Xanax is the brand name for alprazolam, a prescribed medication in a category of drugs known as benzodiazepines. Doctors usually prescribe Xanax to treat patients suffering from panic disorders and anxiety. They might also be prescribed for seizure control, muscle spasms, or to enhance the effects of anesthesia for a painful operation.
When you hear people talking about tranquilizers, benzodiazepines are the classic version of this type of medication. Familiar trade names other than Xanax include Valium and Ativan. These are among the most commonly prescribed medications in the United States.
Benzodiazepines work by interacting with the central nervous system, telling a receptor in the brain that is related to inhibitions to relax, and causing muscle relaxation, sedation, and reduced anxiety levels. Xanax is a fast-acting drug, lasting 6 hours or so, with the majority of the benefits are experienced within an hour of use. Xanax is most frequently abused by people looking for its sedative effects.
Benzodiazepines such as Xanax are frequently abused. This is in part because the drugs are freely available on a widespread basis, and in part due to the toxic effects that they produce. They are often abused chronically, although in hospital emergency departments it’s more common to see overdoses from benzodiazepines, whether intentional or accidental. Serious injuries, illness, or death from benzodiazepine abuse alone are rare; however, Xanax and its cousins are frequently taken with other medications, illegal drugs, or alcohol. Taken in combination, Xanax or other benzodiazepines and alcohol can be dangerous or even fatal.
Xanax is also particularly addictive when it is abused, taken other than as directed or recreationally. Furthermore, Xanax is potentially addictive for anyone. According to the US National Library of Medicine, Xanax use can result in tolerance, dependence, and addiction, if used for a prolonged period or taken in large quantities.
Even those who are prescribed Xanax and take it just as prescribed can become addicted—sometimes without noticing it.
What is Xanax Withdrawal?
People who take Xanax recreationally, or for longer than prescribed, or in large doses are at highest risk of developing an addiction. These people are also more likely to suffer from symptoms of withdrawal, and are more likely to experience more severe side effects, such as seizures and hallucinations.
Withdrawal symptoms are triggered when someone who is physically dependent on Xanax stops taking it suddenly. Because they are physically dependent on Xanax, without it they just can’t feel normal or function well, and they frequently experience emotional and physical pain along with psychological symptoms.
Xanax has some of the most dangerous withdrawal symptoms among the benzodiazepines, in part because it acts fast and leaves the body quickly. This can cause withdrawal symptoms that are both severe and sudden. Even the type of Xanax that is extended-release causes more serious withdrawal symptoms than most other varieties of benzodiazepine. In fact, Xanax is 10 times more potent than Klonopin and Valium, two other benzodiazepines.
In general, the longer you’ve taken benzodiazepines and the higher the doses, the more intense your withdrawal symptoms will be. Withdrawals and the painful side effects they produce make many people with benzodiazepine addictions reluctant to quit or even seek out help. Social norms can also be a problem; many people hold the mistaken belief that only “druggies” experience benzodiazepine withdrawals. This just isn’t so, and anyone who has developed dependence to any drug, including Xanax taken as prescribed, can experience painful withdrawals.
Withdrawal symptoms typically begin a just few hours after the final dose, and can come on suddenly. The most common symptoms include: difficulty concentrating, headaches, heart palpitations, increased anxiety, insomnia, irritability, muscle pain and stiffness, nausea, panic attacks, seizures, suicidal thoughts, sweating, uncontrollable shaking, vomiting, and weight loss.
Rebound symptoms are also possible after stopping use of Xanax. Pre-existing psychological disorders enhance the severity of these rebound effects, which may include panic attacks, anxiety, and inability to sleep.
How Long Does Xanax Withdrawal Last?
Many variables influence the length of benzodiazepine withdrawal. Some include the length and severity of the period of drug abuse, the half-life of the drug, and the age of the person. People who have been using drugs for longer times periods will typically experience more difficult withdrawals.
Long-term benzodiazepine users can typically expect a minimum of five days of withdrawal symptoms. Certain underlying mental health and medical issues can also affect how long withdrawal persists, as the body and brain works to restore themselves to a pre-benzodiazepine state.
For shorter-acting drugs like Xanax, which have a shorter half-life, withdrawal symptoms can begin as quickly as six hours after the last dose. It can take one or two days for withdrawal symptoms to appear with longer-acting drugs such as Klonopin or Valium. The withdrawal symptoms for Xanax and other short-acting benzodiazepines usually peak at the beginning of the acute withdrawal stage and then slowly taper off for a week or more.
However, it’s important to remember that some of the most troubling of the chronic symptoms for Xanax abusers, such as anxiety, dysphoria, and insomnia, can last for weeks or even months after the entire withdrawal period is technically over. This is because long-term, heavy use of benzodiazepines changes many systems in the brain and body.
Although the psychological symptoms of benzodiazepine withdrawal may be the most persistent, the physical symptoms are still very difficult to endure. And while nailing down a precise withdrawal timeline is impossible as all people are different, in general, most people experiencing benzodiazepine withdrawal will loosely follow this timeline.
Xanax Withdrawal Timeline
Beginning with cravings for more Xanax and feelings of anxiety and restlessness, the first phase of Xanax withdrawal worsens as the soothing effects of the drug wears away, with symptoms peaking during the next phase. Typically, benzodiazepine withdrawal begins within about 12 to 24 hours, and as soon as six hours, after the last dose. Most of the symptoms lasting around a week to 10 days.
There are three basic phases of Xanax withdrawal, with the side effects for each phase highlighted below:
Days 1 – 2: Early Withdrawal
Because Xanax is a benzodiazepine with a short half-life, withdrawals should start within approximately six to twelve hours after your last dose. However, if you’ve been using something with a longer half-life, such as Valium, you can expect to begin experiencing withdrawals approximately 30 to 48 hours after your last dose. The first two days can be a real challenge and the risk of relapse is high.
Early withdrawal symptoms usually include:
- Fatigue
- Insomnia
- Irritability
- Mood swings
- Rebound anxiety
- Restlessness
Some people will also experience loss of appetite, pain, and panic attacks.
Day 2 – 6: Acute Withdrawal
- Withdrawal symptoms increase and peak; initial symptoms continue and may be joined by others, including:
- Abdominal pain
- Depersonalization (detachment from self)
- Diarrhea or constipation
- Dry heaving
- Dysphoria (trouble feeling pleasure)
- General anxiety
- Hallucinations and perceptual changes
- Headache
- Hostility and aggression
- Hypertension (high blood pressure)
- Mental confusion
- Muscle aches and cramping
- Muscle spasms
- Nausea
- Racing heart rate or palpitations
- Sensory hypersensitivity
- Short-term memory loss
- Sleep disturbances
- Sweating
- Tension
- Tremors
- Weight loss
Day 6 – 14: Late Withdrawal
For most people, once they’ve made it to Day 6, nearly a week through on the Xanax withdrawal timeline, they have typically made it through the most severe symptoms—but that doesn’t mean it’s over. While the physical symptoms may be declining, the emotional symptoms of anxiety, depression, and moodiness may persist long beyond the initial withdrawal period.
During this phase, the body is re-learning appropriate emotional responses and which endorphins it needs to create at which times. Xanax takes over telling the brain how it should feel when an individual abuses Xanax, but in recovery, the person learns to take control again as the brain’s natural chemical levels come into balance over time.
Symptoms of late withdrawal include:
- Anxiety
- Cravings
- Depression
- Sleep disturbances
- Suicidal thoughts
How long withdrawal lasts depends mainly on how long you have been using and at what levels. Most people continue to abuse Xanax because the prospect of withdrawal is so daunting. However, a person can live happily without Xanax with the right support and qualified medical supervision.
Xanax Withdrawal Complications
Quitting Xanax all of the sudden or “cold turkey” can cause withdrawal symptoms that are severe or even dangerous. For example, withdrawal complications such as catatonia, seizures, and even death are possible. Severe symptoms that may occur if you quit Xanax suddenly without supervision include:
- Coma
- Delirium tremens (DTs)
- Hallucinations
- PTSD
- Psychosis
Particularly if you’ve been using Xanax for more than three months, a carefully supervised tapering off is important, because it can help make symptoms less severe. This is why some medical detox experts will prescribe a longer-acting benzodiazepine such as Valium before starting the tapering off process; this reduces the likelihood of these dangerous complications.
Get Help for Xanax Withdrawals
It’s easy to see why it’s so important to get professional help with quitting Xanax. The support of an addiction medicine specialist can help keep the process safer, and avoid the worst of detox. During a medical detox process, vital signs can be monitored closely, and trained staff can keep you comfortable and safe.
If you or someone you know is dealing with Xanax addiction or going through withdrawal, Casa Palmera can help. To speak to a medical professional, call Casa Palmera at 888-481-4481.
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