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Xanax (alprazolam in its generic form) is one of the more commonly prescribed psychotropic medications in America. Primarily dispensed to treat anxiety and panic disorders, Xanax is a benzodiazepine medication and central nervous system depressant.1
When someone struggles with anxiety or a panic disorder, certain types of brain signaling may be hyperactive or over-excitatory—the individual’s response to stress and other environmental events may essentially be more “turned on” than in someone who doesn’t suffer from one of these mental health disorders. When a person feels stressed, the body ramps up its “fight-or-flight” reaction, which speeds up heart rate, respiration rate, and blood pressure while increasing body temperature. Pathologically excitatory brain activity can result in a person being abnormally hyper-focused, alert, and tense.2 Xanax works to reduce this response by increasing the activity of the inhibitory neurotransmitter GABA (gamma-aminobutyric acid,). As a sedative-hypnotic medication, Xanax helps to tamp down abnormally elevated brain activity to lower tension, help promote sleep, and reduce stress and anxiety.3 Though therapeutic for many, some individuals taking Xanax may experience somewhat of a Xanax “hangover” the day after taking the medication. People may be particularly at risk of these after-effects if the medication is misused in large doses.
It may be difficult to get up the next morning after taking Xanax. Xanax hangover effects may be similar to those associated with an alcohol-related hangover, such as:4
People who take high doses of Xanax may be be more likely to struggle with the hangover side effects; side effects may also be more significant in those who take it every day for an extended length of time. The US Food and Drug Administration (FDA) publishes Xanax prescribing information and states that long-term use of Xanax can lead to drug dependence.5 This happens when the brain adapts to the chemical changes that Xanax elicits and starts to rely on the medication’s effects in terms of baseline functioning. When Xanax then wears off, individuals can experience a kind of “rebound” effect as the brain tries to regain natural balance. Levels of some of the chemical messengers that had been suppressed by Xanax may spike while others drop, and the central nervous system can go into overdrive.5
The higher the dosage and the longer a person takes Xanax, the larger the risk of significant drug dependence and withdrawal.
The FDA advises that people taking more than 4 mg of the drug per day for at least three months are more likely to struggle with Xanax dependence and withdrawal than those taking less of it for shorter periods of time.5
The full spectrum of Xanax withdrawal symptoms may include effects that go beyond those that might be associated with a mere hangover, such as:1
Not everyone who takes Xanax will experience a hangover the next day, and some cases will be worse than others. Making sure to get enough sleep while taking Xanax is a great way to minimize the next-day hangover effect. Try and go to bed earlier than normal and plan to sleep for longer than is typical to reduce the hangover when taking Xanax. Sleeping for longer may help make the effects of the hangover the next day less intense.7 Getting enough sleep can help a person to be more balanced mentally and therefore more able to handle potentially stressful situations and feelings as they may arise throughout daily life.
Exercise can help to naturally boost a person’s energy levels, which may be lower while taking Xanax.7 Going for a walk or participating in other types of healthy physical fitness can aid in stress reduction and the release of endorphins, which help promote sleep and relaxation, the Anxiety and Depression Association of America (ADAA) reports.8 Again, the better the body works physically, the better a person feels, the clearer the mind is, and the more stable a person is emotionally.
Eating a balanced and healthy diet can help as well. Xanax is a tablet that is metabolized through the gastrointestinal system. Giving the body proper fuel, high in protein, vitamins, and minerals and low in saturated fats, processed foods, and refined sugars, can help bodily systems to function better.7
Other holistic methods, such as mindfulness meditation, yoga, acupuncture, massage therapy, and chiropractic care, can be beneficial as well. Stress reduction techniques, counseling, and therapies may be tools for keeping doses of Xanax lower, working as adjunctive measures for anxiety and panic disorders. Lower doses of Xanax less frequently can mean less of a hangover.
Be sure take Xanax exactly as prescribed by a medical professional. Don’t drink alcohol and limit caffeine while taking Xanax as it can interfere with the drug’s intended effects and, in the case of alcohol, make the hangover worse.7 Other drugs may also have adverse, potentially dangerous interactions with Xanax, including opioids. If the opioids in question are prescription, their use should be cleared with a doctor before mixing them with Xanax.
Benzodiazepines, including Xanax, are commonly abused. Anytime the drug is used without a prescription or otherwise for non-medical purposes (such as in larger-than-prescribed doses), it is considered medication misuse and abuse. The National Institute on Drug Abuse (NIDA) indicates that more than 50 million people in the United States have abused a prescription drug at some point in their lives, and benzodiazepines are one of the most commonly abused drug types.10 The Drug Enforcement Administration (DEA) warns that alprazolam is one of the primary drugs diverted onto the illegal drug market from pharmaceutical channels. Alprazolam is considered a controlled substance by the DEA because of its high rate of diversion and abuse.11
Alprazolam is a DEA scheduled substance with known potential for abuse and dependence.11 It can become more difficult to stop taking Xanax the longer a person takes it, and if the drug is abused, it can be even harder. Even if a person takes it under a doctor’s direction for a valid medical reason, some amount of physiological dependence can form that may lead to withdrawal when the drug is no longer used. In some instances, withdrawal avoidance increases the likelihood of developing compulsive patterns of continued drug use. Withdrawal symptoms from Xanax are physically and emotionally intense. In fact, it may seem easier to just keep taking the drug.
Methods of abuse may include crushing up tablets and then snorting, injecting, or smoking the powder. This puts the drug into the bloodstream in a different way than intended, which can raise the risk for overdose and other potentially dangerous side effects, including increasing the rate and onset of drug dependence and possible addiction.12 According to the National Survey on Drug Use and Health (NSDUH), more than a half-million Americans battled addiction involving a drug like Xanax (or other prescription sedative/tranquilizers) in 2016.13
Xanax is one of those drugs that shouldn’t be stopped “cold turkey,” especially without medical supervision and management. The Xanax withdrawal syndrome can be severe and may need to be managed through a medical detox program.1 These programs may use medications to manage the unpleasant and, in some cases, severe symptoms.
Xanax may need to be weaned off slowly through a tapering schedule during detox.1 Other medications may be used to manage specific withdrawal symptoms. Xanax may also be replaced with a longer-acting benzodiazepine that stays in the body longer and therefore requires fewer doses less often during the taper.6
Depending on the severity of drug dependence and the withdrawal side effects, detox may be done on an outpatient basis or in a residential specialty facility. After detox, specialized substance abuse treatment programs can offer support, supervision, as well as extensive counseling and therapy to help people recover from Xanax addiction. The Substance Abuse and Mental Health Services Administration (SAMHSA) publishes that close to 8 million Americans battled co-occurring disorders (e.g., the presence of an anxiety disorder and a substance use disorder) in 2014.14 Behavioral therapies, counseling, medication, relapse prevention skills, and stress reduction tools are all components of a specialized co-occurring disorder or dual diagnosis treatment program that can facilitate and enhance a long and healthy recovery.
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