Anxiety disorders are the most common mental health conditions in the world, with a 4% prevalence rate globally. Given the high incidence of anxiety disorders, benzodiazepines such as Xanax can feel like a lifesaver. However, it’s crucial to be aware that these drugs are highly addictive, have complicated and hazardous withdrawal symptoms, and are not recommended for prolonged use.
Xanax and other benzodiazepines are prescribed to treat anxiety, insomnia and panic disorders and used illicitly without prescription recreationally. Xanax has an edge over other benzodiazepines because it works quickly – but this aspect also makes it riskier to use.
We’re going to dive into the history and culture of this benzodiazepine, what to look out for if you suspect you’re developing an addiction to it, and ways to access help.
History
Alprazolam – the generic name of Xanax – was first marketed in 1981 by Upjohn, now part of Pfizer. There aren’t any reliable statistics on the prevalence of Xanax use and addiction compared to other related or similar drugs (benzodiazepines, thienodiazepines, and the family of drugs known as Z-drugs). However, guidelines state they should not be prescribed for more than 4 weeks due to their addictive nature.
Xanax is a class C drug, and currently, the NHS cannot prescribe it. It is ten times stronger than the most prescribed benzodiazepine, Valium. However, Xanax will usually come in 1mg tablets or 2mg bars5, while Valium is available in up to 10mg per tablet. Xanax’s strength is often cited as a reason for it being dangerous. Still, as long as pharmaceutical-grade Xanax is used and not street presses, this danger is mitigated by the lower milligram-per-pill content of the drug.
As Xanax is not available through the NHS (although it can be obtained via a private prescription), the most common ways to obtain it are illicit – either on the streets or via the clear web or dark web. Bootleg Xanax bars are common, with dealers making their own powder mixes and pressing them into bars.
This creates a new set of problems. Bootleg bars may contain other benzodiazepines or adulterants, meaning the user cannot be sure of exactly what they’re taking. Street bars can suffer from inconsistent dosing due to sloppy mixing – some tablets may only contain traces of the drug, and some many times the stated dose. While overdosing on Xanax alone is not common, it can happen when mixed with other downers such as opioids and alcohol, and this inconsistent dosing can increase that likelihood. Street presses are often far stronger than pharmaceutical presses – Red Devils, a red street press of Xanax, became notorious when they were found to contain up to 5mg of alprazolam per bar. As Xanax is popular but not commonly prescribed, a lot of the Xanax in the illicit market consists of street presses.
The cultural components of Xanax addiction
For Xanax, some aspects make it truly unique – not in terms of its effects, but as a cultural phenomenon.
Unlike other benzodiazepines, Xanax comes in segmented bars with the logo pressed into them. This gives the drug a unique look and makes it highly marketable – images of Xanax bars have appeared on album covers, and gold and silver Xanax bar necklaces can be easily found on Etsy.
For a while, Xanax was strongly associated with the musical subgenre of cloud rap. Xanax addiction was common amongst artists within the genre, with one artist naming themselves Lil Xan after the drug.
Cloud rap incorporated distorted, downbeat sounds, and it was common for artists to use slurred vocals, emphasising the effects of downers popular in the scene, like codeine, promethazine, opioids and Xanax. Usage in the scene amongst both artists and fans was widespread. One of the biggest names in cloud rap, Lil Peep, overdosed on a combination of Xanax and Fentanyl, aged just 21.
While cloud rap is no longer the cultural phenomenon it once was, Xanax’s unique look makes it immediately recognisable, and illicit benzodiazepine usage in the UK shows signs of increasing, not decreasing.
The addictive potential of Xanax
Xanax is a short-acting benzodiazepine with a short half-life – meaning it enters and leaves your system quickly. This fast mechanism of action is one of the reasons that Xanax is so commonly prescribed in America, as relief from anxiety is quick – but short-acting benzodiazepines tend to be more addictive, with a stronger withdrawal. This means that while Xanax does not significantly differ from other benzodiazepines in effect, addiction can occur more rapidly, and withdrawal can be more intense.
Xanax addiction signs
Many people are led to believe that benzodiazepines are relatively harmless due to how widely they are prescribed, and accidentally falling into dependency can happen if the signs are missed. Despite guidelines advising benzodiazepines should not be prescribed for more than four weeks, over-prescription is common, particularly among older people.
Concerningly studies have shown that more than a quarter of a million people in the UK are being prescribed benzodiazepines and related drugs far beyond their recommended timescales.
While in the UK, Xanax is not among these prescribed drugs, the false sense of security fostered by over-prescription of benzodiazepines is dangerous, and users should be on the lookout for the following signs of Xanax addiction.
Increased tolerance
Tolerance rises extremely quickly with habitual benzodiazepine use, and one of the earliest signs is needing more of the drug to feel the effects.
Withdrawal symptoms
With habitual use, withdrawal symptoms will quickly appear when discontinuation is attempted. Unfortunately, a lot of these symptoms are similar to the ones that the drug is meant to treat – insomnia, irritability, anxiety and tremors.
Compulsive use and preoccupation
Repeated redosing and preoccupation with obtaining more of the drug are not unique to Xanax. However, due to its short-acting and addictive nature, these signs will appear quickly.
Continued use despite negative consequences
Once the user has reached this stage of dependence, intervention and help are crucial. Physical addiction to Xanax and other benzodiazepines is extremely dangerous.
Xanax addiction and withdrawal
Drug withdrawal is extremely challenging, no matter the substance, but benzodiazepine addiction is one of the few instances where withdrawal can be fatal, leading to seizures. For someone in the grip of a particularly intense Xanax addiction, medically assisted detox is crucial to ensure safe withdrawal.
In most cases, Xanax withdrawal is not fatal but extremely unpleasant. Benzodiazepine withdrawal syndrome includes disturbed sleep, anxiety, panic attacks, tremors, sweating, difficulty concentrating, nausea, palpitations and head and muscle aches.
Getting help
Xanax drug addiction benefits greatly from engaging with addiction services tailored to both the user and the addiction they’re struggling with.
For some, outpatient tapering with medical advice may be sufficient for Xanax addiction treatment. However, more severe addiction, or polydrug addiction often requires more involved interventions. Providing an intervention is more effective than routine care. Properly managed withdrawal under medical supervision also significantly reduces the risk of seizures and mortality for high Xanax dependency.
If you’re ready for inpatient treatment at UKAT’s Liberty House to address Xanax addiction, reaching out for support is a positive step. Contact us today to begin your journey towards recovery.
