What is Xanax?
Xanax is the brand name of alprazolam, a central nervous system depressant belonging to the broad group of benzodiazepines. Depressants work by ‘depressing’ or slowing down the central nervous system. They reduce the activity of the neurotransmitters in the brain that communicate with the rest of the nerves in the body. This enables Xanax and other similar medications to have a tranquilizing effect.
Uses of Xanax
Xanax is prescribed to treat anxiety, depression-related anxiety, and panic disorders. Aside from slowing brain activity, Xanax stimulates the effects of a brain chemical called GABA, which induces a feeling of calmness and relaxation.
A number of other prescription medications work in the same way. Although considered less addictive than drugs such as opioids or stimulants, Xanax use can nevertheless develop into substance abuse in some individuals.
Xanax is an FDA-approved medication, with legitimate medical uses. Nevertheless, it is a controlled substance, listed as Schedule IV under the Controlled Substances Act. This means that it can be taken under medical supervision, but only with a prescription. It is considered low risk in terms of abuse and dependence. And yet, Xanax misuse is common. When both alcohol and Xanax are combined, or it is taken with other drugs, the risk of Xanax addiction increases.
Medical Use of Xanax
As mentioned above, Xanax is commonly prescribed to treat certain forms of mental illness. General anxiety disorder (GAD) and similar or related conditions such as panic disorders can benefit greatly from this prescription medication. However, the FDA has approved Xanax only for very short-term use in the majority of cases – no more than six to eight weeks for the above conditions.
The therapeutic dosage range for anxiety-related disorders starts from 0.25 to 0.5 milligrams three times a day, and not more than 4 mg per day. Dosage can be adjusted as necessary every three to four days. For panic disorder, slightly higher doses are required and start at 0.5 mg three times daily. Here again, the dose can be increased every three or four days, by no more than 1mg per day. Patients often stabilize at around 5 or 6 mg daily. The absolute maximum safe dose is 10 milligrams daily.
These numbers may mean little to the average person, but they become more significant when you know that a person with a Xanax substance use disorder may take up to 20 to 30 pills daily. This is only possible because the body builds up a tolerance to Xanax very rapidly. As with all drug abuse, a Xanax addiction is best treated in its early stages. Recommended addiction treatment follows the same model employed for other benzodiazepines.
Can Xanax Cause a Substance Use Disorder?
Although Xanax is classed as a Schedule IV controlled substance, the prevalence of Xanax misuse in society demonstrates that it is, in fact, much more addictive than its category implies. Indeed, most addiction specialists consider it highly addictive, and its legitimate medical usefulness is limited by its psychoactive properties. It is estimated that up to one in five people taking Xanax or other benzodiazepines as prescription medications, may develop a substance addiction to these drugs.
Why Does Xanax Cause Substance Addiction?
There are a number of reasons why it’s easy to get hooked on Xanax. Here are some of the main reasons:
- Xanax is rapidly absorbed, and has a short half-life: this means that its effects are felt more rapidly than other benzodiazepines. They are also more intense. But more short-lived too – the drug’s short half-life means it is eliminated by the body more quickly. A rapid ‘high’ that quickly fades is always a potential recipe for addiction.
- Tolerance develops rapidly: a person’s body rapidly gets used to Xanax, so the intensity of its effects quickly decreases. The temptation can be to take more in order to achieve the results initially felt. Fear that the drug is no longer working properly, or a desire for greater relief from anxiety, is not uncommon in subjects who are often battling anxious feelings from the outset.
- Physical dependence also happens easily: taking Xanax at higher than prescribed doses, or for longer than the prescribed duration, can easily lead to physical dependence. This means the body now needs it in order to function normally. As a result, it is very hard to stop taking Xanax.
- Psychological dependence: this state is characterized by a person not being able to take their mind off the drug, almost to the point of obsession. They become convinced that they cannot keep their anxiety, panic disorder, or other condition under control without it. Even the thought of losing this emotional crutch can cause them great anguish.
- Xanax withdrawal symptoms are unpleasant: if someone tapers their use of Xanax off too abruptly, or attempts to stop suddenly, they are likely to experience withdrawal symptoms. The challenge of enduring these can be too great for some, and the easiest way to ease the pain is to take more Xanax.
- Xanax is over-prescribed: A 2018 article by the National Institutes of Health (NIH) stated that “Alprazolam (Xanax) is one of the most widely prescribed benzodiazepines for the treatment of generalized anxiety disorder and panic disorder.” It also pointed out that many primary care physicians persist in prescribing it for longer periods than recommended. The longer a person keeps taking Xanax, the greater the risk of developing a substance addiction.
- Polysubstance abuse: when a person is mixing Xanax with other drugs and misusing both, it is referred to as polysubstance abuse. Combining Xanax with other addictive substances produces a more addictive cocktail. Chronically mixing Xanax with other drugs greatly increases the risk of substance addiction, especially if the other substances are opioids. Indeed, these two drugs are a particularly dangerous combination – in 2020, 16 percent of overdose deaths involving opioids also involved benzodiazepines such as Xanax.
- Mixing Xanax and Alcohol: alcohol and Xanax are a popular combination among users, with alcohol having the advantage of being legally available. Since both Xanax and alcohol are depressants, taking them together means the effects of the two substances are enhanced. Users feel even more ‘spaced out’ and relaxed than on just one drug. As a result, mixing Xanax and alcohol can potentially lead to both a Xanax substance use disorder and to alcohol abuse.
Substance addiction treatment, typically in a treatment center, is generally recommended for Xanax addiction. Substance use disorders, in general, are very difficult to overcome unaided, and there are evidence-based therapies specifically tailored to treating benzodiazepine addiction.
Why Do People Mix Xanax and Alcohol?
Xanax and alcohol are a popular mix, but why should this be? Here are a few reasons why users may want to consume alcohol and Xanax at the same time.
The Two Substances Produce an Extra ‘Buzz’
This may sound obvious, but nobody would combine alcohol and Xanax if they weren’t achieving enhanced effects. Since both Xanax and alcohol act as depressants, a person will feel increased sedative effects and a sense of relaxation under their influence. Xanax also indirectly increases the concentration of dopamine – a feel-good chemical – in the brain. It does this by stimulating the release of the neurotransmitter GABA in the central nervous system. This adds a sense of mild euphoria to the user’s experience.
Alcohol is Legal
Since Xanax is only legally available with a prescription, getting enough of it to use more, or for longer, than the prescribed duration, is problematic. People who abuse Xanax look for ways to make it last longer or go further. One way to do this is to take it with other drugs or alcohol. Since alcohol is freely available, it is an easy choice.
Pre-existing Addictive Tendencies
People who have a history of substance use or alcohol use, or worse, taking multiple drugs or abusing alcohol, are more likely to mix Xanax and alcohol or Xanax with other substances. A single addictive substance can drive a person to substance abuse, but polydrug abuse is a habit that in itself can be addictive. People begin to believe that more drugs or substances are better than one. Addiction treatment for substance use involving multiple substances – prescription drugs or otherwise – is complicated. Detox alone can take longer and provoke more intense withdrawal symptoms.
Just the fact of consuming Xanax and alcohol together is a clear sign that a person’s alcohol use and drug habits have become a threat to their health and safety. While the choice is always up to the individual, a residential treatment program in a treatment center is the surest way for someone to stay in a safe environment and receive the help they need to start their recovery journey.
Dangers of Mixing Xanax and Alcohol
Xanax is never prescribed without the warning “Do not take Xanax if drinking alcohol,” and with good reason. Xanax and alcohol are a risky combination. The primary danger of mixing alcohol and Xanax is overdose. Taking them together can result in excessive sedation. The combined effect of the two substances alone can have serious, and even fatal, consequences.
Furthermore, the user may lose full awareness of what they are doing. This can lead them to take more Xanax for further effects or continue drinking alcohol in greater quantities than they realize. This is a potentially dangerous situation.
Also, each individual reacts differently to Xanax and alcohol. This means that taking them together is a dangerous leap into the unknown, particularly the first time they do it. Mixing Xanax and alcohol may affect their mental state so much they begin to behave recklessly. As a result, alongside fatal overdose, they risk accident or injury from their actions.
When a person’s state deteriorates following their use of alcohol and Xanax, it can be hard to distinguish if they are suffering from Xanax overdose or alcohol poisoning. Either condition is a medical emergency, but for reference, symptoms of a Xanax overdose include:
- poor coordination, slow reflexes
- respiratory depression
- extreme confusion
- extreme drowsiness
- loss of consciousness or coma
Alcohol poisoning can cause similar confusion, and also:
- vomiting, decreased blood pressure
- slowed or irregular breathing
- cold, clammy, or blue-tinted skin
- low body temperature, hypothermia
- loss of consciousness
Overdose doesn’t happen to people who use Xanax in accordance with their prescription and doctor’s instructions. Additionally, such extreme symptoms are unlikely to be experienced by someone who can drink alcohol without excess. In short, an overdose is an unmistakable sign that a person needs addiction treatment services, and to find the safe haven of a treatment center before their condition worsens.
Addiction to prescription medications such as Xanax can happen insidiously. It can creep up on people, who may think there is no harm in taking it just another week or two or upping their dose by just a little bit. This may be enough for their use of Xanax to tip over into addiction. As well, if they discover that alcohol and Xanax give them the extra buzz to feel blissfully relaxed, they’re in the danger zone.
At Alina Lodge, we know all about benzodiazepine addiction. We understand how the fine line between legitimate use and abuse can be crossed before you know it. We’ve been at the forefront of residential addiction treatment for six decades, and offer one of the most well-established programs in the addiction field. Reach out to us, to begin your recovery journey.