Drugs Q & A

What Does Xanax Withdrawal Feel Like?

Drug withdrawal is the group of symptoms that occur upon the abrupt discontinuation or decrease in the intake of pharmaceutical or recreational drugs. In order for the symptoms of withdrawal to occur, one must have first developed a form of drug dependence. This may occur as physical dependence, psychological dependence, or both. Drug dependence develops from consuming one or more substances over a period of time.

Nearly all addictive drugs directly or indirectly target the brain’s reward system by flooding the circuit with dopamine. Dopamine is a neurotransmitter present in regions of the brain that regulate movement, emotion, cognition, motivation, and reinforcement of rewarding behaviors. When activated at normal levels, this system rewards our natural behaviors. Overstimulating the system with drugs, however, produces effects that strongly reinforce the behavior of drug use, teaching the person to repeat it.

Depending on the type of withdrawal you experience, you may have symptoms that last from days to weeks, according to the National Institute on Drug Abuse (NIDA).

What is Xanax?

Xanax is a brand of alprazolam, a powerful benzodiazepine that is used to treat anxiety and panic disorders by decreasing abnormal excitement in the brain. The medication comes in the form of a tablet that quickly dissolves in the mouth, and extended-release tablet, or a concentrated oral solution. Benzodiazepines can have therapeutic anti-anxiety, anti-convulsant, muscle relaxing, and sedative effects.

Xanax is among the most prescribed benzodiazepine drugs in the U.S. and is among the benzodiazepines most often found in the illegal market, according to the Drug Enforcement Administration.

Xanax is often prescribed for mental health disorders related to anxiety. It can be used to treat general anxiety, panic disorder, social anxiety disorder, and phobias. It can also be used to treat seizures. For people who suffer from anxiety, it can create a sense of relief to focus on their lives without issues of anxiety or phobias plaguing them. When used as prescribed, it can calm people down and make them feel relaxed.

Xanax can also reduce physiological symptoms of anxiety and fear, such as a racing heart or hyperventilation. These drugs are so often prescribed because they work well on anxiety and they’re cheap.

However, many people use Xanax for nonmedical reasons taking it in larger doses or more frequently than prescribed because it can create a euphoric feeling, especially at higher doses. Xanax tends to start acting quickly after a person takes it, and the euphoric effects of the drug will usually manifest themselves within about an hour after taking it.

A tendency has grown in some social circles to view Xanax, as a type of “alcohol” in pill form. It’s become socially acceptable among these groups of friends to get together and share Xanax with one another. Of the 30.5 million people who used benzos in 2015, 17.1% misused them. Misusing Xanax or combining it with other substances like alcohol can amplify its effects, but the results can also be deadly.

Along with recreational use, many people rely on Xanax to deal with issues like situational anxiety without having to commit to therapy, which can be expensive and time-consuming. Xanax is popular in America, for example, because there is a tendency for people to love things that are looked at as a quick fix. Xanax isn’t a long-term medication, so some people “take it when they need it” for relief. The temporary relief they feel can help in a fast-paced world with constant exposure to negative world news, stressful jobs, and uncertainty.

Why does Xanax withdrawal occur?

When someone regularly takes Xanax, their brain may begin to adjust to the presence of the drug. They may eventually become physiologically dependent on their substance of choice and utterly reliant on it to function and feel “normal.”

In people who develop significant levels of dependence, withdrawal is often an inevitable response to the sudden absence or declining blood concentration of Xanax. Withdrawal symptoms may develop when a Xanax-dependent person quits “cold turkey” or substantially reduces how much they are using. During withdrawal, the body attempts to reach a new state of homeostasis as it rids itself of any lingering chemical influence of the drug in question. This can result in temporary disruptions in brain chemistry and may be accompanied by significant mental and physical health repercussions.

How to know you are experiencing a Xanax Withdrawal?

Xanax withdrawal symptoms vary in severity and typically begin within 24 hours and may last from a few days to a few months. There is no definitive guide to the symptoms, timeline, or severity of Xanax withdrawal. Each individual may experience Xanax withdrawal differently, depending on factors such as:

  • Dosage
  • Duration of taking Xanax
  • Having an underlying mental health condition
  • Misuse of prescription
  • Misusing other drugs or alcohol
  • Taking other drugs at the same time as Xanax
  • Using the drug without a prescription

There are three possible phases for Xanax withdrawals, each with an estimated timeline, they include:

Early or immediate withdrawal: Early Xanax withdrawal symptoms, sometimes called rebound symptoms, occur shortly after a person stops taking Xanax.

During the early stages of withdrawal, the person may notice the symptoms of the condition that the drug was treating start to return, or rebound. For example, symptoms of anxiety or insomnia may come back or get worse without the drugs. Practices such as Xanax tapering or using other drugs to help ease withdrawal may make early withdrawal symptoms milder and more manageable.

Acute withdrawal: Acute withdrawal begins after the initial Xanax withdrawal symptoms, generally within a few days. Symptoms generally last 5–28 days, though some may last for several months. Most of the withdrawal symptoms will occur in this phase. People who have been through acute Xanax withdrawal often say that this phase is the most difficult. During the acute withdrawal phase, doctors may monitor the person and recommend other drugs to control problematic symptoms.

Protracted withdrawal: Although many symptoms subside after the acute withdrawal phase, lingering side effects are possible. Research in the British Journal of Clinical Pharmacology notes that an estimated 10–25% of people who use benzodiazepines for extended periods experience withdrawal symptoms that last for 12 months or longer.

Protracted Xanax withdrawals may cause their own set of symptoms, often called post-acute withdrawal symptoms, or PAWS. These include:

  • anxiety
  • depression
  • insomnia
  • loss of sex drive
  • mood swings
  • poor concentration

These symptoms may be troubling or affect a person’s quality of life. Some symptoms may appear without warning and can be a significant source of distress.

In general¸ common Xanax withdrawal symptoms include:

•          Difficulty concentrating

•          Headaches

•          Heart palpitations

•          Increased anxiety

•          Insomnia

•          Irritability

•          Muscle pain and stiffness

•          Nausea

•          Panic attacks

•          Rebound Symptoms

•          Seizures

•          Suicidal thoughts

•          Sweating

•          Uncontrollable shaking

•          Vomiting

•          Weight loss

A person should always withdraw from Xanax under the guidance of a healthcare professional. They should never quit Xanax suddenly without first consulting a professional and developing a plan with them.

How to prevent Xanax withdrawal from happening

Xanax withdrawal can be scary, painful, and life-threatening. Fortunately, there are detox methods that can help prevent you from having any symptoms at all so you can experience a safer, more comfortable recovery.

People who suffer from Xanax addiction can receive medications in drug detox that relieve drug cravings and other withdrawal symptoms. Certain medications can be prescribed as part of medical detox or medication-assisted treatment — the latter of which is combined with counseling and behavioral therapy.

Those who suffer from addiction to prescription drugs like Xanax can be put on tapering schedules to avoid withdrawal. Tapering is when doctors reduce doses of these drugs gradually over a period of time until patients are no longer using these medications. Tapering schedules and medication management are included as part of drug detox.

Supportive counseling and other targeted therapies or medications may help a person manage the symptoms and improve their quality of life.

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Dr. Oche Otorkpa PG Cert, MPH, PhD

Dr. Oche is a seasoned Public Health specialist who holds a post graduate certificate in Pharmacology and Therapeutics, an MPH, and a PhD both from Texila American University. He is a member of the International Society of Substance Use Professionals and a Fellow of the Royal Society for Public Health in the UK. He authored two books: "The Unseen Terrorist," published by AuthorHouse UK, and "The Night Before I Killed Addiction."
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