treat addiction. Detox lasts for about a week, and it’s designed to meet your immediate needs, including ones related to withdrawal and other medical complications. Clinicians will assess you and help determine which level of care you will need next. The levels of care after detox include:
This level can range from 24-7 medically monitored service to clinically managed residential service.
At this level, you’ll live independently, but you will have access to more than nine hours of clinical services every week.
You’ll live independently and have more time outside of treatment obligations. However, you’ll still have access to fewer than nine hours of clinical services every week.
In addiction treatment, you will go through a plan that’s tailored to your individual needs. The goal of treatment is to address your substance use disorder and any other underlying needs you might have like mental health problems, legal issues, financial instability, and social problems. In treating your addiction, you may go through cognitive behavioral therapy, which is designed to examine the way your thoughts influence your behavior. This type of therapy is useful in forming relapse prevention strategies, learning coping skills, and identifying high-risk situations.
As a benzodiazepine, Xanax can be fatal in a few different scenarios, even though it is a carefully regulated prescription drug. If you take too much at once, you risk experiencing a fatal overdose. This risk is increased if you use the drug with other depressants like alcohol or with opioids. In these cases, the most dangerous side effect is respiratory depression, which can slow your breathing down to dangerous levels, leading to coma, brain damage, or death.
However, Xanax can also be dangerous during withdrawal symptoms. If you become dependent on Xanax and stop using the drug abruptly, it can cause your nervous system to become overactive. This can cause seizures or a condition called delirium tremens which can be deadly without medical treatment. If you start to feel withdrawal symptoms, seek medical assistance immediately.
American Psychiatric Association. (2017, January). What Is Addiction? Retrieved from from https://www.psychiatry.org/patients-families/addiction/what-is-addiction
Hossain, J. L., & Shapiro, C. M. (2002, June). The prevalence, cost implications, and management of sleep disorders: An overview. Retrieved from from https://www.ncbi.nlm.nih.gov/pubmed/12075483
National Institute of Mental Health. (2017, November). Any Anxiety Disorder. Retrieved from from https://www.nimh.nih.gov/health/statistics/any-anxiety-disorder.shtml
National Institute on Drug Abuse. (2018, March 15). Benzodiazepines and Opioids. Retrieved from from https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids