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Green Xanax Bars: Identifying & Understanding ‘Hulk Xanax’

Green Xanax, also sometimes called Hulk Xanax on the street, is a Xanax pill that has a green color to it.

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Though green Xanax pills are made legally and prescribed to patients who need a 3 mg or higher dose, there are counterfeit versions sold on the street that often contain deadly substances and have contributed to the rise in overdose deaths in recent years.[1] Hulk Xanax may contain fentanyl, which can easily result in a fatal overdose.

What Is Green Xanax Made Of?

Green Xanax, when it is made legally, is alprazolam. Alprazolam is a benzodiazepine that is commonly prescribed to help people who struggle with anxiety or panic disorders.[2]

Legal Green Xanax

Some people take them regularly, while others take them before they are about to encounter an event that typically triggers an anxiety episode, such as before flying in an airplane. Others take them as needed when feeling panicked or out of control.

On their own, Xanax pills of any color have a high potential for abuse and addiction. Long-term use of benzodiazepines is not usually recommended since they can quickly lead to dependence and are subject to misuse.

Black Market Green Xanax

Also called designer Xanax, green Xanax pills sold on the black market are often found to contain fentanyl, an illicit and powerful opioid substance.[3] These are often sold in the shape of a bar rather than the traditionally produced triangular green Xanax. In addition to fentanyl, these pills have been found to contain a range of benzodiazepine substances that are not currently legal in the U.S. 

Side Effects of Green Xanax

Green Xanax is the highest dose of Xanax available in a single pill when produced legitimately. As such, it may be the most likely to trigger side effects when ingested. The most commonly reported side effects are dizziness and drowsiness. For the most part, these tend to dissipate once the body has adjusted to the medication.[4]

In the case of illegitimate green Xanax, the risk of side effects is even higher and more likely to be serious. They can include any of the more severe side effects often attributed to benzodiazepines or those attributed to opioids if they contain fentanyl. 

Serious side effects caused by benzodiazepines may include the following:[5]

  • Respiratory depression
  • Confusion
  • Nausea and vomiting
  • Tremors
  • Loss of consciousness

Side effects caused by use of opioids may include the following:[6]

  • Sedation
  • Loss of consciousness
  • Respiratory depression
  • Nausea and vomiting

Dangers of Green Xanax

It should be noted that both benzodiazepines (like alprazolam) and opioids (like fentanyl) carry similar side effects and can compound each other. This means that taking a pill that has both in it—like green Xanax—is exceptionally dangerous. 

Legal Consequences

Buying or selling illicit substances, which includes green Xanax sold on the street, can lead to a number of legal consequences based on the amount of drugs found in the person’s possession, whether or not they are believed to be selling the substance, and how many previous arrests they have on their record. Fines and jail time may be the result.[7]

Risk of Side Effects 

The side effects associated with benzodiazepines and opioids are greater when the person taking the substance is unaware of what exactly is in the pill. Some may take too many, believing it to be only alprazolam, and ultimately experience far more significant side effects than if they had taken a legitimate pill. 

Risk of Psychosis 

Similarly, the risk of experiencing psychosis (hallucinations and erratic behavior) increases when taking Xanax mixed with fentanyl, especially if the person is living with underlying mental health issues or taking other medications.

Overdose Potential

The risk of overdose increases when taking unknown substances containing fentanyl that are purchased on the black market. In an effort to create a potent drug, drug dealers often add fentanyl to their products because it is cheap and strong. The end result can be an overdose, which can be fatal. 

While there are medications like naloxone that can be used in an emergency situation to reverse an overdose caused by opioids, there is no such medication available for benzodiazepine overdoses.[8] Additionally, fentanyl is so strong that often multiple doses of naloxone may be needed, and even then, medical intervention may not be effective.[9]

Addiction & Dependence

Both alprazolam and fentanyl trigger the pleasure pathway in the brain, which can lead to a psychological craving for the high. Especially in the case of drugs used to manage anxiety, it often doesn’t take long for people to feel as if they need the pills to function. This is why many turn to the black market to augment their supply. 

However, repeated use of these substances leads to tolerance, defined by needing a larger and larger dose in order to feel its effects. When this physical tolerance is compounded by psychological dependence, addiction becomes an issue. 

How Addictive Is Green Xanax?

Both benzodiazepines and opioids are highly addictive substances. Xanax is classified as a Schedule IV drug and fentanyl-related substances are classified as a Schedule I drug under the Controlled Substances Act.[10,11]

While Xanax is considered to be less addictive than fentanyl, it still has the potential for abuse and addiction. Fentanyl-related substances are so addictive that it is one of the most restricted substances in the U.S. These drugs are one of the main drivers behind the opioid overdose epidemic.[12,13] 

The use of fentanyl, other opioids, and benzodiazepines together increases the likelihood of developing an addiction that requires professional treatment. Each use carries a high risk of overdose and other damage to the brain and body. 

Updated March 21, 2024
Resources
  1. Xanax. U.S. Food and Drug Administration. Revised March 2011. Accessed February 27, 2024.
  2. Alprazolam. U.S. National Library of Medicine. Published May 15, 2021. Accessed February 27, 2024.
  3. Washington state drug epidemiology. University of Washington. Accessed February 27, 2024.
  4. George T, Tripp J. Alprazolam. National Institutes of Health. Published October 11, 2019. Accessed February 27, 2024.
  5. Bounds CG, Nelson VL. Benzodiazepines. U.S. National Library of Medicine. Published January 7, 2023. Accessed February 27, 2024.
  6. R B, Am T, S D, et al. Opioid complications and side effects. Pain Physician. Published March 1, 2008. Accessed February 27, 2024.
  7. Frequently used federal drug statutes. United States Department of Justice. Published February 20, 2020. Accessed February 27, 2024.
  8. U.S. Surgeon General’s advisory on naloxone and opioid overdose. U.S. Department of Health and Human Services. Published April 3, 2018. Accessed February 27, 2024.
  9. Amaducci A, Aldy K, Campleman SL, et al. Naloxone use in novel potent opioid and fentanyl overdoses in emergency department patients. JAMA Network Open. 2023;6(8):e2331264-e2331264.
  10. Benzodiazepines: What are benzodiazepines? Department of Justice Drug Enforcement Administration. Published 2020.
  11. Dc D, Doe. Fentanyl-related substances introduction. Drug Enforcement Administration. Published 2019. Accessed February 27, 2024.
  12. Ciccarone D. The rise of illicit fentanyls, stimulants and the fourth wave of the opioid overdose crisis. Current Opinion in Psychiatry. 2021;34(4):344-350.
  13. Park JN, Schneider KE, Fowler D, Sherman SG, Mojtabai R, Nestadt PS. Polysubstance overdose deaths in the fentanyl era. Journal of Addiction Medicine. 2021.
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