What is Xanax?
Xanax is a powerful tranquilliser that is widely used in the US for treating anxiety and insomnia. It is a class C drug in the UK, and it cannot be obtained through the NHS. Private prescription is the only way Xanax is available in the UK.
Xanax belongs to a class of drugs known as benzodiazepines. While several kinds exist, alprazolam — better known as Xanax — is the most well-known and commonly abused.
In the UK, the most commonly prescribed benzodiazepine is diazepam, which is largely known by its trade name, Valium. Compared to Valium, Xanax is a faster-acting drug that is 10 times stronger. As a result, Xanax causes more intense feelings of sedation in a shorter space of time.
While Xanax is effective in treating the medical problems for which it is prescribed, its highly addictive properties make it a risky medication to prescribe. In cases where Xanax is prescribed, it is usually intended to be a short-term remedy.
Xanax’s high dependence liability is the reason why many countries have rigorous prescription requirements before it can be obtained.
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Xanax brand and street names
- Alprazolam. A short-acting benzodiazepine. It’s commonly used in temporary management of anxiety disorders, namely panic disorder and generalised anxiety disorder. Alprazolam is the most readily available type of Xanax. As a result, it is the one that is most prone to misuse and illegal peddling. Many illegal variants of alprazolam contain unsafe amounts of benzodiazepine.
- Xanor. A central nervous system depressant. Xanor slows the nervous system. It is not as largely available in the UK as it is in the US. Xanor is one of the least commercially viable forms of Xanax.
- Niravam. Orally disintegrating formulation of alprazolam. It rapidly disintegrates on the tongue. Niravam is used to treat generalised anxiety disorder and panic disorder. Doctors are recommended to periodically reassess the usefulness of the drug for individual patients. Over time, dosage is gradually decreased.
Available forms and routes of administration of Xanax
Xanax is available in tablets that come in strengths of 0.25 mg, 0.5 mg, 1 mg and 2 mg. The tablets are scored and can be split.
Alprazolam Intensol is a way of taking Xanax in liquid form. It comes in a bottle that has a calibrated dropper. There are markings for various doses.
Orally disintegrating tablets of nivaram and alprazolam are available in strengths of 0.25 mg, 0.5 mg, 1 mg and 2 mg.
The most common way of taking Xanax is by mouth, through disintegrating tablets.
This route of administration carries the risk of possible overdose and severe side effects if the tablet is chewed or crushed in any form, as it will be absorbed into the bloodstream at a toxic rate
Medical uses of Xanax
Xanax is used to treat panic disorders, which are feelings of intense fright that occur suddenly and without warning. Xanax is a favoured treatment for panic attacks because it takes effect quickly.
Xanax is also used in the treatment of anxiety disorders, mostly generalised anxiety disorder (GAD). Sufferers of GAD experience extreme worry for a minimum of six months. Xanax is used during preliminary stages of GAD treatment, but it is not a favourable long-term medication because of its addictive properties.
Long-term anxiety medications can take six to eight weeks to show results, giving Xanax the advantage of being an immediate remedy. However, it is recommended that Xanax intake is stopped as soon as long-term medication starts.
In rare cases, Xanax is used for pre-operative anxiety. A large number of patients experience anxiety before surgery, which can make them difficult to sedate.
For cancer patients who have undergone chemotherapy, Xanax can be used to ease the pain they may suffer in the first few weeks after their treatment.
In all its medical uses, Xanax is only recommended as a short-term treatment due to the high likelihood that individuals may develop dependence. Medical professionals are recommended, and required by law in some jurisdictions, to continually evaluate whether or not a patient requires Xanax.
The Pharmacology of Xanax
Xanax achieves its short-acting properties through its effect on the gamma-aminobutyric acid (GABA) receptor. The receptor Xanax targets is the type A receptor. GABA receptors are inhibitory; their function is to limit the activity of neurotransmitters.
In addition, Xanax allows receptor channels to open, letting more chloride enter cells. This is what gives it its muscle relaxant and anti-convulsant characteristics.
Xanax is given further potency as an antidepressant due to the fact that it elicits increases in dopamine concentrations in the striatum, a part of the brain. The particular dopamine concentrations that Xanax increases are the D1 and D2 types.
With particular regard to its effects on reducing anxiety, Xanax does this by binding with GABA receptors, creating a depressant effect that is mainly focused synaptic transmission.
Chemical formula – C17H13CIN4
Xanax contains 17 molecules of carbon, 13 molecules of hydrogen and 4 molecules of cyanic iodide. The molecular structure and chemical composition of Xanax give it its fast-acting properties.
The high carbon count allows Xanax to be absorbed into the bloodstream quickly, while the hydrogen gives it its long-lasting effects, including a half-life of six hours and the ability to be detected in the body weeks after intake.
Most of Xanax’s psychoactive attributes are derived from cyanic iodide, which is highly stimulative to the brain. Other benzodiazepines, especially the slower-acting types, have less one less molecule of cyanic iodide.
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Xanax Legal Status (UK)
In the UK, Xanax is classified as a class C drug, under Schedule 4. This means that it is illegal for Xanax to be sold except under highly controlled circumstances
Under certain circumstances, however, Xanax can be legally obtained. One of these, which is also the one that is most used, is private prescription.
Even for people suffering from anxiety, depression or any of the medical problems Xanax is known to help with, the drug cannot be obtained through the NHS.
In the UK, police have full rights to seize Xanax if a person is in illegal possession of the drug. Whether or not the police arrest a person for Xanax possession depends on the amount that he or she is found with.
Illegal peddling of Xanax is an offence that can lead to immediate arrest. An eventual prison sentence may be given depending on factors such as to whom the peddler was selling the Xanax and the amounts he or she was selling.
Members of Parliament in the UK have been increasingly debating stricter laws to deal with the growing usage and rising cases of Xanax-related hospital admissions.
Xanax Addiction and How It Develops
As a psychoactive drug, Xanax causes the release and reception of high amounts of dopamine, a neurotransmitter that controls reward and pleasure centres in the brain. Ingesting Xanax reduces the gamma-aminobutyric acid (GABA) in the brain, lessening the barrier between the dopamine-producing parts of the brain and the dopamine-receiving parts.
When the brain receives more dopamine, feelings of pleasure increase, while feelings of anxiety and panic subside. The influx of dopamine in the brain can cause feelings of ecstasy, which is what some look for when they misuse Xanax. Continued use of Xanax leads to the build-up of tolerance, resulting in a user needing to take more of the drug to achieve the intended euphoric effects.
People suffering from anxiety are more prone to addiction than the general population, given that it is easier for them to depend on prescription drugs to alleviate their suffering. Substance dependence can develop even when the drug is being used as prescribed.
The time Xanax addiction takes to develop depends on various factors. These include an individual’s brain chemistry, how regularly the drug is used and in what quantities it is ingested. Other substance habits and environmental aspects can be determining factors.
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Why is Xanax addictive?
Xanax is addictive because it alters brain chemistry in a way that facilitates higher-than-normal releases of dopamine, leading to feelings of relaxation and pleasure. Through continued use of Xanax, tolerance starts to develop.
Tolerance may be immediate or it may take time, depending on dosage, an individual’s metabolism of the drug and whether or not other drugs are being taken simultaneously.
Xanax is also addictive because of its high dependence liability. When substance dependence develops, a user experiences drug withdrawal symptoms when the body goes an extended period of time without receiving a dose. Under these circumstances, the drug has to be continually taken for the body to maintain a level of functionality.
For the desired effects of pleasure and relaxation, an individual may have to take higher dosages of Xanax. Users may also decrease the time between successive doses for the effects to retain their intensity.
Causes and Risk Factors for Xanax Addiction
One of the main causes for Xanax addiction is that it is prescribed to people suffering from anxiety and depression.
Due to its relaxing effects, people suffering from these conditions are predisposed to take high dosages of it, leading to substance abuse.
Another risk factor for Xanax addiction is that it is difficult to observe substance dependence and addiction in the early stages. Whereas with other substances the symptoms of addiction are pronounced even at the onset, signs of Xanax addiction become more noticeable when the addiction is severe.
This makes it difficult for those around users to intervene or for the users themselves to observe and fully appreciate the harmful effects substance abuse may be having on their lives.
Addiction to Xanax is also made more likely by alcoholism and other forms of substance abuse. Taken in conjunction with other substances, the effects of Xanax are amplified, causing the user to develop a craving over time. This leads to substance dependence that develops over a relatively short period of time.
Previous history of substance abuse, even after it has ceased, can make an individual significantly more likely to develop Xanax addiction. In situations of this nature, addiction takes a short time, and individuals tend to take high dosages in quick succession.
Teen Xanax Abuse and Addiction
The UK accounts for 22% of illicit Xanax sales on the Dark Web.
The availability of Xanax on the internet has made it more accessible to teens who may be prone to abusing it and developing substance dependence.
Hospital admission data in England indicates that there has been a sharp increase in the number of teenagers admitted to hospital owing to benzodiazepine poisoning.
Additionally, there has been an increase in the number of Xanax-related police seizures. In 2016, there were fewer than 10 seizures, while 800 seizures were reported in 2017.
Recent data is unavailable. However, the figures are expected to be higher.
Teen substance abuse in the UK is particularly concerning because a large number of illicit Xanax tablets are not of pharmaceutical grade. This can lead to teens taking higher dosages than they believe they are taking, heightening the risk of eventual substance dependence and addiction.
TICTAC, a drug analysis organisation, found that many of the Xanax tablets easily accessible to teens through illegal channels have 10 times more alprazolam than an authentic Xanax tablet.
Apart from increasing the chances of an overdose, counterfeit Xanax can have the effect of causing substance dependence in teens at higher rates than authentic Xanax.
Signs and Symptoms of Xanax Addiction
Some of the signs of Xanax addiction include:
- Nausea
- Unusual sleeping times
- Problems with concentration and memory
- Headaches
- Lethargy
- Lack of coordination
- Irritability
- Drowsiness
- Blurred vision
- Lack of coordination
- Irritability
- Drowsiness
- Blurred vision
The severity of these symptoms depends on how much Xanax the individual is taking as well as the frequency with which it is being taken.
High levels of addiction, which naturally accompany taking higher dosages with greater frequency, lead to more serious signs and symptoms. These include suicidal thoughts, impulses to hurt oneself, aggression and depression.
Other ways to know if someone is addicted to Xanax include routinely failing to meet family, professional or school obligations due to Xanax abuse.
Continued use of Xanax even after it causes negative outcomes for the user is also a sign of addiction. Individuals addicted to Xanax may express a desire to stop but be unable to do so.
Other dishonest practices such as stealing and defrauding friends and family members can be evidence of a Xanax addiction.
The more observable signs of Xanax addiction emerge after an individual has been abusing the drug for a long time. These are largely behavioural signs. They include extreme levels of secrecy and lying. People addicted to Xanax tend to be highly defensive when confronted with the issue, even with evidence.
Going to great lengths to obtain Xanax is often a sign of addiction. Individuals experiencing substance dependence may resort to stealing the drug from those around them. It is not uncommon for individuals addicted to Xanax to visit multiple doctors seeking many prescriptions of the drug so as to attain more of it.
A loss of interest in everyday activities can at times be a sign of Xanax addiction. Formerly motivated individuals may stop participating in events they regularly partook in due to being addicted to Xanax. Likewise, a person who used to be social may develop a preference for being solitary because of a Xanax addiction.
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Co-Occurring Disorders with Xanax Addiction
Alcoholism is a common co-occurring disorder with Xanax. When taking alcohol and Xanax at the same time, individuals tend to take excessive amounts of the latter. This leads to the body’s tolerance for Xanax increasing, prompting users to increase their dosages for the intended effects to be achieved.
Depression can occur as a result of taking high amounts of Xanax, and pre-existing depression can be aggravated by Xanax addiction. The severity of depression, at times reaching the point of compulsive suicidal thoughts, depends on the amount of Xanax a user takes as well as the frequency.
Paranoia is a common result of Xanax addiction. Individuals addicted to Xanax are prone to feelings of paranoia when they have taken a dose and at the onset of drug withdrawal symptoms.
Excessive aggressiveness is a disorder many users face while suffering from Xanax addiction. The manifestation of this particular disorder can range from mild irritability to frequent bouts of physical violence.
An inability to function within professional and familial settings is a common disorder individuals suffering from Xanax addiction face. It can extend to a failure to organise one’s personal life.
Xanax Overdose Explained
Xanax can lead to overdose because of its fast-acting effects. Risk of overdose increases when a tablet is broken or chewed.
As the overdose of Xanax becomes more evident, the symptoms become severe and, in extreme cases, life-threatening. Signs of a mild overdose include sleepiness and slowed reaction time. An overdose of slightly greater severity can cause lack of coordination and loss of balance.
A slower-than-normal heartbeat and difficulty with breathing point to a potentially life-threatening Xanax overdose. Symptoms can progress rapidly without medical intervention, resulting in a coma or death.
Treatment for Xanax overdose depends on various factors. The most important is the amount that was ingested. Other substances taken along with Xanax can also determine the type of treatment needed.
Stomach pumping, otherwise known as gastric lavage, is also used to treat a Xanax overdose. During this process, emergency personnel insert a tube into the stomach, allowing the drug to be pumped out.
Flumazenil has been found to be an effective Xanax overdose treatment. It acts as an antidote that neutralises the effects of Xanax. Over the course of the treatment, the individual is continually monitored for side effects and possible recurrence of overdose symptoms.
Xanax Withdrawal and Detox
After a long period of substance abuse and substance dependence, cessation of use may lead to drug withdrawal symptoms. These vary in severity depending on factors such as alcoholism, the length of addiction, the dosage the user took and the length of time the user was addicted.
Detoxification varies in difficulty depending on the same factors mentioned above. When individuals are attempting to detoxify, it is highly recommended that they seek the aid of professionals. Without proper monitoring and adjustment of treatment to match changes in symptoms, detoxification can be fatal.
Detoxification can be done with the aid of medication, depending on whether or not the individual’s addiction was severe enough to warrant it.
Signs and Symptoms of Withdrawal and Detox
What are the withdrawal symptoms of Xanax?
The onset of symptoms of Xanax withdrawal is comparatively quick, typically starting two days after the last intake and lasting a month.
Some of the effects of Xanax withdrawal are perceivable. However, many are experienced by the user.
Commonly experienced Xanax withdrawal symptoms include insomnia, forgetfulness, increased irritability, tremors, muscle aches and tension, lack of attentiveness, hyperactivity, anxiety and a depressed mood.
Alcoholism, as well as other forms of substance dependence, can heighten the withdrawal symptoms of Xanax. At times, the effects of Xanax withdrawal outlast the above-listed symptoms. Quitting Xanax can lead to ongoing symptoms known as post-acute withdrawal syndrome, abbreviated to PAWS.
The extent to which a user will experience these drug withdrawal symptoms is largely dependent on how much Xanax the user took and how frequently it was taken. The time span over which the drug was taken is another deciding factor.
Xanax detox process
For a former user withdrawing from Xanax, the safest and most recommended method of detoxification is an extended taper. This is where the substance is administered in steadily decreasing amounts over a set period.
The difficulty of the taper will depend on the extent of use as well as previous withdrawal history. In some cases, the individual may be switched to a long-acting benzodiazepine before the taper starts. (3)
After a therapeutic dose that relieves symptoms has been reached, the stabilising drug will be systemically reduced. Longer periods between reductions of doses can lead to a safer and more comfortable detoxification. However, the detoxification process will be prolonged. Clonidine is regularly used in treating opioid withdrawal. Some of the symptoms of Xanax withdrawal it can help with include tremors.
Xanax withdrawal and detoxification can be aggravated by the unpredictable fluctuation of symptoms. Medical supervision ensures that symptoms are observed and treated accordingly.
Xanax Addiction Treatments
Medical professionals will decide which types of Xanax addiction treatments they will use based on several factors. Different types of treatment are used to varying degrees depending on the stage of drug rehabilitation an individual is going through.
In the initial stages, when it is crucial to manage drug withdrawal symptoms, use of medication is often employed. The kind and strength of medication will depend heavily on the individual’s rate of Xanax usage and the length of time he or she has been experiencing substance dependence.
Because of the health risks posed by abruptly stopping the use of Xanax, less potent forms of benzodiazepine are often administered to a user in the early stages of rehabilitation. Medical professionals monitor the emergence of drug withdrawal symptoms to determine whether they should alter the dosage.
If the tapering is successful and withdrawal symptoms diminish, an individual can advance to the next stage of treatment. Subsequent stages of Xanax addiction treatment focus of helping individuals to overcome the impulse to relapse.
Various forms of therapy are available in the later stages of rehabilitation. These include individual and group therapies, which many recovering users choose to alternate. For those whose periods of substance abuse might have caused psychological harm, therapy is often effective.
Overcoming Xanax addiction
Overcoming Xanax addiction is easier and safer under medical supervision. Individuals attempting to overcome substance abuse are heavily advised to do so with the help of medical professionals. Abruptly stopping the use of Xanax after a period of substance dependence can be fatal.
The most advisable way to quit Xanax is to check in to a rehabilitation facility. Not only does this provide access to healthcare professionals who can effectively monitor and respond to withdrawal symptoms, it increases the chances of a successful detoxification.
Rehabilitation facilities also have staff with extensive knowledge of practices that can ensure a safe detoxification with minimal risk of relapse. These can include counselling and methods to help individuals overcome their cravings for Xanax.
Checking in to a rehabilitation facility also offers the benefit of putting an individual in a controlled environment where accessing Xanax is difficult, decreasing the risk of continued substance abuse.
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Xanax Addiction Medications
The most common way to treat Xanax addiction is to taper a user off the drug through the gradual decrease of the user’s daily dosage. To manage withdrawal symptoms, long-acting benzodiazepines may be used in place of Xanax during tapering.
During the course of tapering, benzodiazepine withdrawal symptoms will likely increase in frequency and severity. The medication buspirone is often used to control this.
For long-term users of Xanax, flumazenil is an effective remedy for withdrawal symptoms. For individuals with a history of head injuries and seizures, however, flumazenil may worsen symptoms.
Therapy for Xanax Addiction
Several forms of therapy are available to help individuals recover from Xanax addiction. Most of them focus heavily on dealing with drug withdrawal symptoms so as to avoid relapse while also helping individuals work through emotional trauma that might have occurred during their period of substance dependence.
While some clients opt for a single type of therapy, many find that a combination of two or more provides better support, allowing them to overcome substance abuse in a shorter space of time and with a higher likelihood of successful drug rehabilitation.
The goal of most forms of Xanax addiction therapy is to allow individuals to understand where their substance dependence stemmed from in a psychological context. This can be beneficial to them as they try to live a drug-free life.
Different types of therapy for Xanax addiction focus on either on the individual in isolation or the individual grouped with other people. These can include family members to provide familial support or other individuals attempting to undergo drug rehabilitation. The latter can help former users feel a sense of community and relatability, which can be useful for maintaining emotional well-being during detoxification.
Cognitive behavioural therapy
This is a form of counselling whereby a therapist helps a former user to see how thought patterns and behaviour may have contributed to Xanax addiction. Through this form of counselling, a therapist works with a user to devise healthy ways of dealing with the root causes of Xanax addiction. (4)
Individual therapy
This is a process through which someone suffering from Xanax addiction works one-on-one with a therapist in a safe and confidential environment. The goal is to come to an understanding of the feelings and beliefs of the user and to overcome the mental effects and after-effects of Xanax addiction.
Holistic therapy
As opposed to addressing Xanax addiction as a single problem, holistic therapy focuses on underlying causes through an evaluation of the individual’s mental, physical, social, emotional and spiritual states. A benefit of holistic therapy is that it can help an individual develop self-knowledge, which can in turn lead to a better understanding of why Xanax addiction developed.
Group therapy
Group therapy allows a user to work through his or her Xanax addiction in the presence of other individuals who have also gone through Xanax addiction. It creates a sense of community and belonging that can help recovering Xanax addicts support each other. Group therapy helps to avoid feelings of isolation, which can make recovery more difficult.
Motivational enhancement therapy
Instead of guiding an individual through a step-by-step recovery process, motivational enhancement therapy aims to inspire inherently motivated change. Early sessions focus on setting goals for full recovery, while later sessions are meant to provide perspective as well as encouragement for overcoming addiction.
Family counselling
Through this process, a person suffering from Xanax addiction goes through therapy with the presence and support of family members. Family counselling is effective in situations wherein the individual’s Xanax addiction has had a toll on his or her family as a whole.
Post-Rehabilitation Support for Xanax Addiction
After completing rehabilitation, some individuals may feel that they require more support before final release. For those who feel unprepared to be integrated into society, there is the option of staying at a halfway house or sober home.
This can be helpful to former users who feel they need additional support to fight the impulse to relapse. Some of the restrictions in sober homes include a possible curfew and rules against bringing in contraband substances.
A benefit former users may find in sober homes is the shared sense of purpose with neighbours who have the same goals and are facing similar situations.
To discourage relapsing, some of the activities that individuals can partake in include attending support group meetings and workshops that can aid in reaching recovery goals.
Unannounced drug and alcohol testing are some of the methods employed to ensure that former users do not relapse into substance abuse and alcoholism.
Individuals who feel they require minimal support can attend monthly or weekly group meetings while staying at home. These provide a platform for former users to share challenges they have faced and the progress they have made as well as being an environment wherein mutual support can be fostered.
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