Xanax

Main type

Xanax is the trade name and most commonly used name for the depressant drug Alprazolam. It is part of the Benzodiazepine group of drugs, which also includes Diazepam, Flunitrazepam (Rohypnol), Oxazepam and Temazepam.

It is a prescription medication that is most commonly used for a variety of anxiety disorders, such as generalised anxiety disorder, agoraphobia and panic attacks. Xanax is also sometimes prescribed to diminish anxiety caused by clinical depression. In cancer treatment, it is sometimes used to treat the nausea associated with chemotherapy.

It is most commonly prescribed in the US, and has also been widely abused for non-medical and recreational purposes. It is usually prescribed in tablet form and taken orally.

In common with most other Benzodiazepines, Xanax (Alprazolam) works by enhancing the effects of the neurotransmitter GABA (Gamma Amino Butyric Acid) in the brain. GABA is an essential chemical for the healthy functioning of the human body, and is produced naturally. Its role is to inhibit the function of other chemicals in the brain, thereby ‘calming’ mental activity, reducing anxiety and over-alertness, and promoting healthy sleep patterns. It is often an imbalance of the GABA neurotransmitter that results in anxiety disorders. Alternatively, anxiety caused by other conditions or by external life events may become so acute that the body’s natural supply of GABA, its own natural calming chemical, is unable to cope fully.

In such instances, Xanax can be prescribed to give natural GABA the boost it needs to restore balance. It enhances the effects of this neurotransmitter, making it better able to do its job of calming down brain activity and keeping anxiety under control.

Other Benzodiazepines that work in this way are used as hypnotics to induce sleep.

Xanax has been highly effective in treating anxiety disorders and has been widely prescribed. However, abuse is also common and the drug can be highly addictive if misused.

Some people use it illicitly in the same way that alcohol is used – to provide feelings of intoxication, sedation and even euphoria. In such cases it is acquired on the black market without prescription, and taken more frequently and in larger doses than are normally prescribed.

Prescription users can also become addicted, if they take it more frequently than is prescribed to them, or increase their own dosage to get a high or in response to growing tolerance to the drug.

Other Types

Xanax is the trade name for Alprazolam, a depressant drug of the Benzodiazepine family. Other brand names include Intensol, Niravam and Apo-Alpraz. It is also produced in generic forms as Alprazolam.

When used on the street it may be known by these brand names, or by a variety of slang names. These include Downers, Footballs, Bars, Z-bars, Yellow Boys, White Boys, White Girls, Handlebars, School Bus and Bicycle Parts. Sometimes these names relate to specific versions of the pills and allude to their colour or appearance.

Xanax is prescribed in a variety of different strength tablets, ranging from a low dose of 0.25mg to relatively high dosage strength of 2mg. Each strength of tablet has a different colour and appearance, resulting in these varied street names.

Major Effects

As a Benzodiazepine, the principal effect of Xanax is a reduction in brain activity, leading to reduced anxiety and sedation. In some cases of illicit use, users report a short-lived feeling of euphoria when taking particularly high doses.

As with all Benzodiazepines, Xanax has a high potential for abuse and can lead to strong physical and psychological addictions. In some countries such as the UK, long-term prescription of Benzodiazepines (more than 2-4 weeks) is generally avoided altogether due to their addictive potential and the fast onset of tolerance to the drug.

When tolerance builds, the drug has less effect than it may have done previously, leading the individual to take larger quantities of the drug to get the same effect, or to feel ‘normal’. This is because, in time, the body responds to the GABA-enhancing effects of Xanax by reducing its own production of the GABA chemical.

As well as increasing tolerance to the drug, this creates a chemical dependency in which, if the user were to suddenly stop taking Xanax, their own body would not be producing sufficient levels of GABA to adequately depress brain activity. This in turn results in a range of severe withdrawal effects, including heightened anxiety, insomnia, depression, irritability and powerful cravings to take more of the drug.

Xanax can also form a psychological habit, in which the user strongly desires to return to the state of mind produced by the drug, and will ignore evidence of the detrimental effects it has on their lives.

Common side effects of long term Xanax abuse include memory loss, mental confusion, insomnia, hypertension, heart and breathing problems.

Production countries

Xanax is produced legally in pharmaceutical laboratories using a process of chemical synthesis. It is mostly produced in the US, as this is the primary market of the drug. The principal manufacturer of Xanax is Pharmacia Ltd.

Xanax is only available legally on prescription, and all other usage is a criminal offence in the US, and in most other countries.

Virtually all black market supplies of Xanax come from this legal manufacture of the drug and can be obtained in a number of ways. Firstly, it may be diverted from the point of manufacture by corrupt employees, often under the influence of organised criminal elements. Secondly, it may be stolen from the manufacturer’s depots, from pharmacies, and from other locations that hold supplies of the drug.

Illicit production of Xanax/ Alprazolam generally does not occur and there are not thought to be any illegal labs producing it in the same way as other drugs. This is because of the complex and expensive processes and equipment used, the lack of profitability in such a venture, and the relative ease with which the medication can be diverted from legitimate channels.

Xanax procured in this way is then sold on the street alongside other illicit drugs. In recent years it has been offered for sale by unlicensed online pharmacies. As is the case with all drugs purchased in the manner, this exposes users to the risks associated with not knowing exactly what they are getting, and counterfeit pills have been discovered.

Recreational users of Xanax may also acquire prescriptions duplicitously, or even forge prescriptions for the drug.

Facts and stats

Facts

  • Xanax is a depressant, meaning that it suppresses chemical activity in the brain and elsewhere in the central nervous system.
  • It is also part of the Benzodiazepine family of drugs, which includes Temazepam and Diazepam. Like all Benzodiazepines, the drug works by enhancing the effects of the GABA neurotransmitter – the body’s natural calming chemical.
  • It is a prescription only medication which is used to treat a range of anxiety disorders, including generalised anxiety disorder and agoraphobia.
  • The medical name for Xanax is Alprazolam.
  • It has a high potential for abuse, and many doctors outside the US do not prescribe it for this reason.
  • As with other Benzodiazepines, tolerance and dependency can quickly form, especially when the drug is not taken in the exact doses and frequencies that it is prescribed.
  • During prolonged use of the drug, the body downgrades its own production of GABA, leading to the drug becoming less effective. Those abusing the drug may then take more and more, further fuelling the cycle of increased tolerance and withdrawal.
  • Withdrawal effects of Xanax include sleep difficulties, depression, anxiety, headaches, mood swings and even seizures.
  • Abusers of the drug often do not take it orally in the way that is intended for medical use. A common way of abusing Xanax is to crush it up into a fine powder, and then ‘snort’ it through the nasal passages. This delivers the chemicals into the blood stream much quicker, producing faster and more intense effects, and further strengthening the addiction.

Stats

  • When taken orally as intended for prescription use, Xanax usually takes effect within approximately 30 minutes.
  • If snorted, the full effects can be felt within 1-10 minutes. If allowed to dissolve in the mouth, the effects will also begin in under 10 minutes. These shorter onset times increase the strength of psychological addiction greatly, as it is more likely to be used as a ‘quick fix’ or high.
  • The duration of Xanax’ effects can vary depending on the individual, the amount taken and the tolerance levels that have built up to the drug. Generally the effects can last 4-6 hours.
  • Xanax tablets contain between 0.25mg and 2mg of active ingredient.
  • According to a 2009 US government survey, 20% of students in high school admitted to having taken a prescription-only medication without a prescription.
  • In 2008, a US study revealed that 2.4% of 8th grade students had taken tranquilisers such as Benzodiazepines illicitly in the past year.
  • 4.6% of 10th grade students admitted to taking tranquilisers without a prescription in the past year.
  • 12th grade students reported the highest levels of tranquiliser abuse, with 6.2% admitting some form of illicit use in the past year.
  • According to medical guidance in the UK, the use of Benzodiazepines for longer than 2-4 weeks should be avoided, due to their high potential for abuse.
  • In New York City, Xanax is the most commonly abused tranquiliser on the street.

Addiction Signs

Xanax, like all Benzodiazepines, has a high potential for addiction on both physical and psychological levels. And it is not only illicit users who can develop powerful addictions to the medication, but those who have been prescribed it for a legitimate purpose too.

In prescription users, there are several signs of abuse which may be outwardly visible. The individual may appear to be obsessed with the drug and be overly fixated on their next dose. Their supplies of the drug may dwindle faster than expected as a result of taking it more frequently than is stated in their prescription. They may also take larger quantities of the drug, and in manners not usually associated with legitimate pharmaceutical use (snorting nasally, for example).

When they have not taken the drug for some time, they may display a range of physical and psychological withdrawal symptoms. These include shakiness, irritability, anxiety, insomnia and panic. When they have taken a dose of the drug, they may appear sedated, intoxicated and unusually relaxed.

Illicit users who are buying the drug may also exhibit these symptoms. Bottles, boxes or small bags of pills may be found amongst their possessions. These pills come in a range of colours according to dosage strength, including white, blue and orange.

People who are addicted to Xanax may also seem to care little about important aspects of their lives, and may be more or less solely concerned with their next dose. They may frequently appear to suffer from memory loss, suffer from mood swings and act uncharacteristically.

Treatments

Because Xanax is highly addictive on both physical and psychological levels, professional help is often needed to treat the addiction.

Frequent Xanax use results in a chemical dependency on the drug. What this means is that the body gets used to having a certain amount of the substance. In response to GABA enhancing properties of Xanax, it reduces its production of the chemical. In those who have developed substantial tolerance and so take a particularly strong dose, this reduction can be severe.

When the user stops ingesting the drug, there are insufficient levels of the GABA neurotransmitter available in the body to fulfil its necessary functions, most notably calming mental activity and regulating sleep. This in turn leads to a range of withdrawal symptoms including anxiety, depression, insomnia, aggression and in some instances, suicidal thoughts.

Because of the potential severity of Xanax withdrawals, it is often recommended for heavy and long-term abusers of the drug to undertake an inpatient rehabilitation programme in a specialised treatment centre. This is not always necessary though, and treatment may also be administered on an outpatient basis.

Because there are two main aspects of the addiction – the physical dependency and the psychological habit – each of these must be treated as part of a holistic approach to recovery.

Detox from the drug is the first step. In some cases this may be done cold turkey, usually under medical supervision. Medications may be prescribed to help counteract the worst of the unpleasant withdrawal symptoms, and the process is monitored by an experience professional.

Another approach, and one which is often necessary with heavy Xanax addictions, is the gradual tapering off of the drug. In this case, the dosage is slowly reduced in a controlled manner, and may be temporarily substituted with another medication that acts in a similar way.

The psychological and behavioural element of the addiction is often dealt with through a range of therapies and counselling sessions. These treatments will often explore the underlying reasons for the abuse of Xanax, and what can be done to address these in a more constructive and healthy manner.

Cognitive behavioural therapy (CBT) is one such treatment which has been highly effective in treating many different forms of addiction. CBT can be used to address the behaviours involved in drug abuse and identify what is perpetuating them. It can also be used to develop healthy alternative behaviours through practical and talk-based sessions with a qualified CBT therapist. One specific use of CBT is to help the individual develop personalised techniques to beat the powerful cravings for Xanax that may take place post-cessation.

In instances where Xanax has been prescribed for anxiety, it may also be necessary to explore alternative treatment options for the initial condition. Doing so can greatly eliminate the chances of relapse into further drug seeking behaviours.

Individuals who are recovering from a Xanax addiction are often very fragile, and emotional support is another integral aspect of treatment. Addiction support groups with similar people can be effective in providing this.