Xanax is a Central Nervous System (CNA) depressant known as benzodiazepine which is commonly prescribed by physicians to treat panic attacks, nervousness, and tension. Xanax, also known as alprazolam and considered to be a Schedule IV controlled substance under the Controlled Substance Act (CSA).
Xanax has been used as a tranquilizer since the 1960s with strong opposition to the use of benzodiazepines in the 1970s. Today with approximately three million Americans (1.6% of the adult population) have used benzodiazepine on a daily basis for at least 12 months.
According to the United States Department of Justice Drug Enforcement Agency (DEA) and under the CSA all controlled substances are rated on a five-schedule system. Schedule V, is the lowest for the potential for abuse or dependency and I, is the highest. Xanax is a Schedule IV. All Schedule IV controlled substances have the following attributes:
- A low potential for abuse
- A currently accepted medical use in treatment in the United States
- If abused, may lead to limited physical dependence or psychological dependence
Although there are many benefits to taking Xanax and other Schedule IV drugs many patients are becoming addicted and therefore require an intervention and drug treatment program to overcome their addictions. The patient’s body can also build up a tolerance to the drug and require larger doses if taken for long periods of time. With these increases in Xanax use come physical and psychological dependencies. Xanax is not a drug you should quit cold turkey.
The Journal of Postgraduate Medicine stated that up to 25 percent of patients who stop taking their medication experienced withdrawal symptoms such as:
- Vivid dreams
The National Institute on Drug Abuse found during a two-year treatment outcome study that fifteen percent of heroin users also used benzodiazepines daily for more than one year and seventy-three percent used benzodiazepines more often than weekly. Studies also indicate that from five percent to as many as ninety percent of methadone users are also regular users of benzodiazepines.
With this information in mind the Xanax abuse treatment involves careful monitoring and counseling in an in-patient or outpatient treatment facility. The American Psychiatric Association’s (APA) report on benzodiazepines revealed that eleven to fifteen percent of the adult population has taken a benzodiazepine one or more times during the preceding year but only one to two percent have taken benzodiazepines daily for twelve months or longer.
In psychiatric treatment settings and in substance-abuse populations the prevalence of benzodiazepine use, abuse and dependence is substantially higher than that in the general population. Treatment encompasses a patient’s thought process, behavior, and helps them to cope with everyday life. Patients suffering from Xanax addiction should be tapered off gradually. There are basic outpatient plans available for discontinuation of the drug including:
- Gradual discontinuance over a six to 12 week schedule.
- Monitoring and helping the patient to feel in control of their dosage
- Supplying a helpline when the patient needs reassurance.
Other plans include:
- Inpatient Treatment Centers
- 12-step programs such as:
- Narcotics Anonymous
- Drug Treatment Exchanges such as:
Although these substitutes can be dangerous an inpatient setting where dosages can be monitored by physicians until the patient can reach a zero dose of the benzodiazepine is recommended.
In conclusion Xanax and other benzodiazepines can be addictive drugs that are hard to discontinue however; they are also drugs of great benefit to patients who suffer from the following:
- Fear of open spaces (agoraphobia)
- Premenstrual syndrome
- Panic attacks
The patient and the physician should work together to regulate long-term usage monitoring side effects and any signs of abuse.
- DuPont, RL, Benzodiazepines: The Social Issues. Rockville, MD, Institute for Behavior and Health, 1986.
- DuPont, RL, Abuse of benzodiazepines – the problem and the solutions. A report of a Committee of the Institute for Behavior and Health, Inc. Am J Drug Alcohol Abuse 1988; 14 (suppl 1):1-69.
- Mellinger, GD, Balter MB, Prevalence and patterns of use of psychotherapeutic drugs: Results from a 1979 national survey of American adults, In Tognoni G, Bellantuono C, Lader, M (Eds): Epidemiological Impact of Psychotropic Drugs. Amsterdam, Elsevier, 1981, pp 117-135.
- The Controlled Substances Act: Chapter 1.
- Journal of Postgraduate Medicine
- Salzman, C, for Task Force on Benzodiazepine Dependency, American Psychiatric Association, Benzodiazepine dependence, toxicity, and abuse: a task force report of the American Psychiatric Association, Washington, D.C.: American Psychiatric Association, 1990.
- Ciraulo, DA, BF Sands and RI Shader. Critical review of liability for benzodiazepine abuse among alcoholics. Am J Psychiatry 1988; 145:1501-6.
- Busto, UE, MK Romach and EM Sellers. Multiple drug use and psychiatric comorbidity in patients admitted to the hospital with severe benzodiazepine dependence. J Clin Psychopharmacol 1996; 16:51-7.
- DuPont, RL, A Patient’s Gude to Getting Off a Benzodiazepine. Rockville, MD, DuPont Associates, 1989.