Table of Contents
Xanax Addiction, Abuse, and Symptoms


The Basics

Xanax is typically prescribed as a treatment for generalized anxiety disorder and panic disorder. The main symptom of generalized anxiety disorder is persistent worry, according to the Anxiety and Depression Association of America. Panic disorder causes panic attacks, which may be accompanied by a racing heartbeat, chest pain, sweating, and other symptoms. Xanax also has off-label use as a treatment for depression.

Non-medical users sometimes take Xanax to enhance the feelings of euphoria produced by other substances. Xanax is also said to help reduce unwanted side effects caused by stimulants, opioids, and other substances. However, the non-medical use of Xanax does come with risks, including the threat of sudden death in some individuals.

According to an article published in American Family Physician, long-term abuse of Xanax can result in a loss of self-confidence, development of drug-seeking behavior, and overreliance on the substance. Sudden withdrawal from Xanax and other benzodiazepines may cause sweating, insomnia, high blood pressure, increased heart rate, and shaking. These side effects may be more pronounced in individuals who have chronic health conditions, such as heart disease, high blood pressure, and diabetes. Combining Xanax with other substances can also intensify these unpleasant side effects.

This guide explains the effects, trends, and dangers of Xanax use, as well as an unbiased analysis of the medicinal and behavioral treatment methods for Xanax addiction based on current research and publically available statistics. In some cases, usage statistics are derived from general prescription tranquilizer use, which includes Xanax, Librium, Klonopin, and Ativan, or from general prescription benzodiazepine use.

Primary Xanax Dangers

  • Addictiveness: In 2007, Nutt et al. published a study in the peer-reviewed medical journal The Lancet on the addictiveness of several substances. The study determined the potential addictiveness of 20 substances based on three factors: physical harm, social harm, and dependence. Benzodiazepines — including Xanax —were ranked the seventh most harmful based on an average score of 1.63 for physical harm, 1.69 for social harm, and 1.83 for dependence. Nutt et al. conducted this study to develop a scale that could be used to assess the safety risks posed by several common substances.
  • Risk of overdose: Use of prescription benzodiazepines, including Xanax, can cause sudden death, especially when they are combined with alcohol, opioids, stimulants and other substances. According to the National Institute on Drug Abuse, there were 11,537 overdose deaths caused by benzodiazepines in 2017. In a study published in Drug and Alcohol Review, Liang and Shi stated that benzodiazepine overdose deaths have been increasing at an “alarming rate” for the past 20 years.
  • Unintended side effects: Xanax use can lead to muscle weakness, headaches, vertigo, confusion, memory impairment, and a change in sleep patterns. In some cases, Xanax may even cause difficulty thinking, slower reaction times, and anterograde amnesia, which is when an individual loses the ability to form new memories.
  • Legal risks: Xanax is a Schedule IV (4) substance. Possession of Xanax without a prescription is usually charged as a misdemeanor, but some states consider it a felony. A conviction typically results in a fine and referral to a treatment program. However, jail time is a possibility, especially if there are aggravating circumstances.

Xanax Background Information

Derived From Synthetic substance containing carbon, hydrogen, chlorine, and nitrogen
Ways Used Ingestion, rectal administration, snorting, crushing
Scientific Name 8-Chloro-1-methyl-6-phenyl-4H-s-triazolo [4,3-α] [1,4] benzodiazepine
Slang/Street Names for Xanax Xannies, zannies, handlebars, totem poles, blue footballs, zanbars, benzos, upjohn, Z-bars, xanbars, bars
How Long in Bodily System Half-life: 6.3 to 26.9 hours
Elimination usually occurs within four days in occasional users, but it may take up to a week in heavy users.
Punitive Legal Measures: Using/Possession Possession of Xanax without a valid prescription is a criminal offense. It is typically charged as a misdemeanor, with penalties for a conviction ranging from fines to court-ordered drug treatment.
Punitive Legal Measures: Selling/Distributing Selling or distributing Xanax without a valid professional license may be charged as a misdemeanor or felony. The penalties for a conviction are much harsher, with some defendants facing up to 20 years in prison. If the offense occurs within a school zone, the penalties are even more severe.
DEA Drug Rating Schedule IV

Signs of Abuse

Behavioral Symptoms of Xanax Usage and Abuse

How Xanax affects the brain

Xanax enhances the effects of GABA, a natural chemical that plays a role in the function of the central nervous system. Thus, it makes the nervous system less excitable, producing a calming effect. Xanax also allows more dopamine, a natural chemical that transmits messages between nerve cells, to enter the brain. As a result, some users experience a sense of euphoria, increasing the potential for misuse.

Xanax works in an area of the brain called the hippocampus, according to an article by Arvat et al. published in The Journal of Clinical Endocrinology & Metabolism. The hippocampus plays a role in memory formation, which is why long-term misuse of Xanax can cause memory loss or interfere with the brain’s ability to create new memories.

Behavioral signs of Xanax usage and abuse

Long-term use of Xanax can lead to tolerance, a state in which the user no longer responds to the substance in the same way, according to the National Institute on Drug Abuse. Once a user develops a tolerance for Xanax, higher doses of the drug are needed to achieve the same effects, which can cause significant behavioral changes.

In some users, these behavioral changes include irritability, anger, aggression, difficulty controlling impulses, and an increased level of excitement. Rarely, users may develop antisocial behaviors, causing them to experience fits of rage or lash out at others.

According to the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-V), an individual with a substance use disorder may have trouble focusing on important aspects of life, such as school, work, and relationships. Some users stop paying their bills on time or show other signs of financial distress because they are using most of their money to buy Xanax. Another possible behavioral change is an increase in secretive behavior. The individual may start hiding things from friends and family members in an attempt to conceal Xanax misuse.

Some Xanax users also engage in a practice known as doctor shopping. These users visit multiple prescribers within a short period in an attempt to conceal their dependence on Xanax. To combat this problem, some states have implemented monitoring programs, which rely on electronic databases to track prescriptions for controlled substances.

Physical Symptoms of Xanax Abuse

How Xanax affects the body

Xanax is a benzodiazepine that intensifies the effects of a substance known as GABA, or gamma-Aminobutyric acid. GABA is a chemical that controls the excitability of the cells in the central nervous system. After taking Xanax, the user typically feels calmer. However, misuse of Xanax can produce some concerning physical symptoms. Depending on the amount of Xanax taken, the user may experience fatigue, drowsiness, blurred vision, vertigo, and difficulty coordinating body movements.

Early physical effects of Xanax

Xanax and other benzodiazepines act quickly, causing physical and psychological symptoms to appear in as little as 30 to 45 minutes. Some of these side effects are unpleasant, and others can be life-threatening.

This table illustrates the possible short-term physical effects associated with Xanax.
Short-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.) Dizziness
Lingering (within an hour of taking the drug) Fatigue
Muscle relaxation
Slurred speech
Post-Use (several hours to days after use) Insomnia

Severe and long-term physical effects of Xanax

Long-term use of Xanax causes the user to build up a tolerance that makes the substance less effective at smaller doses. As a result, some users take Xanax more often than prescribed or in larger doses than prescribed to continue experiencing desirable effects, such as reduced anxiety and feelings of euphoria.

Xanax is frequently taken with alcohol, opioids, and other substances, as Xanax can reduce the undesirable side effects of these substances. Taking Xanax with alcohol, illicit drugs, or other medications can increase the risk of sudden death. Combining Xanax with opioids is especially common, with the National Institute on Drug Abuse reporting that more than 30% of opioid overdoses also involve benzodiazepines.

Taking Xanax in combination with alcohol can cause life-threatening side effects. Like Xanax, alcohol enhances the effects of GABA on the central nervous system, which can cause impaired coordination, drowsiness, dizziness, and other physical and psychological effects. When an individual combines Xanax and alcohol, the tranquilizing effects of each substance are intensified. Therefore, mixing Xanax with alcohol can cause an individual to lose consciousness or slip into a coma. Depending on how much Xanax and alcohol are consumed together, combining these substances can even cause the user to stop breathing.

As noted by Jeremy Barnett, Credentialed Alcoholism and Substance Abuse Counselor, “While heroin and other opioids tend to dominate the public’s attention, Xanax – and benzodiazepine abuse in general – can wreak havoc on users in similar ways. Many prescribing doctors are unaware of their patients’ often excessive alcohol consumption and may skip educating on the dangers of combining Xanax with alcohol. Both alcohol and Xanax have identical neurological effects, resulting in a deadly, and possibly fatal, outcome if taken together or in excess. If Xanax use is stopped abruptly after a physiological tolerance has been built up, seizures and even death can result.”

This table illustrates the possible long-term physical effects associated with Xanax.
Long-Term Physical Symptoms
Initial (direct effects of drug, 30 – 60 min.) Dizziness
Slurred speech
Lingering (within an hour of taking the drug) Memory impairment
Difficulty thinking
Increased impulsivity
Loss of appetite
Weight gain
Weight loss
Post-Use (several hours to days after use) Worsening anxiety
Panic attacks
Trouble concentrating
Muscle pain
Heart palpitations
Muscle stiffness
Psychotic reactions

Further Resources

Both the National Institute of Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) offer in-depth information on both the symptoms and treatment of prescription benzodiazepine addiction.

Xanax Usage

Worldwide benzodiazepine use has increased over the past 20 years

In a 2017 report, the United Nations Office on Drugs and Crime referred to the non-medical use of benzodiazepines as a “growing threat to public health.” While misuse of benzodiazepines is dangerous on its own, the UN report also revealed that counterfeit medications are a serious problem in some countries. For example, 400 people in the Democratic Republic of Congo suffered serious side effects after taking counterfeit Xanax in 2015.

The 2018 World Drug Report, published by the United Nations Office on Drugs and Crime, indicates that some Western nations are also dealing with an increased demand for non-controlled substances that have the same effects as benzodiazepines. These substances are marketed as “designer benzodiazepines” or “legal benzodiazepines.” Some individuals are combining these substances with Xanax and other benzodiazepines, increasing the risk of overdose and other serious consequences.

Data related to the seizure of controlled substances by worldwide law enforcement organizations further highlights the growing problem of benzodiazepine use. According to the 2018 World Drug Report, there was a 700% increase in the quantities of benzodiazepines seized in 2016.

Xanax Usage Demographics in the U.S.

Abuse of prescription tranquilizers is increasing in the United States, especially among adolescents and young adults

Although Xanax is classified as a benzodiazepine, it also acts as a tranquilizer, so it is sometimes included in tranquilizer usage statistics. In 2016, approximately two million individuals aged 12 and older misused tranquilizers at some point during the year. The problem is especially prevalent among young adults. According to the 2016 National Survey on Drug Use and Health, approximately 536,000 individuals between the ages of 18 and 25 had misused tranquilizers within the previous month.

The total number of individuals who misused tranquilizers in 2016 represents approximately 0.7% of the American population, while the number of individuals between the ages of 18 and 25 who misused tranquilizers within the previous month accounts for just under 0.17% of the population.

Tranquilizer use among adolescents has also been increasing. The National Institute on Drug Abuse conducted the Monitoring the Future Study: Trends in Prevalence, which examined substance use in three groups of adolescents: 8th graders, 10th graders, and 12th graders. According to the data, lifetime tranquilizer use among 8th graders increased from 3% in 2015 to 3.5% in 2018. The number of 8th graders who reported using tranquilizers within the past year increased from 1.7% to 2% in 2018 as well. Lifetime use among 10th graders increased from 5.8% in 2015 to 6% in 2018, while lifetime use among 12th graders decreased from 6.9% in 2015 to 6.6% in 2018.

Demographics of Prescription Usage
Past Year (2018) Lifetime
8th grade (14-15 yo) 2% 3.5%
10th grade (15-16 yo) 3.9% 6%
12th grade (17-18 yo) 3.9% 6.6%

How to Find Help

Long-term Xanax use can lead to tolerance or dependence, making the substance less effective at its usual dose. As a result, users must take Xanax more often or take larger doses each time, increasing the risk of addiction. For individuals who decide to stop taking Xanax, sudden withdrawal can cause severe physical and psychological side effects, increasing the risk of seizures, coma, and even sudden death.

Therefore, treating Xanax addiction usually involves a gradual reduction in the amount of the substance ingested. Tapering the dose instead of suddenly stopping Xanax reduces the risk of serious withdrawal symptoms, makes relapse less likely, and ensures that the individual has plenty of social support. To learn more about the treatment process, review our guide to Xanax rehabilitation, which provides comprehensive information on the entire process.

Staging an Intervention

If you have a loved one who’s struggling with addiction, staging an intervention is often the first necessary step towards sobriety, but it’s important to be strategic and loving in your approach. Even the most well-meaning of interventions can have a negative effect if they aren’t handled correctly.

5 Tips for Staging an Intervention
1. Don’t Do It Alone. A professional interventionist is always the most qualified to guide a successful intervention. Also, rely on non-addict family and friends – especially those who have a close relationship with you or the addict.
2. Research Ahead of Time. It’s best to do plenty of research ahead of time to gather insight on the addiction and how it affects the addict. Also, be prepared with local resources for getting help.
3. Write Out Your Statement. During the actual intervention, emotions will likely be running high, so it’s best to have a statement of how the person’s addiction has impacted you and your relationship with him or her. These statements should be honest, yet written from a place of love – no personal attacks.
4. Offer Help. It’s important for everyone attending the intervention to offer tangible help and support as the person works through detox and rehabilitation.
5. Set Boundaries. If the person refuses to seek help and take the next steps outlined, it’s important that they understand that everyone present will end codependence and enabling behaviors.

Disclaimer: The information contained on is for informational and educational purposes only and should not be relied upon for any medical or diagnostic purpose. The information on should not be used for the treatment of any condition or symptom. None of the material or information provided on is not intended to serve as a substitute for consultation, diagnosis, and/or treatment from a qualified healthcare provider.