Xanax is a benzodiazepine used for the treatment of anxiety and panic disorders. Xanax or alprazolam may also be used in the treatment of depression and insomnia. Misuse or use of Xanax in a fashion other than prescribed can cause physical dependence on the medication, with regular intake of the drug necessary to function normally.
Even prolonged use of therapeutic doses of Xanax can cause dependence. Xanax may also be abused for recreational purposes because of its ability to cause disinhibition, reduce anxiety and cause euphoria.
How Long Does Xanax Stay In Your System?
Xanax is rapidly absorbed into the bloodstream and reaches its peak concentration one to two hours after intake. Xanax or alprazolam is primarily metabolized by the liver and eliminated through urine. Xanax has a plasma half-life of 11.5 hours which is the time required to reduce the amount of drug in the plasma to half.
Xanax has a shorter half-life than other benzodiazepines like diazepam and is categorized as a short-acting benzodiazepine. Due to its shorter half-life, Xanax tends to have more severe withdrawal symptoms that last for a shorter duration relative to long-acting benzodiazepines.
Xanax Withdrawal Symptoms
Long-term use of Xanax can lead to the development of dependence on Xanax. Abstinence following prolonged use of Xanax leads to withdrawal symptoms that can potentially be life-threatening. Some of the more severe and life-threatening side-effects of Xanax withdrawal include seizures and psychotic episodes. Less severe symptoms include muscle stiffness, insomnia, headaches, and anxiety.
Some of the physical symptoms of Xanax withdrawal include:
- Physical Xanax Withdrawal Symptoms
Elevated heart rate and blood pressure
Muscle and bone pain
Decreased appetite and weight loss
Some of the psychological symptoms of Xanax withdrawal include:
- Psychological Xanax Withdrawal Symptoms
Trouble concentrating and problems with memory
Delirium or mental confusion
Tinnitus: a feeling of ringing in the ear
Abnormal body sensations such as tingling or a sensation of pins and needles in the extremities
Feelings of unreality or out-of-body experiences
Increased sensitivity to noise, smell, and light
Xanax Withdrawal Timeline
Symptoms of Xanax withdrawal emerge 24-48 hours following the onset of abstinence from the drug. These symptoms generally peak within the first 1-3 days after discontinuation of Xanax use and may last between 2-4 weeks. Some symptoms may persist beyond this initial acute withdrawal phase and persist for several weeks or months.
Acute Xanax Withdrawal
The acute withdrawal phase has an onset after 1-3 days after discontinuation of the drug and may last until 2-4 weeks. Xanax is often used for the treatment of anxiety, panic, and insomnia. These symptoms may reappear during the first 1-4 days after discontinuation of Xanax and are referred to as rebound symptoms. These rebound symptoms occur at a higher intensity than the pre-treatment levels and return to pre-treatment levels within 1-3 weeks. Besides these rebound symptoms, new symptoms are also observed during withdrawal from Xanax such as headaches, diarrhea, nausea, visual disturbances and other such symptoms listed above. These symptoms generally recede over the duration of 2-4 weeks after discontinuation of drug use.
Protracted Xanax Withdrawal
A small proportion of individuals who discontinue the use of Xanax may continue to experience withdrawal symptoms several weeks or months after maintaining abstinence. These symptoms that are present beyond the acute withdrawal phase are collectively referred to as protracted withdrawal or post-acute withdrawal syndrome. Some of the symptoms experienced during protracted withdrawal from Xanax may include anxiety, depression, muscle spasms, and tinnitus.
Factors Impacting Xanax Withdrawal
The severity of symptoms of Xanax withdrawal is influenced by the history of Xanax use and factors that influence the metabolism of an individual. Some of the factors that influence the severity of Xanax withdrawal include:
- Xanax Withdrawal Factors
The dose of Xanax used
The frequency of use
The duration of drug use
Dependence on other substances including alcohol, prescription medications, and illicit drugs
Presence of a co-occurring psychiatric disorder
Abrupt cessation of Xanax use
Factors that influence drug metabolism including genetics, age, environmental factors, and overall health
Coping with Xanax Withdrawals
Xanax or alprazolam is a benzodiazepine with a short half-life and causes more severe withdrawal symptoms than observed with long-acting benzodiazepines. Abrupt cessation of Xanax use results in very severe withdrawal symptoms. Gradually reducing or tapering the dose of Xanax is considered to be the best method to deal with Xanax withdrawal. This reduces the intensity of withdrawal symptoms and decreases the chances of seizures.
Alternatively, individuals using Xanax may be switched to an equivalent dose of a long-acting benzodiazepine like diazepam. Diazepam, being a long-acting benzodiazepine is less potent and can help ease the withdrawal symptoms. Other remedies for Xanax withdrawal involve medications for specific symptoms such as muscle cramps, insomnia, nausea, etc. Physical exercise and relaxation techniques like yoga and meditation can help in coping with the symptoms of Xanax withdrawal.
The Dangers of Withdrawing from Xanax Alone
The symptoms of Xanax withdrawal are severe and can be life-threatening due to the possibility of seizures and psychotic episodes. These psychotic episodes may result in agitation and distress, leading individuals to cause harm to others or themselves. Hence, it is not recommended to undergo detoxification at home. However, in the case of undergoing detoxification at home, one must enlist the help of a family member or friend.
Quitting the use of Xanax cold-turkey, i.e. abrupt discontinuation of Xanax use, can lead to severe withdrawal symptoms. The dose of Xanax must be gradually tapered over several weeks. A doctor can help set up a taper schedule as well as provide advice regarding the use of medications to help the individual cope with the withdrawal symptoms. Detoxification must be undertaken in a calm and safe environment and one should immediately call 911 in case of seizures or other life-threatening symptoms.
Detoxing Off Xanax
Detoxification from Xanax involves the elimination of the drug from the body and helping the individual cope with the withdrawal symptoms. As described above, the withdrawal symptoms of Xanax can be life-threatening. Furthermore, the symptoms of Xanax withdrawal can cause significant discomfort and cause a relapse. Hence, treatment at an inpatient or outpatient detox is advisable.
Medically Assisted Detox
Treatment at a medical detox involves round-the-clock supervision provided by medical professionals. This allows addressing any adverse symptoms that may occur while tapering the dose of Xanax. The continuous medical supervision also enables adjustment of the taper schedule, should the withdrawal symptoms become unmanageable. Besides tapering the dose of Xanax, other medications may be used in conjunction to reduce the severity of withdrawal symptoms.
Drugs used to treat seizures (anticonvulsants) like carbamazepine and pregabalin, as well as antidepressants like trazodone, can be effective in the management of withdrawal symptoms. Flumazenil, a drug that inhibits benzodiazepine receptors, may also be useful in reducing the intensity of withdrawal symptoms. Other medications may also be used to treat the emergent symptoms of Xanax withdrawal.
For example, non-steroidal anti-inflammatory drugs may be used for muscle cramps, while metoclopramide may be used for nausea. Treatment at a medical detox may also include behavioral therapy. Behavioral approaches such as cognitive behavioral therapy used in combination with gradual dose reduction are more effective in the management of withdrawal symptoms.
When to Find Help: Xanax Rehab in Florida
Prolonged use of Xanax can lead to the development of physical dependence on the drug. In other words, neurons adapt to the intake of the drug, making continuous drug use necessary to function normally. In such cases, attempts to discontinue Xanax use results in withdrawal symptoms. Xanax withdrawal symptoms can cause significant discomfort and often cause a relapse. In such cases of Xanax dependence and addiction, it is necessary to seek treatment.
Due to the severe and potentially life-threatening withdrawal symptoms of Xanax withdrawal, it is advisable to undergo detoxification at an inpatient detox. Detoxification only involves helping the individual cope with the withdrawal symptoms. Treatment at a rehab must be sought to address the psychological issues underlying the addiction to Xanax.
If you or a loved one are addicted to benzodiazepines like Xanax, The Recovery Village Palm Beach at Baptist Health can help. The Recovery Village Palm Beach at Baptist Health provides quality care and treatment for substance use disorders delivered by experienced and accredited medical professionals. Call us today to explore treatment options and find the help you deserve.
George, Tobin T.; Tripp, Jayson. “Alprazolam.” NCBI Bookshelf, Updated March 3, 2019. Accessed September 21, 2019.
Brett, Jonathan; Bridin, Murnion. “Management of benzodiazepine misuse and dependence.” Australian Prescriber, October 2015. Accessed September 21, 2019.
Medical Disclaimer: The Recovery Village aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.