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Xanax Addiction

Xanax can be a critical part of a treatment program for people with anxiety. But typically, people take the medication for a few weeks (or less) to manage short-term symptoms.

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Misusing the drug for long periods comes with real risks and side effects, including the potential for seizures and even death.[5]

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, making worrisome moods less powerful. 

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-grade 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 to discuss their drugs. 

Common Street Names for Xanax
White GirlsPlanksXannies
Bicycle PartsSchool BusYellow Boys
Blue FootballsUpjohnZ-Bars
BricksWhite BoysZanbars/Xanbars

Source: [13]

Addiction Potential: 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 addiction. 

Benzodiazepines are addictive because they increase dopamine levels. Dopamine is 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 takes large Xanax doses for long periods could develop an addiction. But risk factors could make your drug use even more dangerous. 

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. 

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. 

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 the drug have a history of some form of substance misuse or a substance use disorder (SUD). Without help, they could become 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

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 Signs & Symptoms of Xanax Addiction 

Tolerance Time spent using or getting XanaxSpending time with dealers 
Withdrawal symptomsContinued use despite problems Withdrawal from activities once enjoyed
Cravings Drug use in hazardous situationsRequests for privacy 

Sources: [5,16]

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 the following:[17]

Increased anxietyPanic attacks
Suicidal thoughtsSeizures
SweatingWeight loss
Heart palpitationUncontrollable shakes
HeadachesDifficulty concentrating
Nausea and vomitingMuscle pain and stiffness

Detox & Treatment Options for Withdrawal 

It’s very difficult (and not safe) to quit using Xanax without support. 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 symptoms. 

Quitting Xanax and other benzos cold turkey isn’t safe.[17] Shifting to sobriety suddenly can lead to severe withdrawal symptoms, including seizures. 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 therapy for any symptoms that might appear. You’ll be removed from all temptations to relapse to Xanax misuse, increasing your chances of success. 


Detox alone isn’t a treatment for addiction. To ensure you stay sober, you’ll need to build relapse prevention skills and identify your triggers. Rehabilitation can help. 

In an inpatient rehab program, you live within the treatment facility and away from temptation. In an outpatient rehab program, you continue to live at home while you heal. Either model could be right for you. 


After rehab programs, 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. 

How long does Xanax stay in your system?

Xanax is a long-lasting benzodiazepine drug that can stay in your body for two days or longer.

Does Xanax cause weight gain?

Yes, Xanax can cause weight gain

Is it safe to quit Xanax cold turkey?

No. It’s not safe to quit Xanax cold turkey. Doing so can lead to life-threatening symptoms, including seizures.

Is it safe to crush and snort Xanax?

No. Xanax tablets are designed to move through the digestive tract. Crushing and snorting Xanax can lead to an overdose, sinus infections, and more.

How long does it take for Xanax to kick in?

It can take an hour or so for Xanax to start working if you take the medication orally.

Is Xanax an opioid?

No. Xanax is a benzodiazepine medication, not an opioid. 

Can you overdose on Xanax?

Yes. Take too much Xanax, and you can experience extreme sedation, including very slow breathing. These episodes can be fatal.

Profile image for Dr. Alison Tarlow
Medically Reviewed By Dr. Alison Tarlow

Dr. Alison Tarlow is a Licensed Clinical Psychologist in the States of Florida and Pennsylvania, and a Certified Addictions Professional (CAP). She has been a practicing psychologist for over 15 years. Sh... Read More

Updated September 23, 2023
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  2. Drug overdose death rates. National Institute on Drug Abuse. Published June 30, 2023. Accessed July 5, 2023.
  3. Chatterjee, R. Steep climb in benzodiazepine prescribing by primary care doctors. NPR. Published January 25, 2019. Accessed July 5, 2023.
  4. 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.
  5. Xanax. U.S. Food and Drug Administration. Published September 2016. Accessed July 5, 2023.
  6. Tan KR, Brown M, Labouèbe G, et al. Neural bases for addictive properties of benzodiazepines. Nature. 2010;463(7282):769-774. doi:10.1038/nature08758
  7. Molecule of the week archive: Alprazolam. American Chemical Society. Published November 2014. Accessed July 5, 2023.
  8. 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.
  9. Alprazolam. U.S. National Library of Medicine. Published May 15, 2021. Accessed July 5, 2023.
  10. Benzodiazepines and opioids. National Institute on Drug Abuse. Published November 7, 2022. Accessed July 5, 2023.
  11. Schmitz A. Benzodiazepine use, misuse, and abuse: A review. Ment Health Clin. 2016;6(3):120-126. Published 2016 May 6.
  12. Pétursson H. The benzodiazepine withdrawal syndrome. Addiction. 1994;89(11):1455-1459.
  13. Slang terms and code words: A reference for law enforcement personnel. DEA Intelligence Report. Published July 2018. Accessed July 5, 2023.
  14. Kendler KS, Prescott CA, Myers J, Neale MC. The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Arch Gen Psychiatry. 2003;60(9):929–937. doi:10.1001/archpsyc.60.9.929
  15. Prescott CA, Khoddam R, Arpawong TE. Genetic risk for substance abuse and addiction: Family and Twin Studies. eLS. Published 2016:1-11.
  16. Brett J, Murnion B. Management of benzodiazepine misuse and dependence. Aust Prescr. 2015;38(5):152-155.
  17. Vicens C, Fiol F, Llobera J, et al. Withdrawal from long-term benzodiazepine use: randomised trial in family practice. Br J Gen Pract. 2006;56(533):958-963.
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