Chronic Xanax abuse can lead to a compulsive pattern of misuse known as Xanax addiction. Xanax addiction is a chronic and complex condition that typically requires professional treatment, such as inpatient or outpatient rehab. Misusing Xanax for long periods comes with harmful health risks as well, including the potential for seizures and even death.[5]
Why is Xanax Addictive?
Quick Answer
Xanax is so addictive because it causes intense calming and pleasurable effects that may cause people to abuse it. It also has a rapid onset of effects and short duration of action, which means people may take repeated doses, which speeds up the development of tolerance, dependence, and addiction. Xanax also has distressing withdrawal symptoms, which may lead to a cycle of misuse in order to relieve these symptoms.
What is Xanax?
Xanax (generic name: alprazolam) is a prescription benzodiazepine medication. It’s one of the most prescribed medications in its class.[5]
Electrical activity deep within your brain translates into emotions like fear, anxiety, and mania. Benzodiazepines like Xanax slow electrical surges, relieving anxiety and panic attacks. Because Xanax can cause physiological dependence, doctors typically only prescribe it for short-term relief.
Key Facts About Xanax
Key Facts
- In 2019, doctors wrote more than 17 million prescriptions for alprazolam.[1]
- The Centers for Disease Control and Prevention says 12,499 deaths were attributed to benzodiazepines like Xanax between 2019 and 2021.[2]
- Benzodiazepines like Xanax are overprescribed. Between 2003 and 2015, the percentage of outpatient visits that led to a benzo prescription doubled.[3]
- People who use benzos with opioids have an up to 55% increase in the predicted risk of a more serious outcome when compared to benzo use alone.[4]
Xanax’s Effects on the Brain
Benzodiazepines like Xanax are prescription drugs. They work directly on critical transmitters deep within the brain.
GABA receptors within the brain play a key role in electrical activity. When benzodiazepines latch to these receptors, they slow electrical activity. Sedation follows. For people with anxiety, this sedation is a relief.[5]
Medical Use & Doses
Xanax is approved by the U.S. Food and Drug Administration (FDA) to treat anxiety disorders, including agoraphobia and short-term panic disorder. The average dose used in studies is 5 mg to 6 mg. Doctors may prescribe more or less to help their patients.[5]
Common Street Names
People who abuse Xanax may use slang terms to discuss their drugs.
| Common Street Names for Xanax | ||
| Bars | Handlebars | Benzos |
| White Girls | Planks | Xannies |
| Bicycle Parts | School Bus | Yellow Boys |
| Blue Footballs | Upjohn | Z-Bars |
| Bricks | White Boys | Zanbars/Xanbars |
| Green Hulk | ||
Source: [13]
How Addictive Is Xanax?
The FDA says Xanax is an addictive drug.[5] Take it for too long, and it can cause brain cell changes that lead to tolerance, dependence, and addiction.
Benzodiazepines are addictive because they increase dopamine levels. Dopamine is the pleasure neurotransmitter involved in the addictiveness of well-known drugs like heroin.
With repeated abuse, your brain cells no longer make this drug without Xanax. You’ll keep taking the drug just to feel normal.
“Benzodiazepines are widely used in clinics and for recreational purposes, but will lead to addiction in vulnerable individuals. Addictive drugs increase the levels of dopamine and also trigger long-lasting synaptic adaptations in the mesolimbic reward system that ultimately may induce the pathological behavior.”[6]
Risk Factors & Causes of Xanax Addiction
Anyone who abuses Xanax could develop an addiction. But certain risk factors could make some people more susceptible to Xanax addiction than others.
These are known risk factors:[14,15]
Genetic Factors
Genetics can influence your reaction to drugs like Xanax. If you have many receptors within your brain and body, you’ll feel more euphoria with each dose. That could make the drug more reinforcing and, therefore, more addictive. Additionally, addiction tends to run in families—if your parents or relatives have struggled with substance abuse, you may be more vulnerable to Xanax addiction.
Environmental Factors
People who abuse Xanax need a constant supply, and they often can’t get it from doctors. Living in a place where Xanax is easy to access could facilitate an addiction. For example, if you work in a hospital or medical clinic, you could get the drug easier than if you work in an elementary school.
Other environmental factors and risks include:
- Trauma
- Childhood neglect
- Childhood physical, emotional, or sexual abuse
- Parental substance abuse
- Family rejection of gender identity or sexual orientation
- Poor parental monitoring
- Delinquent behaviors
- Low academic achievement
- Peer pressure
- Lack of family involvement
- Using substances at a young age
Co-Occurring Mental Health Disorders
Experts say Xanax addiction risks are low among people with prescriptions, but people who use the drug recreationally could face unintended consequences.[7]
Most people who misuse Xanax have a history of some form of substance misuse or a substance use disorder (SUD). Without help, they could become addicted to Xanax. Additionally, untreated or undiagnosed mental health disorders like anxiety or depression can increase the risk of misusing and becoming addicted to Xanax.
Misuse & Recreational Use of Xanax
People with an ongoing Xanax habit must take more pills to feel the effects that once came with one pill. Their bodies are tolerant to the impact, so they must take more to get high. Some people experiment with the way they use the drug in response.
Common methods people use to abuse Xanax include the following:
- Crushing and snorting: Xanax pills are made for oral ingestion. But the ingredients can enter the brain when the powder connects with your nasal and sinus membranes.
- Injection: Some people mix their crushed pills with fluids and inject the solution. Doing so can put ingredients (like coatings) into your blood vessels, causing clots.
- Sublingual administration: Some people crush their pills and put the powder beneath their tongues, ensuring the ingredients enter the body faster.
Side Effects: How Xanax Affects the Body Over Time
Like most prescription medications, Xanax can cause side effects. Even if you use the medication as prescribed, the drug can make you uncomfortable.
Short-Term Side Effects
Most people who take Xanax experience drowsiness accompanied by a slight headache. As your brain and body grow accustomed to the drug, these problems typically fade away.[5]
Some people have unexpected reactions to Xanax, and they feel very ill with each dose. Rare side effects include the following:[5]
- Changes in sex drive
- Constipation
- Difficulty urinating
- Dry mouth
- Joint pain
- Nausea
- Talkativeness
- Weight gain
- Depression
Long-Term Side Effects
Brain cells adjust to Xanax with each dose you take. In time, your body grows accustomed to the drug and cannot function properly without it. Try to quit, and you’ll develop difficult withdrawal symptoms.
Some long-term Xanax users develop a form of mental fogginess. They struggle to concentrate, learn new things, and remember details.
Researchers say some people don’t recover their cognitive function for six months or longer. Some people never get better.[8]
Side Effects of Xanax Abuse[5]
| Short-Term Effects | Long-Term Effects |
| Drowsiness | Withdrawal symptoms |
| Minor headache | Higher risk of addiction |
| Changes in sex drive | Mental fogginess |
| Dry mouth | Poor cognitive function |
Mixing Xanax With Other Substances
Some people have life-threatening reactions to Xanax. These issues can happen while taking alprazolam alone, but they’re more common in people who combine drugs.[9]
Serious side effects include the following:[5]
- Confusion
- Poor coordination
- Seizures
- Skin rashes
- Speech problems
- Yellow skin or eyes
People who take Xanax with opioids like Vicodin can lose their lives. Researchers say people with prescriptions for both drugs have a 10 times higher overdose death rate than those getting opioids alone.[10]
Signs & Symptoms of Xanax Abuse
People with a substance use disorder related to Xanax have clear symptoms doctors search for via questionnaire. To qualify for a diagnosis, people must have at least two of the following symptoms within 12 months.[11]
A person with a misuse issue may not be clinically addicted to the drug. Even so, looking for these signs can help a Xanax issue to become clear.
Physical Signs
Someone with a Xanax problem will generally meet the following criteria:[16]
- Need bigger Xanax doses due to tolerance for the drug
- Try to cut back on use but will feel ill or unable to do so
- Feel cravings for Xanax
- Experience withdrawal symptoms when trying to quit
Behavioral Signs
Someone with a Xanax problem will do the following:
- Spend a lot of time trying to get or use Xanax
- Continue use even when it causes problems
- Keep using, even in hazardous situations
Social Signs
Someone with a Xanax problem may exhibit the following social symptoms:
- Stopping social or recreational activities they previously enjoyed because of Xanax
- Spending more time with dealers or people who have Xanax
- Asking for privacy
Comparing Xanax Abuse Symptoms
| Physical | Behavioral | Social |
| Tolerance | Time spent using or getting Xanax | Spending time with dealers |
| Withdrawal symptoms | Continued use despite problems | Withdrawal from activities once enjoyed |
| Cravings | Drug use in hazardous situations | Requests for privacy |
Sources: [5,16]
Xanax Compared to Other Drugs
Xanax Withdrawal Symptoms
As your body and brain grow accustomed to Xanax, you must keep up the continual supply. Taper your dose too quickly or stop drug use altogether, and you could experience very real health problems.
Benzodiazepine withdrawal typically lasts about two weeks. But you may feel sick and anxious for much longer as your brain cells heal.[12]
Xanax withdrawal symptoms include:[17]
| Insomnia | Irritability |
| Increased anxiety | Panic attacks |
| Suicidal thoughts | Seizures |
| Sweating | Weight loss |
| Heart palpitation | Uncontrollable shakes |
| Headaches | Difficulty concentrating |
| Nausea and vomiting | Muscle pain and stiffness |
Detox & Xanax Addiction Treatment
It’s very difficult (and not safe) to quit using Xanax without support—this is because xanax withdrawal symptoms like seizures can be life-threatening. Medical detox can help manage your withdrawal symptoms and keep you safe. Xanax addiction treatment programs can help you get sober and build up your relapse prevention skills. The following elements might be included in your recovery program:
Supervised Taper: Getting Off Xanax Safely
During a supervised taper, your doctor provides smaller amounts of Xanax to allow your brain time to adjust to sobriety. Some people take a smaller dose every day, while others need a slower schedule to avoid uncomfortable and potentially dangerous symptoms.
Quitting Xanax and other benzos cold turkey isn’t safe.[17] Quitting suddenly can lead to severe Xanax withdrawal symptoms, including seizures and psychosis. Never try to quit Xanax without a doctor’s help.
Medical Detox
Since detoxing from Xanax can be life-threatening, it’s wise to enroll in a medical detox program. Here, a team will supervise your Xanax taper process and offer treatment for withdrawal symptoms and complications. You’ll be removed from all temptations to relapse to Xanax misuse, increasing your chances of success. You’ll receive supportive care, counseling, and withdrawal medications.
Xanax Rehab Options
Detox alone isn’t a treatment for addiction—it simply helps manage withdrawal. To ensure you stay sober, you’ll need to build relapse prevention and coping skills and identify your triggers. Rehabs for Xanax addiction can help.
In an inpatient rehab program, you live within the treatment facility and away from temptation. It’s the most intensive option and involves a myriad of treatment modalities paired with structure and routine.
In an outpatient rehab program, you continue to live at home while you heal. Either model could be right for you.
Aftercare
After you complete Xanax rehab, you’ll have the skills you’ll need to stay sober, but you may face new challenges that put your recovery at risk. Your aftercare program can help you stay in touch with treatment. You might use support group meetings or therapy sessions to ensure you stay on the right track.
Xanax Abuse & Addiction FAQs
We’ve compiled some of the most frequently asked questions about Xanax abuse.
Xanax can be detected in your urine for about four days, saliva for two, blood for one day, and hair for about one month.
Yes, Xanax can cause weight gain.
No. It’s not safe to quit Xanax cold turkey. Doing so can lead to life-threatening symptoms, including seizures.
No. Xanax tablets are designed to move through the digestive tract. Crushing and snorting Xanax can lead to an overdose, sinus infections, and more.
It can take an hour or so for Xanax to start working if you take the medication orally.
No. Xanax is a benzodiazepine medication, not an opioid.
Yes. Take too much Xanax, and you can experience extreme sedation, including very slow breathing. These episodes can be fatal.
- Number of alprazolam prescriptions in the U.S. 2004-2020. Statista. Published October 17, 2022. Accessed July 5, 2023.
- Drug overdose death rates. National Institute on Drug Abuse. Published June 30, 2023. Accessed July 5, 2023.
- Benzodiazepines: It's Time to Return to the Evidence. (October 2020). The British Journal of Psychiatry.
- Chatterjee, R. Steep climb in benzodiazepine prescribing by primary care doctors. NPR. Published January 25, 2019. Accessed July 5, 2023.
- Benzodiazepines in combination with opioid pain relievers or alcohol: Greater risk of more serious ED visit outcomes. The DAWN Report. Published December 18, 2014. Accessed July 5, 2023.
- Xanax. U.S. Food and Drug Administration. Published September 2016. Accessed July 5, 2023.
- Tan KR, Brown M, Labouèbe G, et al. Neural bases for addictive properties of benzodiazepines. Nature. 2010;463(7282):769-774. https://www.nature.com/articles/nature08758
- Molecule of the week archive: Alprazolam. American Chemical Society. Published November 2014. Accessed July 5, 2023.
- Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018;12(1):4-10.
- Alprazolam. U.S. National Library of Medicine. Published May 15, 2021. Accessed July 5, 2023.
- Benzodiazepines and opioids. National Institute on Drug Abuse. Published November 7, 2022. Accessed July 5, 2023.
