Alprazolam Addiction & Abuse

Alprazolam – more commonly known by the trade name Xanax – is a short-acting benzodiazepine used to treat numerous anxiety disorders amongst other conditions. Whilst a useful and beneficial medication when used correctly, alprazolam – a class-C controlled substance in the UK – is unfortunately also commonly abused as a recreational drug and is significantly habit-forming, with many thousands of addicts now to be found around the world.

What is Alprazolam Dependence?

Alprazolam dependence is the state whereby a person using alprazolam over a period of time becomes accustomed to a certain level of the drug in their system; that person’s system adjusts to that elevated level of alprazolam and subsequently requires it (becomes dependent on it) in order to function normally. If a dependent person stops taking alprazolam suddenly, they are likely to experience a range of withdrawal symptoms – some of which can be dangerous – whilst their system readjusts to the new absence of alprazolam.

Other names for alprazolam

As previously noted, alprazolam is more often known by the trade name Xanax, but is also provided under other names including Alprax, Alprocontin, Alzam, Alzolam, Anzilum, Apo-Alpraz, Helex, Kalma, Mylan-Alprazolam, Niravam, Novo-Alprazol, Nu-Alpraz, Pacyl, Restyl, Tranax, Trika, Xycalm, Xanor, Zolam, and Zopax. On the street, alprazolam may be known by slang terms including xannies, zanies, bars, ladders, xanbars, xans, z-bars, footballs, planks, poles, blues and blue footballs.

Alprazolam has the chemical formula C17H13ClN4.

What is Alprazolam Used to Treat?

Alprazolam is most commonly used in the short-term management of anxiety disorders, panic disorders, and nausea due to chemotherapy. It has also been prescribed to treat borderline personality disorder, depression, dysautonomia and tinnitus.

Factors Contributing to Alprazolam Addiction

Every case of addiction is unique, and there is no single standard course of events leading to addiction for any one individual; moreover, the precise causes of addiction are not completely understood – although it is accepted that both environmental and genetic factors play a part. Individuals most susceptible to addiction include those with family histories of the condition; people experiencing significant trauma and/or difficulties; those with pre-existing mental health conditions; and those associating with people consuming drugs.

Risk factors associated with alprazolam addiction specifically include taking the drug for more than two to four weeks; taking in higher doses than recommended; and having an established proclivity for drug abuse.

How addictive is alprazolam?

Alprazolam is one of the more potent benzodiazepines, and consequently one of the more addictive. It is generally considered to have a high dependence liability, though exactly how addictive it is remains a matter for debate in the medical community.

Neurological and physical basis of alprazolam addiction

Consuming benzodiazepines over time can result in physical dependence (see above) in which the user’s system becomes reliant upon the presence of alprazolam to function normally. Cessation of use results in withdrawal symptoms which along with cravings can drive repeated usage. While the psychological basis of addiction (as opposed to dependence) is still being researched, it is generally considered to be a disorder of the brain’s reward centre whereby pleasurable stimuli are engaged in repeatedly despite an awareness of negative consequences.

Deadly Alprazolam Drug Interactions

Alprazolam is known to interact dangerously with a variety of other substances including CYP3A4 inhibitors (such as cimetidine, erythromycin, norfluoxetine, fluvoxamine, itraconazole, ketoconazole, nefazodone, propoxyphene, and ritonavir); alcohol; kava; St John’s wort; and various oral contraceptives.

Routes of Administration of Alprazolam

Alprazolam is provided in tablet form, to be consumed orally. Some evidence exists of recreational users grinding up alprazolam tablets to be snorted or even injected, but such usage is thought to be comparatively rare.

Spotting Alprazolam Abuse in Family and Friends

Alprazolam abuse and addiction may well be demonstrated via the manifestation of various signs and symptoms (see below). However, if you notice these signs in a loved one, it is important to note that this does not automatically imply the presence of an addiction. Moreover, confronting your family member or friend may cause more harm than good. Speak to an addiction specialist about how to proceed.

Alprazolam Abuse Signs and Symptoms

Due to the stigma associated with substance abuse, many people abusing alprazolam will go to great lengths to hide that abuse and it may not be immediately identifiable; nevertheless, some signs of alprazolam abuse include frequent intoxication including drowsiness, slurred speech, dizziness, blurred vision and impaired motor control; “doctor shopping” to obtain multiple prescriptions; increased intoxication when consuming other substances, especially alcohol; a preoccupation with obtaining and consuming alprazolam; long-term symptoms including anxiety, insomnia, anorexia, weakness, cognitive impairment and brain damage; and the manifestation of withdrawal symptoms upon cessation of use.

Long-term effects of alprazolam

Along with the danger of dependence and addiction, long-term alprazolam use poses various dangers including the risk of: overdose, potentially resulting in death; disinhibition; impaired concentration and memory; depression; sexual dysfunction; fatigue; insomnia; dyspnoea; constipation; anxiety; cognitive impairment including damage to verbal learning, memory, psychomotor, visuo-motor and visuo-conceptual capacity; mania; psychosis; delirium; hallucinations; immunological disorders; suicide and self-harm; and brain damage.

Co-Occurring Disorders

Because of its use to treat certain mental disorders, alprazolam is more likely than many other substances to feature in cases of dual diagnosis (substance abuse disorders existing alongside other mental disorders). In such cases of co-occurring disorders, the approach to treatment is necessarily more complex and specialised care is typically required.

Who is at Risk for Alprazolam Addiction?

Anyone consuming alprazolam for any length of time is at risk of developing an addiction; it is vital that alprazolam should only ever be consumed in strict accordance with the instructions of the prescribing doctor.

Teen Alprazolam Abuse and Addiction

Because of its relative ubiquity and affordability, and the ease with which it may be obtained from the dark web and/or on the streets, alprazolam abuse is a growing problem amongst teens. If you are concerned that a teenager or young person close to you is abusing alprazolam, contact an addiction specialist for advice immediately.

Cost of Alprazolam Addiction in Families

Alprazolam addiction can be catastrophic for a family, regardless of who specifically in the family is abusing the drug. If you believe a family member is addicted to – or simply abusing – alprazolam, do not rush to confront them: call an addiction specialist to discuss your situation and to request advice on how to proceed.

• anterograde amnesia and concentration problems
• ataxia, slurred speech
• disinhibition
• drowsiness
• dizziness
• lightheadedness
• fatigue
• unsteadiness
• impaired coordination
• vertigo
• dry mouth (infrequent)
• hallucinations (rare)
• jaundice (very rare)
• skin rash
• respiratory depression
• constipation
• suicidal ideation or suicide
• urinary retention (infrequent)

Relationship between Alprazolam and Other Substances

Like other benzodiazepines, alprazolam acts upon the GABA receptor in the brain in a similar way to various other subsequent substances; as a result, consuming alprazolam can lead to a phenomenon known as cross tolerance, whereby the affected individual will also develop a tolerance for other substances acting upon GABA receptors. Cross tolerance has been identified between benzodiazepines, alcohol, the nonbenzodiazepine class of drugs, barbiturates and corticosteroids.

• coma and death if alprazolam is combined with other substances
• fainting
• hypotension (low blood pressure)
• hypoventilation (shallow breathing)
• impaired motor functions
• dizziness
• impaired balance
• impaired or absent reflexes
• muscle weakness
• orthostatic hypotension (fainting while standing up too quickly)
• somnolence (drowsiness)

Alprazolam Withdrawal

If you are taking alprazolam over a sufficient period of time and in sufficient quantities for you to have developed dependence, stopping taking alprazolam may lead to the manifestation of various potentially unpleasant and even dangerous symptoms known as withdrawal symptoms.

Symptoms of Withdrawal

People who have developed a physical dependence to alprazolam, and who withdraw gradually from their consumption, may develop at least some of the following symptoms:

• akathisia
• agitation and anxiety, possible terror and panic attacks
• blurred vision
• chest pain
• depersonalization
• depression (can be severe, with possible suicidal ideation)
• derealisation
• dilated pupils
• dizziness
• dry mouth
• dysphoria
• elevation in blood pressure
• fatigue and weakness
• gastrointestinal disturbance (including nausea, diarrhoea, vomiting)
• hearing disturbance
• headache
• hot and cold spells
• hyperosmia
• hypertension
• hypnagogic hallucinations
• hypochondriasis
• increased sensitivity to touch
• increased urinary frequency
• insomnia
• impaired memory and concentration
• loss of appetite and weight loss
• mild to moderate aphasia
• mood swings
• muscular spasms, cramps, discomfort or fasciculations
• nightmares
• obsessive compulsive disorder
• paraesthesia
• paranoia
• perspiration
• photophobia
• postural hypotension
• REM sleep rebound
• restless legs syndrome
• stiffness
• taste and smell disturbances
• tachycardia
• tinnitus
• tremor
• visual disturbances

• catatonia, which may result in death
• confusion
• convulsions, which may result in death
• coma (rare)
• delirium tremens
• hyperthermia
• mania
• neuroleptic malignant syndrome-like event (rare)
• organic brain syndrome
• post-traumatic stress disorder
• psychosis
• suicidal ideation or suicide
• violence and aggression

Duration of Withdrawal

Each case of withdrawal from alprazolam is unique, with durations differing significantly from one case to the next. Generally speaking, in most cases withdrawal symptoms will last between a fortnight and two months; in some cases, however, protracted – or post-acute – withdrawal syndrome will develop, with symptoms persisting for months or even years.

Alprazolam Withdrawal Timeline

Again, each case of alprazolam withdrawal is unique; however, a rough timeline of withdrawal might look as follows:

• Days 1-2 (early stage): withdrawal symptoms can commence as soon as six hours after the last dose, with symptoms beginning to manifest including fatigue, irritable moods, restlessness, insomnia and panic attacks.
• Days 3-7 (acute): existing symptoms intensify and are likely to be joined by numerous others including nausea, dysphoria, diarrhoea, headaches, hypertension, anxiety, confusion, muscle spasms, hypersensitivity, sweating, tremors, and changes in weight.
• Day 8 onwards (late stage): the aforementioned symptoms typically recede over time, though anxiety, depression, suicidal ideation, disturbed sleep and strong cravings may persist for another two to six weeks (and longer in the case of protracted withdrawal syndrome).

What to Do if you Need Help Quitting

If you have tried and failed to stop taking alprazolam it is absolutely vital that you seek help immediately in order to avoid the risk of further damage. Contact your GP and/or an addiction specialist straightaway.

Alprazolam Addiction Treatment

Fortunately, in parallel with the rise of instances of alprazolam addiction, there has been a growth in the capacity and capability of treatment facilities across the UK. Alprazolam addiction can now be treated at a very high level.

Alprazolam recovery plan

Key to treatment is the provision of a coherent recovery plan outlining the phases of treatment and what to expect from withdrawal and recovery. Engaging in different elements of treatment piecemeal is much less likely to have permanently beneficial consequences.

Detox

Detoxification is a vital first phase of treatment; it is the process of removing substances of abuse from an addict’s system over time. During detoxification withdrawal may manifest, which in the case of alprazolam can be extremely dangerous: detox should always be carried out under the supervision of qualified medical professionals.

Residential rehab

Some alprazolam addicts may opt for, or be referred to, residential rehabilitation (rehab) in which both detoxification and therapy will be provided alongside other treatment elements. Stays typically last for between one and three months.

Outpatient treatment

For addicts for whom inpatient treatment is not an option, both the NHS and private services run outpatient treatment for alprazolam addiction. This may be more problematic than residential rehab, however, as it does not remove the patient from their environment of substance abuse.

Support groups

Numerous support groups operate throughout the country providing help for drug addicts including those addicted to alprazolam specifically. For more information on support groups in your area speak with your GP and/or an addiction specialist.

Therapy for Alprazolam Addiction

Psychotherapy lies at the heart of all addiction treatment, as only therapy can both reveal and address the underlying psychological causes of addiction. A great variety of therapy models and formats are provided in treatment, in both one-on-one and group settings. For more information on relevant therapy approaches, contact an addiction specialist.

Alprazolam Addiction Statistics

• Alprazolam was first introduced to the public in 1981. In 2016 it was in the top 20 most commonly prescribed drugs in the United States.
• People aged 18 to 25 are twice as likely to abuse alprazolam as over-25s.
• Alprazolam has been linked with over 200 deaths in the UK since 2015.
• UK customs officials have seized counterfeit Xanax tablets worth over £1 million since 2016.
• A growing quantity of counterfeit Xanax tablets now contain the highly dangerous drug fentanyl.
• The UK is the second largest market globally for alprazolam sold over the dark web.

Ready to Get Help?

If you are struggling with an alprazolam addiction and want to stop, if you are prepared to acknowledge that addiction you can get help – and that help could transform and even save your life.

Get help today

Don’t waste any more time: seize the day and reach out for help today. Call your GP and/or an addiction specialist to discuss your particular situation and what treatment options might be appropriate to you.

Take control of your life – get started on the road to recovery

No matter how long you have been a slave to your alprazolam addiction, and how severe it may be, you can take back control by asking for the professional help you need. Speak with your GP and/or an addiction specialist and take the first step on the path back to the healthy, happy life you deserve.

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