What Is a Xanax Addiction?

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Table of Contents

Signs and Symptoms

Causes

Diagnosis

Treatment

How to Find Help

Frequently Asked Questions

Xanax (alprazolam) is abenzodiazepinedrug widely prescribed to treat anxiety disorder. Benzodiazepine addiction is a growing concern in the United States, with around 30% of opiate overdose deaths also involving drugs like Xanax.

Addiction is now classified as a substance use disorder in theDiagnostic and Statistical Manual of Mental Disorders, Edition 5(DSM-5). Benzodiazepine use can be apparent if someone appears intoxicated or there is drug-seeking behavior, but the problem can also be well concealed.

Treatment may involve a combination of strategies, including detoxification and various psychotherapeutic and psychosocial approaches.

Other commonly prescribed benzodiazepines that pose a risk of dependence include Valium (diazepam) and Ativan (lorazepam).

Theresa Chiechi / Verywell

Xanax, one of the most commonly prescribed benzodiazepines, is generally considered safe for short-term use, but it can cause side effects like sleepiness, headaches, lethargy, dry mouth, and memory problems.

Among older adults, long-term use of Xanax can also lead to cognitive issues that may resemble dementia. However, the impairment may resolve after the drug is stopped.

While Xanax is sometimes prescribed for longer than a few weeks to manage certain anxiety disorders, prolonged use can lead to a rebound of anxiety symptoms when the drug is eventually stopped.Prolonged use also increases the risk of withdrawal syndrome.

Acute withdrawal can result in death in some cases if the medication is stopped without medical supervision.

Moreover, some people using Xanax can develop drug tolerance. If you develop tolerance to Xanax, you may need to use higher doses to maintain a therapeutic effect. This can lead to excessively high dosing, intoxication, and, in some cases, drug-seeking behaviors.

Signs of Xanax addiction include:

The potential for addiction is higher with Xanax than with lower-potency benzodiazepines like Librium (chlordiazepoxide).

Complications

The use of Xanax and other sedatives and hypnotics has some association with an increased risk of death. The exact reason for this is unclear, but it may relate to a potential increase in depression, infections, respiratory issues, and accidents.Furthermore, there is some association of Xanax with an increased risk of suicide.

Another concern with Xanax addiction is the risk of overdose, which can result in acute benzodiazepine toxicity. Overdose can occur with Xanax alone, but the majority of deaths occur when Xanax is combined with other drugs such as opioids, including heroin. Polydrug use (using multiple drugs) is common among people with benzodiazepine addiction, with 54.2% abusing opioids and 24.7% abusing alcohol.

Due to these risks, the FDA issued a boxed warning in 2016 against the concomitant use of benzodiazepines and opioids.

Signs and symptoms of Xanax overdose can include:

Signs of overdose usually develop within four hours of a dose, which is the time when the drug concentration is highest in the body. The symptoms of an overdose may persist for 12 to 36 hours.

However, even after the symptoms of a Xanax overdose wear off, the consequences to the body may persist, potentially with lasting effects. For example, pulmonary aspiration during a lethargic state can lead toaspiration pneumoniaor permanent lung damage.

Xanax overdose causes central nervous system (CNS) depression, which is a direct result of the drug’s effect on reduced neuronal excitability. CNS depression leads to impaired respiration and bradycardia (slow heart rate), which can cause coma or cardiac arrest (interruption of the heartbeat).

If you suspect that you or someone else may be experiencing Xanax overdose, contact Poison Control (800-222-1222) or call 911 immediately.

Fear of Withdrawal

Even at relatively low doses, Xanax addiction can develop—in part because the drug has a relatively short half-life of 11 hours, which means that its effects wear off quickly.

And, as you develop tolerance to the drug (this can happen with any dose), the duration of its therapeutic effects becomes shorter, while the feeling of “comedown” leading to the withdrawal comes quicker.

Even if a person tries to stop taking Xanax, the fear of withdrawal and rebound can be so strong that the adverse consequences of stopping seem to outweigh the benefits. Xanax addiction is specifically part of a subcategory of substance use disorder known as sedative, hypnotic, or anxiolytic use disorder.

Risk Factors

Benzodiazepine addiction can happen to anyone, but certain groups are at greater risk. Risk factors for developing Xanax addiction include:

There are several proposed explanations for why these groups may be at risk. Research shows that young adults who use Xanax tend to use it along with illegal drugs and are also more likely to have psychiatric conditions, which might be undiagnosed or untreated.

Additionally, some people are predisposed to substance addiction, possibly due to genetic factors and altered activity of neurotransmitters in the brain.

A substance use disorder is a condition in which there is a cluster of cognitive, behavioral, and physiological symptoms leading to an individual continuing to use the substance despite significant adverse health or emotional effects or problems at work, school, or home.

Like many drugs, the presence of Xanax can be detected with laboratory tests. This drug can be detected in urine, saliva, and hair follicles, although the reliability of these tests is not consistent.

And while the drug can be identified in the body, there are no blood or lab tests that can diagnose Xanax addiction. The diagnosis of Xanax addiction is based on whether a person meets certain diagnostic criteria outlined in theDSM-5.

For a person to be diagnosed with substance use disorder, they must meet at least two of 11 criteria within a 12-month period:

The severity of the disorder can be classified as “mild” if two to three criteria are met, “moderate” if four to five are met, and “severe” if six or more are met. These classifications may help direct the most appropriate course of treatment.

Your healthcare provider cannot know the answers to these questions unless you are willing to participate in your diagnostic process—this means that you have to be interested in being diagnosed and treated. Sometimes family and friends can help in encouraging you to seek help and in pointing out these issues to you.

In some situations, an alternative approach—harm-reduction strategies—may be considered, particularly for people in whom abstinence is difficult.

Treatment can sometimes be delivered on an outpatient basis, but it often requires a period of inpatient care in a treatment center. Because Xanax addiction is usually associated with abuse of other substances, rehabilitation for opioid or alcohol addiction may also be needed.

Detoxification

Detox is a process during which a person stops taking a harmful drug. The process can be rapid or gradual, depending on the drug.

With Xanax, the effects of drug withdrawal can be severe and even dangerous, so detox is often a gradual process, especially if it had been used in high doses and/or for a prolonged period of time. For example, to reduce the risk of seizures, the Xanax dose is gradually tapered over weeks under medical supervision.

During Xanax detox, you would be monitored for signs of withdrawal, and you might need to receive treatment to alleviate and prevent harmful complications.

Behavioral Therapy

Behavioral therapy is an important component of recovery from drug addiction. While detox medications are focused on avoiding adverse effects of withdrawal, behavioral therapy is a process that is focused on maintaining recovery.

You might need to continue to meet with a therapist for months after your detox is complete, or even for longer. The purpose of therapy is for you to understand your addiction and to gain control so you can avoid misusing Xanax or another drug in the future.

A number of different types of therapy are used in the treatment of substance abuse disorders.

You may benefit from one or more of these types of behavioral therapy. Upon leaving the treatment center, many people will pursue a 12-step recovery program to maintain abstinence or stabilization and maintenance.

The long-term abstinence rates after recovering from Xanax addiction vary significantly. About 80% of older adults achieve abstinence, while about 25% of those with complicated addiction with polydrug use achieve abstinence.

If you or a loved one is struggling with substance abuse or addiction, you can contact theSubstance Abuse and Mental Health Services Administration (SAMHSA) National Helplineat1-800-662-4357. SAMHSA also provides an online treatment center location.

If you or someone you know are having suicidal thoughts, dial988to contact the988 Suicide & Crisis Lifelineand connect with a trained counselor.

Frequently Asked QuestionsNo, Xanax is not a narcotic. The word narcotic refers to an opioid, or a certain class of drugs that primarily offer pain relief. Examples of narcotics include morphine, OxyContin, and Vicodin.Long-term effects of Xanax can include impairments to general memory, sensory processing, speed of processing, verbal speed, and motor performance. These may be less likely to occur with low doses of Xanax.An anxiolytic is a specific type of medication used for treating anxiety. One common type of anxiolytic includes benzodiazepines, such as Xanax. They are not usually chosen as the first step in anxiety treatment since benzodiazepines can become addictive.Learn MoreWhat to Know About AnxiolyticsThe half life of Xanax is 11 hours. This is considered a short half life and contributes to the ease in which addiction can develop.

No, Xanax is not a narcotic. The word narcotic refers to an opioid, or a certain class of drugs that primarily offer pain relief. Examples of narcotics include morphine, OxyContin, and Vicodin.

Long-term effects of Xanax can include impairments to general memory, sensory processing, speed of processing, verbal speed, and motor performance. These may be less likely to occur with low doses of Xanax.

An anxiolytic is a specific type of medication used for treating anxiety. One common type of anxiolytic includes benzodiazepines, such as Xanax. They are not usually chosen as the first step in anxiety treatment since benzodiazepines can become addictive.Learn MoreWhat to Know About Anxiolytics

An anxiolytic is a specific type of medication used for treating anxiety. One common type of anxiolytic includes benzodiazepines, such as Xanax. They are not usually chosen as the first step in anxiety treatment since benzodiazepines can become addictive.

Learn MoreWhat to Know About Anxiolytics

The half life of Xanax is 11 hours. This is considered a short half life and contributes to the ease in which addiction can develop.

16 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Benzodiazepines and opioids.Schmitz A.Benzodiazepine use, misuse, and abuse: A review.Ment Health Clin.2016;6(3):120-126. doi:10.9740/mhc.2016.05.120Chowdhury ZS, Morshed MM, Shahriar M, Bhuiyan MA, Islam SM, Bin Sayeed MS.The effect of chronic alprazolam intake on memory, attention, and psychomotor performance in healthy human male volunteers.Behav Neurol.2016;2016:3730940. doi:10.1155/2016/3730940Guina J, Merrill B.Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017American Addiction Centers.Xanax abuse: Symptoms and signs of addiction.Uzun S, Kozumplik O, Jakovljević M, Sedić B.Side effects of treatment with benzodiazepines.Psychiatr Danub. 2010 Mar;22(1):90-3. PMID: 20305598Kripke DF.Mortality risk of hypnotics: Strengths and limits of evidence.Drug Saf.2016 Feb;39(2):93-107. doi:10.1007/s40264-015-0362-0Cato V, Holländare F, Nordenskjöld A, Sellin T.Association between benzodiazepines and suicide risk: a matched case-control study.BMC Psychiatry. 2019;19(1):317. doi:10.1186/s12888-019-2312-3US Food and Drug Administration.Xanax label.The Royal Children’s Hospital Melbourne.Benzodiazepine poisoning.Schepis TS, Teter CJ, Simoni-Wastila L, McCabe SE.Prescription tranquilizer/sedative misuse prevalence and correlates across age cohorts in the US.Addict Behav.2018;87:24-32. doi:10.1016/j.addbeh.2018.06.013Kurtz SP, Buttram ME, Surratt HL.Benzodiazepine dependence among young adult participants in the club scene who use drugs.J Psychoactive Drugs. 2017;49(1):39-46. doi:10.1080/02791072.2016.1269978Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM, Schuckit M, Grant BF.DSM-5 criteria for substance use disorders: recommendations and rationale.Am J Psychiatry. 2013;170(8):834-51. doi:10.1176/appi.ajp.2013.12060782Priory.What happens during alcohol or drug detox?Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr.2015;38(5):152-5. doi:10.18773/austprescr.2015.055Department of Justice/Drug Enforcement Administration.Drug Fact Sheet: Narcotics.

16 Sources

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.National Institute on Drug Abuse.Benzodiazepines and opioids.Schmitz A.Benzodiazepine use, misuse, and abuse: A review.Ment Health Clin.2016;6(3):120-126. doi:10.9740/mhc.2016.05.120Chowdhury ZS, Morshed MM, Shahriar M, Bhuiyan MA, Islam SM, Bin Sayeed MS.The effect of chronic alprazolam intake on memory, attention, and psychomotor performance in healthy human male volunteers.Behav Neurol.2016;2016:3730940. doi:10.1155/2016/3730940Guina J, Merrill B.Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017American Addiction Centers.Xanax abuse: Symptoms and signs of addiction.Uzun S, Kozumplik O, Jakovljević M, Sedić B.Side effects of treatment with benzodiazepines.Psychiatr Danub. 2010 Mar;22(1):90-3. PMID: 20305598Kripke DF.Mortality risk of hypnotics: Strengths and limits of evidence.Drug Saf.2016 Feb;39(2):93-107. doi:10.1007/s40264-015-0362-0Cato V, Holländare F, Nordenskjöld A, Sellin T.Association between benzodiazepines and suicide risk: a matched case-control study.BMC Psychiatry. 2019;19(1):317. doi:10.1186/s12888-019-2312-3US Food and Drug Administration.Xanax label.The Royal Children’s Hospital Melbourne.Benzodiazepine poisoning.Schepis TS, Teter CJ, Simoni-Wastila L, McCabe SE.Prescription tranquilizer/sedative misuse prevalence and correlates across age cohorts in the US.Addict Behav.2018;87:24-32. doi:10.1016/j.addbeh.2018.06.013Kurtz SP, Buttram ME, Surratt HL.Benzodiazepine dependence among young adult participants in the club scene who use drugs.J Psychoactive Drugs. 2017;49(1):39-46. doi:10.1080/02791072.2016.1269978Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM, Schuckit M, Grant BF.DSM-5 criteria for substance use disorders: recommendations and rationale.Am J Psychiatry. 2013;170(8):834-51. doi:10.1176/appi.ajp.2013.12060782Priory.What happens during alcohol or drug detox?Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr.2015;38(5):152-5. doi:10.18773/austprescr.2015.055Department of Justice/Drug Enforcement Administration.Drug Fact Sheet: Narcotics.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

National Institute on Drug Abuse.Benzodiazepines and opioids.Schmitz A.Benzodiazepine use, misuse, and abuse: A review.Ment Health Clin.2016;6(3):120-126. doi:10.9740/mhc.2016.05.120Chowdhury ZS, Morshed MM, Shahriar M, Bhuiyan MA, Islam SM, Bin Sayeed MS.The effect of chronic alprazolam intake on memory, attention, and psychomotor performance in healthy human male volunteers.Behav Neurol.2016;2016:3730940. doi:10.1155/2016/3730940Guina J, Merrill B.Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017American Addiction Centers.Xanax abuse: Symptoms and signs of addiction.Uzun S, Kozumplik O, Jakovljević M, Sedić B.Side effects of treatment with benzodiazepines.Psychiatr Danub. 2010 Mar;22(1):90-3. PMID: 20305598Kripke DF.Mortality risk of hypnotics: Strengths and limits of evidence.Drug Saf.2016 Feb;39(2):93-107. doi:10.1007/s40264-015-0362-0Cato V, Holländare F, Nordenskjöld A, Sellin T.Association between benzodiazepines and suicide risk: a matched case-control study.BMC Psychiatry. 2019;19(1):317. doi:10.1186/s12888-019-2312-3US Food and Drug Administration.Xanax label.The Royal Children’s Hospital Melbourne.Benzodiazepine poisoning.Schepis TS, Teter CJ, Simoni-Wastila L, McCabe SE.Prescription tranquilizer/sedative misuse prevalence and correlates across age cohorts in the US.Addict Behav.2018;87:24-32. doi:10.1016/j.addbeh.2018.06.013Kurtz SP, Buttram ME, Surratt HL.Benzodiazepine dependence among young adult participants in the club scene who use drugs.J Psychoactive Drugs. 2017;49(1):39-46. doi:10.1080/02791072.2016.1269978Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM, Schuckit M, Grant BF.DSM-5 criteria for substance use disorders: recommendations and rationale.Am J Psychiatry. 2013;170(8):834-51. doi:10.1176/appi.ajp.2013.12060782Priory.What happens during alcohol or drug detox?Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr.2015;38(5):152-5. doi:10.18773/austprescr.2015.055Department of Justice/Drug Enforcement Administration.Drug Fact Sheet: Narcotics.

National Institute on Drug Abuse.Benzodiazepines and opioids.

Schmitz A.Benzodiazepine use, misuse, and abuse: A review.Ment Health Clin.2016;6(3):120-126. doi:10.9740/mhc.2016.05.120

Chowdhury ZS, Morshed MM, Shahriar M, Bhuiyan MA, Islam SM, Bin Sayeed MS.The effect of chronic alprazolam intake on memory, attention, and psychomotor performance in healthy human male volunteers.Behav Neurol.2016;2016:3730940. doi:10.1155/2016/3730940

Guina J, Merrill B.Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits and alternatives.J Clin Med. 2018;7(2):17. doi:10.3390/jcm7020017

American Addiction Centers.Xanax abuse: Symptoms and signs of addiction.

Uzun S, Kozumplik O, Jakovljević M, Sedić B.Side effects of treatment with benzodiazepines.Psychiatr Danub. 2010 Mar;22(1):90-3. PMID: 20305598

Kripke DF.Mortality risk of hypnotics: Strengths and limits of evidence.Drug Saf.2016 Feb;39(2):93-107. doi:10.1007/s40264-015-0362-0

Cato V, Holländare F, Nordenskjöld A, Sellin T.Association between benzodiazepines and suicide risk: a matched case-control study.BMC Psychiatry. 2019;19(1):317. doi:10.1186/s12888-019-2312-3

US Food and Drug Administration.Xanax label.

The Royal Children’s Hospital Melbourne.Benzodiazepine poisoning.

Schepis TS, Teter CJ, Simoni-Wastila L, McCabe SE.Prescription tranquilizer/sedative misuse prevalence and correlates across age cohorts in the US.Addict Behav.2018;87:24-32. doi:10.1016/j.addbeh.2018.06.013

Kurtz SP, Buttram ME, Surratt HL.Benzodiazepine dependence among young adult participants in the club scene who use drugs.J Psychoactive Drugs. 2017;49(1):39-46. doi:10.1080/02791072.2016.1269978

Hasin DS, O’Brien CP, Auriacombe M, Borges G, Bucholz K, Budney A, Compton WM, Crowley T, Ling W, Petry NM, Schuckit M, Grant BF.DSM-5 criteria for substance use disorders: recommendations and rationale.Am J Psychiatry. 2013;170(8):834-51. doi:10.1176/appi.ajp.2013.12060782

Priory.What happens during alcohol or drug detox?

Brett J, Murnion B.Management of benzodiazepine misuse and dependence.Aust Prescr.2015;38(5):152-5. doi:10.18773/austprescr.2015.055

Department of Justice/Drug Enforcement Administration.Drug Fact Sheet: Narcotics.

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