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Xanax Withdrawal Symptoms, Signs, & Detoxification

Xanax is a prescription benzodiazepine medication used to manage anxiety and panic disorder.1

However, when used for prolonged periods of time or otherwise misused, it is relatively easy to become physically dependent upon Xanax and other drugs like it.

Once dependence develops, potentially severe withdrawal symptoms may arise in those who attempt to abruptly cut off their use.1

Due to the risks associated with Xanax withdrawal, a person who needs to stop using Xanax should do so only under medical supervision.2

Can I Become Dependent?

Person struggling with substance abuseXanax is a medication commonly prescribed to help people cope with anxiety or manage panic attacks, but misuse of this drug is common. Some people abuse Xanax for recreational purposes for its sedating high.3 Others may use it in order to self-medicate their anxiety or their insomnia. Xanax is also commonly sought out by people looking to alleviate the side effects or soften the comedown of a stimulant high (such as from cocaine, meth, or Adderall).4

Xanax binds to certain receptors in your central nervous system and, in doing so, increases the activity of an inhibitory neurotransmitter known as GABA. The resulting increase in GABA activity creates a temporary calming and sedating effect. While benzodiazepines can be effective anxiolytic medications, their misuse can quickly lead to physical dependence. Once you’ve become significantly physically dependent on a benzodiazepine, you may require professional help to quit, in order to safely manage a withdrawal syndrome that can be both physically and psychologically severe (and sometimes life-threatening, in the case of seizures).1

Physical dependence is often an indication of a more overarching problem—addiction—though people who are not addicted and also use Xanax as prescribed may experience some degree of withdrawal upon stopping. Addiction encompasses much more than simply going through withdrawal upon substance cessation; it involves compulsively seeking and using a substance even when it has a multitude of negative effects on your life, such as:4

  • Job loss.
  • Problems at school.
  • Family conflict/strained relationships.
  • Legal charges.
  • Damage to physical or mental health.

Some people using Xanax on a prescription basis may not feel that they need any help when they decide to quit. However, for anyone who has developed significantly severe physical dependence on a benzodiazepine, there is a high level of risk associated with abruptly quitting. Medical detox provides a safe environment for withdrawal and minimizes the chances of a relapse or serious medical complications.2

What Is Withdrawal Like?

Xanax withdrawal symptoms may vary in severity from person to person, and not everyone experiences all of them. Xanax withdrawal symptoms include:2,5

  • Anxiety.
  • Insomnia.
  • Restlessness.
  • Unintentional and purposeless movements.
  • Hand tremors.
  • Muscle spasms.
  • Excessive sweating.
  • Rapid pulse.
  • Nausea/dry heaving.
  • Vomiting.
  • Weight loss.
  • Muscle pain.
  • Headaches.
  • Hallucinations
  • Delirium.

The biggest physical risk of withdrawal from Xanax is that of seizures. Seizures can be life-threatening if not treated properly.

A person experiencing anxietyAnother risk of Xanax withdrawal that can be extremely distressing to the individual is rebound anxiety, a condition in which anxiety symptoms recur or even escalate to a level higher than a person experienced before taking Xanax.4,6

Additionally, some people experience a condition known as post-acute withdrawal syndrome (PAWS), in which people experience changes in mood and cognitive functioning lasting for many weeks or even months after withdrawal from a drug. Researchers believe that PAWS arises as a result of physiologic changes to the brain that result from repeated drug use. The symptoms of PAWS, as well as their severity and how often they occur, vary from person to person. The most common symptoms include:7

  • Cognitive problems, including issues with learning and memory.
  • Anxiety
  • Depression
  • Irritable mood.
  • Obsessive-compulsive behaviors.
  • Loss of interest in most things.
  • Problems interacting with others.
  • Greater sensitivity to stress.
  • Cravings for drugs.

Why Quit Xanax?

You may wonder if Xanax is a dangerous drug, especially if you are taking it with a doctor’s approval. For many people, a short-term course of Xanax can be safe and effective. However, Xanax is associated with a number of risks that extend beyond that of physical dependence: 1,4,8

  • Irritability.
  • Drowsiness.
  • Lightheadedness.
  • Hypotension.
  • Slowed pulse.
  • Respiratory depression.
  • Changes in sex drive.
  • Changes in weight.
  • Problems concentrating.
  • Impaired memory.
  • Long-lasting cognitive impairments.
  • Susceptibility to accidents/injuries.
  • Increased rate of birth defects in pregnant women.
  • Suicidal thoughts.
  • Addiction.

Person suffering from overdoseOverdoses are a real risk with Xanax, as well. This risk is heightened when the drug is consumed simultaneously with certain other substances. The greatest danger for overdose occurs when people mix Xanax with opioid painkillers or alcohol, as all of these substances are central nervous system depressants, and the compounding effects of mixing these substances can significantly repress breathing and may lead to a coma or death.1 It is also important to note that the elderly are more sensitive to the effects of Xanax and may accidentally overdose more easily than younger people.1

What Are My Treatment Options?

Withdrawal symptoms can persist for a long period of time, but the symptoms will differ according to the phase of recovery: 8

  • When you first quit, you'll experience the more medically threatening, acute symptoms. A rapid reduction or complete cessation of Xanax may trigger the most severe and dangerous adverse effects, such as seizures.2 A medical detox approach will help you to taper off Xanax and will reduce the risks of dangerous complications.
  • Longer-term treatment avenues and engagement with aftercare can help with the more drawn-out, protracted symptoms—keeping people on track and perhaps making relapse in response to persisting symptoms less likely.

Doctor with patientDetox treatment plans will vary for each individual and will be influenced by many factors, including any polysubstance dependence, as well as the individual's overall mental and physical health. In some cases, the doctor will first order a slow taper off Xanax to give the body time to safely adjust to lower doses. Reducing the dose helps alleviate, and may even prevent, many common symptoms experienced during withdrawal.

Sometimes, the doctor may first switch the patient to a longer acting sedative, such as chlordiazepoxide, clonazepam, or phenobarbital, which will then be tapered off slowly and safely to prevent complications such as withdrawal seizures.2

Some people can undergo a Xanax taper under a doctor’s supervision on an outpatient basis. However, this option is only appropriate when the person's doctor has thoroughly evaluated the risks and determined whether it is safe. Additionally, while some people may prefer the idea of detoxing on an outpatient basis, many reported that inpatient treatment worked best for them.3

Xanax Information at a Glance1,4,9
Medication Name, Costs Class of Medicine
  • Generic Name: Alprazolam
  • Brand Name: Xanax
  • Brand Name Variations: Xanax XR
  • Cost/Price: Varies
  • Used to Treat Addiction? No
  • Used for: Anxiety treatment
  • Chemical Name: 8-Chloro-1-methyl-6-phenyl-4H-s-triazolo[4,3-α] [1,4]
  • Duration of Action: Several hours
Form, Intake, and Dosage Interactions and Complications
  • Drug Forms: Tablets
  • Administration Routes: Administered orally
  • Dosage: Up to 4 mg per day
  • Overdose: Exceeding 5 mg per day
  • Alcohol Interaction: Heightened side effects, including memory loss, dizziness, and respiratory depression.
  • Prescription Medications: N/A
  • Contraindications: Glaucoma, Concomitant Ketoconazole, Itraconazole
Effects and Adverse Reactions Substance Abuse
  • Short-Term: Headaches, insomnia, constipations, diarrhea, blurred vision, drowsiness, nausea, memory loss, thoughts of self-harm or suicide
  • Long-Term: Depression, unusual behavior, memory loss
  • Risk of Substance Abuse: Yes
  • Signs of Abuse: Irritability, confusion, mood changes, symptoms of depression
Physiological Problem Signs and Symptoms Dependence and Addiction Issues
  • Withdrawal Syndrome Onset: 6-8 hours after last dose
  • Withdrawal Symptoms: Increased anxiety, nausea, irritability, sweating, insomnia, tremors, seizures, delirium
  • Tolerance: Users may develop tolerance.
  • Physiological dependence: Yes
Legal Schedules and Ratings
  • Controlled Substances Act Rating: Schedule IV

How Can I Recover?

Some people who have become addicted to Xanax may be afraid to get treatment because they don’t see how they will cope with anxiety without Xanax.

Treating an addiction to Xanax involves much more than just undergoing detox to remove the drug from your body. After detox, a follow-up treatment program, either on an inpatient or outpatient basis, is necessary to help you deal with the addiction itself and learn improved coping skills that don't involve turning to Xanax or any other substances when you're feeling triggered or overwhelmed by cravings.

However, several non-pharmacologic therapies can help a person to cope with anxiety without benzodiazepines. These include:10

  • Cognitive behavioral therapy, or CBT. Studies have shown that CBT is effective for many people who have various forms of anxiety, such as panic attacks, generalized anxiety disorder, and social anxiety.
  • Eye movement desensitization processing (EMDR). This is another practice found to be effective with post-traumatic stress disorder (PTSD), as well as panic disorders and phobias.
  • Dialectical behavioral therapy (DBT). This therapy type involves learning skills such as mindfulness to cope with dysregulated feelings and emotions. DBT has been helpful to many people who have anxiety disorders.

Commonly Asked Questions

What Are Some Street Names for Xanax?

 Candy, totem poles, Z-bars, tranks, downers, chill pills.11
 
Are There Any Home Remedies for Getting Clean Safely?

No. Seizures are a real risk during Xanax withdrawal. If you or someone you know is suffering while trying to quit Xanax, you should seek professional help from a rehabilitation center to ensure safe withdrawal.2
 
How Long Does it Take to Detox from Xanax?

The length of detox varies and depends on a lot of factors, including your substance usage patterns, health, and mental well-being.

Can I Ever Take Xanax Again?

You may be scared that you can’t handle your anxiety without Xanax. It is not likely that your doctor will want to prescribe Xanax after you have developed an addiction to it. In addition to therapy to help with anxiety, there are non-addictive medications, known as selective serotonin reuptake inhibitors (SSRI) and selective noradrenaline reuptake inhibitors (SNRI) that can provide relief to many people who have anxiety. Commonly prescribed SSRIs include sertraline (Zoloft), fluoxetine (Prozac), and citalopram (Celexa). Some of the popular SNRIs include venlafaxine (Effexor) and duloxetine (Cymbalta).12 You may be able to work with your doctor on developing a treatment regimen that utilizes medications with a much lower addictive potential.

For help near you, call 1-888-935-1318Who Answers? or visit our locator page to receive help online.

References:

  1. U.S. National Library of Medicine. (2017). Daily Med: Xanax: Alprazolam Tablet.
  2. Substance Abuse and Mental Health Services Administration. (2006). Physical Detoxification Services for Withdrawal from Specific Services.
  3. Liebrenz, M., Gehring, M. T., Buadze, A., & Caflisch, C. (2015). High-Dose Benzodiazepine Dependence: A Qualitative Study of Patients’ Perception On Cessation and Withdrawal. BMC Psychiatry15(1), 116.
  4. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th Ed.). Arlington, VA: American Psychiatric Publishing.
  5. Petursson, H. (1994). The Benzodiazepine Withdrawal Syndrome. Addiction, 89 (11), 1455–1459.
  6. Herman, J. B., Brotman, A. W., & Rosenbaum, J. F. (1987). Rebound Anxiety In Panic Disorder Patients Treated with Shorter-Acting Benzodiazepines. The Journal of Clinical Psychiatry.
  7. University of California at Los Angeles. (2018). Post-Acute Withdrawal Syndrome.
  8. Ashton, C.H. (2004). Protracted Withdrawal Symptoms from Benzodiazepines.
  9. U.S. National Library of Medicine. (2018). Medline Plus: Alprazolam.
  10. Anxiety and Depression Association of America. (2016). Treatment: Therapy.
  11. U.S. National Library of Medicine. (2016). Substance Use: Prescription Drugs.
  12. Lampe, L. (2013). Drug Treatment for Anxiety. 
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