24 Jun Xanax Withdrawal Symptoms
History and Prevalence Of Xanax
Xanax is the trade name for alprazolam, a prescription drug primarily used to treat anxiety and panic disorder, but also prescribed as part of other treatment plans. Xanax is a short-acting drug of the benzodiazepine class of medications that has seen a surge in use, both prescribed and illicit, over the last three decades. Similar to other benzodiazepines such as Valium, Klonopin, and Ativan, Xanax functions by depressing specific functions within the central nervous system to reduce feelings of anxiety. Xanax was first released in the United States in 1981 and marketed as a treatment for panic disorder. It quickly gained in popularity, with prescriptions of Xanax surpassing those of other benzodiazepines within a short time.
Xanax is extremely effective in treating panic disorder and anxiety due to its short acting nature. It interacts powerfully and quickly with the GABA receptors in the central nervous system, resulting in reduced communication between neurons and causing a calming and sedative effect. The effects of Xanax are usually fully felt within 20-40 minutes. This short action, however, comes with a number of significant downsides. The first is that the effects of Xanax last only a short time, usually between 4-7 hours depending on the dose and tolerance of patient or person taking it.
The second downside to Xanax’s short action is that while it has been shown to be extremely effective, it also carries with it a great risk for developing a chemical dependency. This leads to the last downside of Xanax’s short acting nature; Xanax is the most abused benzodiazepine in the United States today. Over the last decade, more people have been admitted to the emergency room for overdose or drug interaction complications due to Xanax than any other drug in the benzodiazepine class of substances.
The short half-life and rapid onset that makes Xanax so effective for treating anxiety and panic disorder also makes it the drug of choice for those that abuse benzodiazepines. While Xanax is the leading cause of emergency room visits for benzodiazepine abuse, it is also the most prescribed benzodiazepine in the United States today. Xanax is most commonly prescribed to treat panic and anxiety disorders, for which it has been proven to be highly effective since its introduction.
Xanax has also been used to treat side effects of other treatments, such as chemotherapy, and also used as an anti-convulsive medication in some instances. Less commonly, Xanax has been used to treat depression, although typically selective serotonin reuptake inhibitors (SSRI’s) are more frequently prescribed for depression. Xanax is sometimes prescribed alongside SSRI’s to be taken on an “as-needed” basis at the onset of panic attacks or severe anxiety.
The frequency with which Xanax is prescribed has resulted in abuse across a wide range of demographics in the United States. In some cases, illicit use of Xanax follows a period of time where it has been prescribed and used at therapeutic dosages over the length of many years. Given the tens of millions of Xanax prescriptions in the United States, this does not occur as frequently as one might think.
Most patients that are prescribed Xanax do not increase their dosage on their own over time. That being said, detoxing from even long-term prescribed Xanax usage can be difficult and dangerous. The frequency of Xanax prescriptions has also resulted in a robust black market for Xanax, making it the cheapest and most widely available benzodiazepine on the street. Although Xanax abuse has been overshadowed by the recent rise of opiate abuse in the United States, Xanax remains commonly abused and results in longstanding addiction in millions of users.
With the troubling rise in the use, and abuse, of Xanax, there has been closer scrutiny of the frequency with which Xanax is prescribed and the length of time it is prescribed for. From its outset, Xanax has been prescribed with a recommended length of usage of 2-4 weeks. Typically, prescription usage is maintained far beyond this recommended length. This is due in part to the fact that many Xanax prescriptions are issued to be used “as needed”, or to be used at the onset of a panic attack or severe anxiety and prescribed alongside SSRI’s for depression or anxiety.
Because Xanax is frequently prescribed in this manner, it is difficult to track how often a patient is using Xanax. Additionally, although Xanax abuse results in some common side effects, it is less obvious or stigmatized as other drugs such as opiates. This allows for Xanax to be taken for much longer periods of time before doctors or family members may become concerned. Despite these concerns and because of its effectiveness, many people prescribed therapeutic dosages of Xanax maintain Xanax use for extended periods of time.
Symptoms of Xanax Withdrawal
Withdrawal from Xanax can be extremely difficult, and in some cases dangerous. In particular, in cases where users quit Xanax “cold turkey” or suddenly without medical supervision, withdrawal can be intense and agonizing. In cases where Xanax has been used at high dosages over a long period of time, quitting suddenly without proper medical care can be life threatening. Withdrawal symptoms and their severity depend greatly on the habit of the person quitting Xanax.
Specifically, the dosage Xanax is being used at, the frequency with which it is being used, and the length of time a person has been using Xanax have a significant impact on the acuity of symptoms during withdrawal. As with other benzodiazepines, quitting Xanax should be done under medical supervision and with a comprehensive treatment plan in place. This both ensures the safety of the patient if potential severe withdrawal symptoms arise, and results in much greater chances of a successful transition to sobriety.
Xanax withdrawal symptoms vary widely from person to person. Chemical dependency on Xanax can occur quickly even at therapeutic levels and is often formed between 3 and 6 weeks of regular use. In such cases, withdrawal symptoms may be relatively mild but can still be extremely uncomfortable. If Xanax use is continued over 6 months or longer, even at prescribed doses, withdrawal symptoms become much more severe.
Mild to Moderate Xanax Withdrawal Symptoms
- Muscle stiffness
- Inability to concentrate
- Increased heart rate
Severe Symptoms of Xanax Withdrawal
- Severe insomnia
- Severe anxiety/panic attacks
- Psychosis (hallucinations/delusions)
- Distortions of perception
- Visual disturbances
- Ataxia (changes in gait or inability to fully control movement)
- Sensory hypersensitivity
- Paresthesia (burning or tingling of the skin)
- Agoraphobia (fear of places or situations that might cause panic or embarrassment)
Xanax Withdrawal Timeline
Due to the short half-life of Xanax in the blood stream, the onset of withdrawal symptoms occur much more rapidly than some other benzodiazepines. Typically, withdrawal symptoms begin to manifest shortly after Xanax is broken down and excreted from the body after around 6 hours. This coincides with the onset of early withdrawal symptoms, which will begin to increase in intensity over the next 6 to 12 hours.
Early symptoms are most frequently rebound anxiety and insomnia. Withdrawal becomes increasingly uncomfortable over the first four days, at which point it generally begins to diminish. During this period many people experience flu-like symptoms of varying intensity, such as nausea, vomiting, diarrhea, chills, and muscle fatigue. Although these symptoms will begin to decrease in intensity over the course of the first week, they may continue over the course of two weeks or even longer in some cases. Many people experience only mild symptoms past the two-week period, but in some cases, they may experience protracted withdrawal symptoms. Protracted withdrawal symptoms can have a sudden and unpredictable onset, and may manifest over a period of months or even years.
In situations where a person has built up a tolerance to a high dosage over a long period of time, Xanax withdrawal symptoms will be much more intense and severe. In these situations, quitting Xanax suddenly can lead to serious medical side effects such as hallucinations and seizures. Debilitating depression leading to suicidal thoughts has also been linked to severe withdrawal from benzodiazepines. In most cases, the onset of severe withdrawal symptoms occurs from quitting benzodiazepines suddenly, or “cold-turkey”.
Xanax Withdrawal Treatment
Detoxing from benzodiazepines, and Xanax, in particular, should be undertaken under medical supervision and with a treatment plan in place. This is true even in cases where a patient has been taking a prescribed, therapeutic dosage of Xanax over a long period of time. Although all benzodiazepines share a difficult withdrawal process, particularly after a long period of use of high dosages, Xanax withdrawal is often more acute and intense. This is due to the rapid half-life of Xanax within the body. While it’s rapid half-life makes Xanax act quickly and effectively on the central nervous system, it consequently results in a more intense and debilitating withdrawal process. As such, it is extremely important to conduct a detox from Xanax in a safe, effective way.
Detoxing from Xanax under medical supervision is most commonly conducted through a tapering or replacement process. With the tapering approach, the dosage of Xanax is steadily reduced over time until it is at a low enough dose that it can be safely eliminated. In some cases, Xanax is replaced with a benzodiazepine with a longer half-life, which is then tapered off over time. These approaches are most often undertaken in an outpatient setting when the prescribing doctor believes the use of Xanax is no longer required.
Quitting Xanax through a tapering approach may work for individuals that have only used Xanax for a short period of time, and at low doses. Because quitting Xanax can be quite difficult and often results in relapse, even patients that have maintained a prescribed therapeutic dose of Xanax over a long period of time often need the extra care that an inpatient drug rehab center offers. Within an inpatient setting, rather than taper or replace Xanax with another benzodiazepine, other medications, such as chlormethiazole, promethazine, propranolol, and antidepressants are used to minimize the effects of withdrawal symptoms. These medications have been proven to be highly effective at medically managing Xanax detox. Antidepressants, such as SSRI’s, can often be effective at managing the underlying medical condition, whether it be anxiety or panic disorder, for which an individual was prescribed Xanax.
At the same time that tapering or replacement is being undertaken, concurrent methods of treatment also begin. Cognitive behavior therapy, in particular, is widely used to ease specific aspects of the withdrawal process while helping the patient work through the underlying conditions that led to use of Xanax. Cognitive behavior therapy has proven an effective means of treating anxiety and depression and therefore is highly effective at minimizing the impact of these common symptoms of Xanax withdrawal. Alongside structured therapy sessions, counseling and other activities can help bring the mind and body to a state of normalcy and reduce the impact of the detox process.
The most effective means of detoxing from Xanax is by enrolling in an inpatient drug rehab center with qualified medical staff that have proven methods of helping patients detox from benzodiazepines. Inpatient treatment centers reduce the risks of benzodiazepine detox by offering medical management throughout the withdrawal process, which helps reduce the symptoms and complications that can result from withdrawal. Additionally, in an inpatient setting, the patient has immediate access to medical care at all times. This adds an important level of security for patients by minimizing the health risks that can result from severe symptoms of Xanax withdrawal.
Inpatient treatment gives the patient a safe space in which to conduct their Xanax detox process, allowing them to focus on their withdrawal and address the underlying causes of addiction. Lastly, inpatient care reduces the chances of a relapse, which is extremely common in Xanax withdrawal as patients grapple with intense anxiety and other symptoms. For these reasons, inpatient care is the most effective and safest route of detoxing from Xanax and will give the patient the best chances for a successful and lifelong recovery.