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Understanding Rehab for Xanax Addiction and The Recovery Process

Last Medical Review On: July 18, 2024
Updated On: June 15, 2024
6 min read
Written by:

Amanda Stevens, B.S.

Medical Review by:

Dr. Po-Chang Hsu, M.D., M.S.

Xanax is a prescription medication primarily prescribed for the management of anxiety and panic disorders.[1] As a benzodiazepine, Xanax works by enhancing the effects of a neurotransmitter called gamma-aminobutyric acid (GABA) in the brain, resulting in a calming effect on the central nervous system.

However, Xanax is sometimes misused and abused for these calming sedative effects. Its potent properties can lead to side effects such as drowsiness, dizziness, and impaired coordination. Long-term misuse or dependency on Xanax can result in tolerance, dependence, and Xanax withdrawal symptoms upon cessation.

Xanax Addiction

Key Points

  • Xanax, also known as alprazolam, is a benzodiazepine medication primarily prescribed for managing anxiety disorders and panic attacks.
  • Xanax enhances the effects of gamma-aminobutyric acid (GABA) in the brain, calming the central nervous system.
  • Despite its therapeutic benefits, Xanax is frequently misused and abused due to its sedative properties, leading to various adverse effects.
  • Xanax is classified as a Schedule IV controlled substance under the Controlled Substances Act due to its recognized medical use and potential for abuse.
  • Xanax misuse has been implicated in numerous overdose deaths, particularly when combined with other substances like opioids.
  • Co-occurring Xanax addiction and mental health disorders present unique treatment challenges, highlighting the need for integrated care.
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    What is Xanax?

    Xanax, known by its generic name alprazolam, is a prescription medication classified as a benzodiazepine.[2] It is primarily prescribed to manage anxiety disorders and panic attacks due to its ability to produce calming effects on the central nervous system.

    Xanax is widely prescribed in the United States. However, its popularity also contributes to its potential for misuse and abuse.” According to the Substance Abuse and Mental Health Services Administration (SAMHSA), approximately 4.8 million individuals aged 12 or older reported misusing prescription benzodiazepines, which may include Xanax, in 2019.[3] In 2022, benzodiazepines were implicated in almost 11,000 overdose deaths in the USA, according to the National Institute on Drug Abuse (NIDA).[4]

    Under the Controlled Substances Act (CSA) in the United States, Xanax is classified as a Schedule IV controlled substance.[5] This classification acknowledges its recognized medical use for treating anxiety disorders and panic attacks while also acknowledging its potential for abuse and dependence. As a Schedule IV drug, Xanax is subject to regulatory measures to mitigate the risks of misuse and diversion, including strict prescribing guidelines and monitoring of distribution channels.

    Xanax Addiction and Abuse

    Xanax’s addictive nature is largely attributed to its ability to amplify the effects of gamma-aminobutyric acid (GABA), a neurotransmitter responsible for inhibiting brain activity. By enhancing GABA activity, Xanax induces feelings of calmness and relaxation, which can be reinforcing and lead to the development of addiction.[6]

    The drug functions by binding to specific receptors in the brain known as GABA-A receptors, thereby inhibiting neuronal activity. This mechanism results in the alleviation of anxiety and promotion of relaxation—but prolonged use of Xanax can lead to tolerance, necessitating higher doses to achieve the same effects.

    Xanax Quick Reference Chart

    Drug Category Anxiolytic (benzodiazepine)
    Commercial & Street Names Xannies, zannies, Xanbars, bars, Totem poles
    DEA Schedule Schedule IV
    Administration Orally, snorted


    Statistics on Xanax Use, Misuse, and Addiction

    A total of 30.6 million adults in the US — accounting for 12.6% of the population — reported past-year benzodiazepine use during 2015 and 2016.[7] Among them, 25.3 million individuals (10.4%) used benzodiazepines as prescribed, while 5.3 million adults (2.2%) reported misuse. Notably, misuse accounted for 17.2% of overall benzodiazepine use. Benzodiazepine misuse has also been strongly associated with the misuse and abuse of prescription opioids or stimulants, highlighting the interconnected nature of substance misuse disorders.

    From 2019 to 2020, benzodiazepine-related overdose visits per 100,000 emergency department visits increased by 23.7%.[8] This increase was observed both in cases involving opioid co-involvement (34.4%) and those without (21.0%). Over the same period, from April to June 2019 to April to June 2020, overdose deaths involving prescription and illicit benzodiazepines surged significantly. Prescription benzodiazepine-involved overdose deaths increased by 21.8%, while illicit benzodiazepine-involved overdose deaths increased by 519.6%.

    From January to June 2020, 92.7% of benzodiazepine-involved overdose deaths also involved opioids. Additionally, illicitly manufactured fentanyls were implicated in 66.7% of these overdose fatalities, highlighting the lethal combination of benzodiazepines and potent opioids.

    Xanax Addiction and Abuse

    Xanax abuse can profoundly impact overall well-being, leading to a range of physical, social, and behavioral consequences:[9]

    Physical Effects

    • Respiratory depression: Xanax, a potent benzodiazepine, can suppress breathing, particularly when taken in high doses or combined with other central nervous system depressants like alcohol. This can lead to dangerous levels of oxygen deprivation and potentially fatal consequences.
    • Gastrointestinal distress: Xanax abuse may cause nausea, vomiting, and other gastrointestinal symptoms, contributing to discomfort and potential complications.
    • Cognitive impairment: Xanax abuse can induce drowsiness and sedation and impair cognitive function, leading to difficulties in concentration, memory, and decision-making.
    • Risk of overdose: High doses of Xanax or its combination with other substances can increase the risk of overdose, potentially resulting in coma or death.

    Social and Behavioral Effects

    • Relationship problems: Xanax abuse can strain relationships with family members, friends, and colleagues due to erratic behavior, mood swings, and prioritization of drug use over responsibilities.
    • Legal issues: Obtaining Xanax through illicit means or engaging in criminal activities to support addiction can lead to legal consequences, including arrest, charges, and incarceration.
    • Financial difficulties: Supporting a Xanax addiction can be financially draining, leading to debt, unemployment, and financial instability.
    • Social isolation: Individuals struggling with Xanax abuse may withdraw from social activities, isolate themselves from loved ones, and experience feelings of loneliness and despair.

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    Xanax Addiction and Mental Health

    Xanax abuse can detrimentally affect cognitive function and emotional regulation, impeding daily functioning and exacerbating mood swings.[10] The sedative properties of Xanax can further exacerbate symptoms of anxiety and depression, creating a cycle of dependency and exacerbation of mental health issues.

    People struggling with co-occurring Xanax addiction and mental health disorders encounter distinct treatment hurdles, necessitating integrated care that addresses both aspects simultaneously. However, the stigma surrounding mental illness and substance abuse can act as a barrier to seeking help, underscoring the critical need for de-stigmatization efforts and access to evidence-based treatment modalities.

    Xanax Addiction Treatment

    Treatment for Xanax abuse typically aims to address the physical, psychological, and social aspects of addiction. The cost, duration, and process of addiction treatment can vary based on factors such as the severity of the addiction and the selected treatment facility, among other considerations.

    Cost of Treatment

    The cost of Xanax addiction rehabilitation can vary significantly, depending on the type of program (inpatient, outpatient, residential), treatment duration, geographical location, and amenities provided by the facility. Many treatment centers accept health insurance, which can help alleviate the financial burden of treatment. Additionally, some facilities offer sliding-scale fees or financial assistance options for needy individuals.

    Length of Treatment

    In general, the duration of Xanax addiction treatment spans from several weeks to several months or longer. Short-term detoxification programs typically last from a few days to a couple of weeks, focusing on safely managing withdrawal symptoms. Longer-term rehabilitation programs may extend for 30, 60, or 90 days, providing intensive therapy, counseling, and support to address underlying factors contributing to addiction and facilitate sustained recovery.

    Xanax Addiction Treatment Levels of Care

    Everyone’s treatment needs are unique—which is why these programs usually offer several different levels of care that can best align with your specific needs:

    • Medical Detoxification (Detox): Detoxification, often known as detox, is the intentional removal of harmful substances like drugs or alcohol from the body. This procedure usually occurs under careful supervision in medical facilities or specialized detox centers. The main goal of detox is to safely navigate the physical symptoms of withdrawal while preparing individuals for subsequent stages of treatment and rehabilitation.
    • Medically Managed Care: Medically managed care integrates medical expertise with therapy to support patients throughout their recovery. This level of care provides vigilant monitoring by medical professionals who tailor treatments and collaborate with other team members. This holistic approach promotes comprehensive healing and long-term well-being by addressing the physical and psychological dimensions of patients’ conditions.
    • Inpatient Residential Treatment: Inpatient residential treatment involves individuals residing full-time at a specialized facility as part of their rehabilitation program. With continuous care provided by healthcare professionals, these programs typically include individual and group therapy sessions, educational workshops, and recreational activities. By immersing individuals in this structured environment, inpatient treatment facilitates focused recovery efforts, intensive therapy sessions, and the development of coping skills essential for maintaining long-term sobriety.

    Therapies Used in Xanax Addiction Treatment

    Alpas offers several evidence-based approaches to treat Xanax addiction:

    • Cognitive Behavioral Therapy (CBT): Cognitive Behavioral Therapy (CBT) is a widely embraced therapeutic approach focusing on addressing negative thought patterns and behaviors associated with mental health conditions, including addiction. Through collaborative sessions with a therapist, individuals are guided to challenge distorted thinking, acquire coping strategies, and effectively manage cravings. This empowering method enables individuals to gain insight into their thought processes and behavior patterns, fostering positive changes and facilitating sustainable recovery.
    • Dialectical Behavior Therapy (DBT): Dialectical Behavior Therapy (DBT) integrates mindfulness, acceptance, and behavior change strategies within a cognitive-behavioral framework. Initially developed for borderline personality disorder, DBT has expanded its applications to address a range of mental health concerns, including addiction. It emphasizes cultivating skills in emotion regulation, interpersonal effectiveness, and distress tolerance. Therapists utilize a combination of individual sessions, group training, coaching, and assignments to impart coping skills and promote emotional stability in individuals undergoing treatment.
    • Motivational Interviewing (MI): Motivational Interviewing (MI) is a counseling approach to amplify motivation for behavior change. Therapists engage in collaborative conversations, demonstrating empathy and utilizing reflective listening techniques to assist individuals in aligning their behavior with their desired goals. MI empowers individuals by reinforcing their readiness and commitment to making significant life changes.
    • Contingency Management: Contingency management is a therapeutic strategy that utilizes rewards to incentivize desired behaviors, such as maintaining sobriety. Individuals receive incentives for achieving treatment goals, such as attending sessions or passing drug tests. These rewards, including vouchers or prizes, enhance motivation and encourage adherence to treatment objectives.
    • Motivational Enhancement Therapy (MET): Motivational Enhancement Therapy (MET) is a counseling approach to increase motivation and commitment to behavior change. MET addresses ambivalence about changing behaviors through structured discussions and feedback by helping individuals clarify their values and goals. By fostering confidence in their ability to change, MET prioritizes internal motivation for positive transformation rather than delving into the root causes of addiction.
    • Experiential Therapy: Experiential therapy employs interactive activities to facilitate emotional processing and personal growth. Departing from traditional talk therapy, it integrates hands-on approaches like role-playing and art therapy. By engaging in these activities, individuals can express emotions and acquire coping skills within a supportive environment encompassing the body, mind, and spirit, fostering profound personal transformation.
    • Relapse Prevention: Relapse prevention plays a critical role in recovery, helping individuals identify triggers, develop coping strategies, and create plans to prevent relapse. In this therapy, participants learn to recognize warning signs like stress and emotional triggers and acquire skills to manage them effectively. By fostering self-awareness and providing practical tools, relapse prevention therapy addresses the root causes of addictive behaviors, thereby promoting long-term sobriety.
    • Twelve-Step Facilitation: Twelve-step facilitation is instrumental in addiction recovery by engaging individuals in programs like Alcoholics Anonymous (AA) or Narcotics Anonymous (NA). These programs utilize group meetings, step work, and peer support to foster community and accountability. Active participation in these programs allows individuals to establish and maintain sobriety while gaining valuable tools for long-term recovery.
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    Frequently Asked Questions About Xanax


    How long does it take for Xanax to start working?


    Xanax typically starts working within 15 to 30 minutes after ingestion, with peak effects reached within 1 to 2 hours. However, the onset of action can vary depending on factors such as metabolism, dosage, and whether the medication is taken on an empty or full stomach. It’s essential to follow the prescribed dosage and instructions provided by your healthcare provider to ensure the safe and effective use of Xanax.


    Can I drink alcohol while taking Xanax?


    It is not recommended to drink alcohol while taking Xanax. Combining Xanax with alcohol can potentiate the sedative effects of both substances, leading to increased drowsiness, dizziness, confusion, impaired coordination, and respiratory depression. Additionally, the concurrent use of Xanax and alcohol significantly raises the risk of overdose, which can be life-threatening. It’s crucial to avoid alcohol consumption while taking Xanax to minimize the risk of adverse reactions and ensure the medication’s effectiveness in treating anxiety or panic disorders.


    What are the signs of Xanax overdose?


    Signs of Xanax overdose may include extreme drowsiness, confusion, impaired coordination, slowed or shallow breathing, fainting, and loss of consciousness. In severe cases, overdose can lead to respiratory failure, coma, or death. If an overdose is suspected, it is crucial to seek immediate medical attention. Emergency medical services should be contacted, and the individual should be taken to the nearest emergency room for evaluation and treatment. It’s essential to store Xanax securely and take it only as prescribed to minimize the risk of overdose and other adverse effects.


    [1] MedlinePlus. (2021, May 15). Alprazolam: MedlinePlus Drug Information. on April 5, 2024

    [2] Alprazolam (Oral Route) Description and Brand Names – Mayo Clinic. (2020). on April 5, 2024

    [3] SAMHSA. (2019). Key Substance Use and Mental Health Indicators in the United States: Results from the 2019 National Survey on Drug Use and Health. on April 5, 2024

    [4] Drug Overdose Death Rates. (2023, June 30). National Institute on Drug Abuse; National Institutes of Health. on April 5, 2024

    [5] Drug Enforcement Administration. (2018, July 10). Drug Scheduling.; United States Drug Enforcement Administration. on April 5, 2024

    [6] Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2017). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10. on April 5, 2024

    [7] Maust, D. T., Lin, L. A., & Blow, F. C. (2019). Benzodiazepine Use and Misuse Among Adults in the United States. Psychiatric Services, 70(2), 97–106. on April 5, 2024

    [8] Liu, S. (2021). Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines — 38 States and the District of Columbia, 2019–2020. MMWR. Morbidity and Mortality Weekly Report, 70. on April 5, 2024

    [9] George, T. T., & Tripp, J. (2022). Alprazolam. PubMed; StatPearls Publishing. on April 5, 2024

    [10] Cafasso, J. (2021, July 23). Xanax for depression: What you need to know. Healthline. on April 5, 2024

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