What Is Xanax (Alprazolam)?
Xanax, a brand name formulation of alprazolam, is a widely prescribed benzodiazepine medication.1 Benzodiazepines are central nervous system (CNS) depressants used therapeutically for their sedative-hypnotic and anxiolytic properties.
Benzodiazepines like Xanax act on and influence activity of the inhibitory neurotransmitter signaling molecule GABA (gamma-aminobutyric acid) at the GABA receptor. By increasing the effect that GABA has on its transmitter, these medications can calm an otherwise over-excited nervous system and contribute to feelings of sedation.1
Benzodiazepines are generally intended for short-term use as physical dependence can develop in as little as 2 weeks of use.2 Xanax may be prescribed as an oral tablet in various doses, with the largest available dose sometimes referred to as Xanax bars, as the tablets are oblong in shape and multi-scored to be divided.3
Xanax Uses
Xanax is prescribed to treat:3
Generalized anxiety disorder.
Panic disorder.
The medication is meant to be taken as prescribed, for the conditions listed above. However, Xanax is often misused either in an effort to achieve a euphoric effect or to medicate without a prescription.1,3 Other examples of Xanax misuse include:4
Ingesting Xanax in unintended ways.
Taking more than the dose prescribed by your doctor.
Taking or buying Xanax without a prescription.
Xanax misuse includes snorting or injecting Xanax as opposed to swallowing it.4 Combining Xanax with other substances in an attempt to enhance its euphoric effects is another example of misuse.1 Any type of Xanax misuse increases the risk of addiction development.3
Xanax Misuse Side Effects and Risks
Like with many substances, prescription or otherwise, there are potential risks and side effects when using or misusing Xanax.
Some of the associated risks and severity of the side effects may be increased when taken in larger than therapeutic doses and/or when combining Xanax with other substances like opioids or alcohol.1,3
Common side effects include:
Drowsiness.
Decreased blood pressure.
Dizziness.
Decreased motor skills.
Impaired coordination.
Difficulty speaking clearly.
Slowed thinking.
Changes in sex drive.
There may be certain more persistent or long-term effects associated with benzodiazepines like Xanax, including:5
Cognitive impairments (e.g., decreased neural processing speed, memory problems).
Impaired psychomotor skills/deficits in motor control and performance.
Over time, Xanax misuse can also increase the risk of developing:3
Tolerance, which means the repeated use of the drug results in a reduced response. Benzodiazepine tolerance can lead to escalating patterns of use, as a higher dose becomes required to produce the desired effects.
Physical dependence.
Withdrawal symptoms when you stop taking Xanax.
In addition to the above adverse effects, the compulsive misuse of a drug like Xanax may, over time, cumulatively increase the likelihood of experiencing a Xanax overdose.
Xanax Overdose
Xanax toxicity or overdosing on xanax is possible and could be life-threatening in severe cases.3 Symptoms of Xanax overdose include:
Over-sedation.
Confusion.
Impaired coordination.
Diminished reflexes.
Coma.
While it is possible to fatally overdose on Xanax alone, it is more likely a fatal overdose involving Xanax, or other similar benzodiazepines, will also involve other substances such as alcohol or opioids.6
If you suspect someone has overdosed on Xanax, you should call 911 immediately. Do not wait for all of the symptoms to be present before making the call. As opioids are so commonly involved in cases of benzo overdose, it is important to administer naloxone (Narcan) if you have it available.
Mixing Xanax With Other Drugs
Taking Xanax with opioids, alcohol, or other CNS depressants can increase your risk of:3
Profound sedation and diminished levels of consciousness.
Slowed breathing rate.
Coma.
Fatal overdose.
Mixing opioids with Xanax can contribute to increasingly slowed and difficult breathing, and can ultimately increase your risk of fatal respiratory arrest.3
Mixing Xanax with alcohol is another prevalent type of Xanax misuse. As with concurrent opioid use, this can increase the risk of adverse effects, including fatal overdose.3 How Addictive Is Xanax?
Xanax has a known risk of addiction and is categorized as a Schedule IV drug under the Controlled Substance Act by the Drug Enforcement Administration (DEA).7 The risk of addiction development may increase if a person misuses the medication.3
At certain doses, substances like Xanax can produce euphoric effects in association with neurochemical changes within the brain’s reward circuitry.9 Such changes serve to reinforce drug-using behavior which makes stopping drug use incredibly difficult and can lead to addiction—the compulsive use of substances despite negative consequences.9
Signs of Xanax Addiction
Keep in mind that only a medical professional can diagnose addiction. However, it can be helpful to know the signs of xanax abuse to recognize when help is needed.
Xanax addiction is formally diagnosed as a sedative, hypnotic, or anxiolytic use disorder in the Diagnostic and Statistical Manual of Mental Disorders Fifth Edition (DSM-5).10
To be diagnosed, you must have significant distress or impairment and meet at least 2 of the following criteria within a 12-month period:
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