Xanax is the brand name for a fast-acting benzodiazepine medication, alprazolam. This medication is prescribed for short-term treatment of generalized anxiety, panic disorders, anxiety associated with depression, and social anxiety disorder. Rarely, it is used to treat insomnia or seizures, but among benzodiazepine medications, Xanax is not the most efficient at this. Even more rarely, alprazolam can be prescribed to treat more intense and immediate symptoms of depression. However, it is important to remember that benzodiazepines, especially Xanax, work rapidly, so they are prescribed to treat the intense and sudden symptoms associated with panic or related conditions; they are no longer seen as a long-term treatment.
There are many reasons that Xanax and other benzodiazepines are not considered appropriate long-term treatment for most conditions. Most people rapidly develop a tolerance to the drugs; they can cause euphoria so may lead to compulsive or addictive behaviors; and they can take time to detox from. People who abuse Xanax may doctor shop, steal prescriptions from friends or family, or get multiple prescriptions from multiple doctors. This increases the risk of addiction to Xanax, which can lead to long-term health problems.
The Long-Term Harm of Abusing Xanax
Xanax is one of the fastest-acting benzodiazepines available. It works on the brain within 15 minutes after being ingested and lasts for up to six hours. Although the immediate effects wear off fairly quickly, metabolites of the drug remain in the body for up to 15 hours, so drinking alcohol, taking more benzodiazepines, or taking other sedatives like Ambien or opioids can be very dangerous.
The Food and Drug Administration (FDA) has approved Xanax for very short-term treatment for most conditions. Eight weeks is the maximum amount of time they should be taken, specifically to treat panic disorder.
Most physicians or therapists will prescribe Xanax for “as-needed” treatment. When someone suffering from anxiety feels a surge of panic, or their anxiety prevents them from performing a task like driving or sleeping, taking a dose of Xanax can be extremely helpful.
Taking Xanax regularly is very rare since the medication acts on the brain so quickly, and most people who frequently take Xanax are misusing or abusing their prescription. People who misuse Xanax are at risk of developing an addiction to this drug or at least a physical dependence on it to regulate their brain chemistry. This can lead to long-term abuse, which includes taking this medication for months or even years without appropriate medical supervision.
This may lead to chronic health problems, including:
- Paradoxical reactions: A long-term side effect of abusing Xanax is symptoms that mimic the underlying conditions the drug is prescribed to treat, like insomnia, panic attacks, or intense anxiety. People who misuse Xanax are at risk of taking even more in an attempt to treat paradoxical symptoms rather than seeing their doctor; this can lead to addiction and even overdose.
- Physical side effects: Xanax and other benzodiazepines are sedatives, so slow heart rate, irregular or slowed breathing, and low blood pressure are associated with taking too much of these drugs. While these can also be overdose symptoms in their most extreme forms, mild versions of these symptoms can lead to memory problems, cognitive difficulty, and damage to organs due to slow, steady oxygen deprivation.
- Brain atrophy: Xanax has been associated in some studies with enlargement of an area of the brain called the cerebral ventricular, which is associated with brain atrophy that can lead to dementia-like symptoms.
- Psychological changes: Drug abuse and addiction change behaviors, so people who struggle with addiction may make poor decisions, become abusive, stop taking care of themselves, or display other problems. Xanax in particular can trigger narcissistic personality traits, hyper-confidence, and carelessness. By depressing neurotransmitters, the brain chemistry associated with empathy is reduced, according to some small-scale studies. This can lead to problematic behaviors that strain personal relationships, making other psychological problems worse.
- Tolerance and dependence: With tolerance, the original dose no longer produces the same effects, and the person feels like they must take more of the drug to compensate. This is especially harmful if the person changes their Xanax dose without consulting a doctor first. Tolerance often leads to physical dependence on the drug.
Solutions for Treating Anxiety or Insomnia without Xanax
Xanax is a great prescription drug for as-needed purposes, and it can be helpful for some people who need to take the drug regularly for certain panic disorders with a doctor’s oversight. But finding ways to manage and understand anxiety will provide the best foundation for people suffering from these conditions.
Ultimately, approaching anxiety or insomnia treatment without medication is the best long-term solution.
Dozens of areas of medicine involve benzodiazepines in some capacity: anesthesiology, emergency rooms, and immediate psychiatric treatment. Half of people who take any benzodiazepine do so for short-term insomnia treatment, and about 26 percent take this class of drugs to treat general restlessness, agitation or tenseness, or consistent, intense nervousness.
Again, a medical professional will only prescribe a benzodiazepine like Xanax after speaking with their patient to understand the symptoms, and they will only prescribe these drugs for a short time. Other drugs, like Z-class drugs (e.g., Ambien, Lunesta) have been developed to replace benzodiazepines in some short-term treatments for sleep problems. Long-term anxiety disorders may benefit from a different medication regimen, involving antidepressants or similar drugs.
For those with insomnia, sleep therapy can be effective. Sticking to a set schedule of waking up and going to bed at the same time; restricting the bed to just sleep; avoiding stimulating entertainment, food, or devices before sleeping; and other approaches can be helpful. Anxiety disorders require more complex treatment, but working with a talk therapist using Cognitive Behavioral Therapy or a similar evidence-based approach provides the most solid foundation for managing anxiety on a long-term basis. Complementary treatments like mindfulness meditation, yoga, visualization, exercise, nutrition, and more can manage more immediate responses to anxiety or sleep disorders. Sometimes, working with a therapist on exposure therapy for more intense panic disorders is helpful.
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Xanax Detox with Medical
Overcoming Xanax abuse or addiction begins with supervised detox. This process can start with a tapering regimen as prescribed by a doctor, or it may involve managing withdrawal symptoms as they appear if the person does not experience intense withdrawal. For short-acting drugs like Xanax, withdrawal symptoms typically begin within 1-2 days after the final dose, and they usually mimic the underlying psychiatric condition they were designed to treat, such as insomnia, anxiety, panic, and irritability. Some people who abuse Xanax for a long time may be at risk of seizures, so working with medical professionals is extremely important.
Other uncomfortable withdrawal symptoms may include:
- Rebound symptoms like anxiety or insomnia
- Intense cravings for the drug
- Foggy thinking
- Poor memory
- Muscle aches and tensions
- New symptoms of psychiatric conditions if they did not exist prior
These individuals may be placed on Valium (diazepam) rather than tapered off Xanax. Valium lasts longer, so it can be more effectively managed without several doses over the course of the day.
Detoxing from Xanax with medical help may take a couple weeks, but the slower process is important since the body must relearn to manage its own neurochemistry. Once detox has been completed, an evidence-based treatment program can continue the process of overcoming addiction. Detox by itself is not addiction treatment, and this is especially true for people who struggle with a co-occurring mental illness like panic disorder as well as addiction to a drug like Xanax.
Talk therapy in groups and individually is the best approach during rehabilitation. An aftercare plan is also key to staying sober and managing an anxiety disorder or insomnia.
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