Xanax Overdose: A Comprehensive Guide

Part of the complete guide to understanding addiction

Xanax, the brand name for Alprazolam, is the most widely prescribed anti-anxiety drug in the United States. It should therefore come as no surprise that it is also the most misused. According to a study conducted by the Substance Abuse and Mental Health Services Administration (SAMHSA) [1] in 2020, 2.2% of people aged 12 or older in the US misused tranquilizers or sedatives. The percentage was highest among young adults aged 18 to 25. Its high rates of misuse make the risk of a Xanax overdose a very real and dangerous problem.

Xanax falls under the category of benzodiazepines, which are central nervous system (CNS) depressants. The drug is used as a sedative to treat insomnia, and as a tranquilizer for the relief of anxiety and other panic disorders. It works by enhancing a type of natural brain chemical and tranquilizer known as GABA. This slows brain activity by “turning down the volume” of the signals passing between brain cells, and therefore has a calming effect.

Xanax Overdose Symptoms

The Centers for Disease Control and Prevention (CDC) [2] writes that in addition to the serious risks of addiction, abuse, and overdose, the use of prescription opioids can have a number of side effects, even when taken as directed:

Tolerance (the need to take more of the medication for the same pain relief)
Physical dependence (withdrawal symptoms begin when medication is stopped)
Increased sensitivity to pain
Constipation
Nausea, vomiting, and dry mouth
Sleepiness and dizziness
Confusion
Depression
Low testosterone levels that can result in reduced sex drive, energy, and strength
Itching and sweating
Memory loss
Muscle weakness
Aggressive behavior

When the drug is taken in excess, these side effects can be more pronounced, and can even be lethal.

How Much Xanax is Too Much?

It is hard to predict the difference between the amount of Xanax it takes to get high, and the amount it takes to overdose. When it comes to any drug misuse, the difference between life and death can lie in just a few small measurements. As a person develops tolerance to the drug, they find themselves needing to take higher and higher doses to achieve the desired effect. The exact lethal dose of Xanax will often depend on a number of factors, such as:

The user’s age
If the user has any underlying medical conditions
The amount of time the user has been misusing the drug
Whether they are using it alongside any other medication

How Can You Die From Xanax Use?

When taken in excess, central nervous system (CNS) depressants cause significantly slowed breathing and airway closure, which can lead to death. This is made all the more risky when Xanax is used in combination with other substances, such as alcohol or opioids.

Why Do People Misuse Xanax?

As opposed to illegal drugs that are difficult to obtain, Xanax is a widely available prescription drug. When a drug can be obtained by prescription, people sometimes think that this means it is unquestionably safe and has no harmful side effects. This misconception paves the way for the drug to be misused. Xanax can be misused by taking a higher dosage than that stated on the packaging or using it in ways other than intended, such as snorting, smoking, or injecting.

In addition, Xanax is designed to provide short-term treatment, and the drug is not meant to be taken for more than 6-8 weeks. Exceeding this timeframe is another way the drug is misused. A number of other factors contribute to PDA (prescription drug abuse), including an increase in the number of prescriptions written, aggressive direct-to-consumer marketing, the perceived safety of prescription drugs, and ease of availability. Due to its potential to become addictive, Xanax can be particularly dangerous for people with histories of substance use disorder.

Those looking to get a “quick high” are often drawn to Xanax - its rapid absorption means that it has a very fast onset of action, and its effects are usually felt within 20 minutes of ingestion. Over half the dosage remains in a person’s system for between 6-20 hours after the drug is taken, and it is 10 times more potent than diazepam, another type of benzodiazepine. The fast-acting nature of the drug greatly increases the likelihood of misuse, dependence, and addiction.

What Does Withdrawal Look Like?

Somewhat ironically, during drug detox treatment the withdrawal symptoms of Xanax are similar to the problems that often lead a person to turn to Xanax to begin with - like insomnia, panic attacks, and anxiety. In some cases, the “rebound anxiety” experienced after discontinuing Xanax use is even more severe than the anxiety experienced before using. Other withdrawal symptoms include nausea, headaches, seizures, and psychosis. In the article Our Uneasy Tranquility [3], author Heather Zieger explains, “What was once a relief from anxiety becomes its source, and so the person becomes enslaved to the substance that was meant to offer freedom.”

Xanax Overdose Treatment

Seeking treatment options before the damage becomes irreversible (like brain damage or death) is incredibly important for anyone with an addiction to Xanax.

For the immediate, short term, there is a drug called Flumazenil which is a Xanax antidote, capable of undoing some of the potentially lethal effects of benzodiazepines. While this relief does exist, it does not guarantee a safe or reliable Xanax overdose reversal.

Xanax Addiction Treatment

Part of the recovery process at outpatient or residential addiction treatment involves treating not only the effects of the drug, but the cause of the drug misuse in the first place. Many cases of Xanax overdose are instances in which people are attempting to handle anxiety, not realizing that it provides short-term relief while the underlying problems that initiated the drug use still linger on under the surface. Heather Zieger explains, “Tinkering with brain chemistry alone does not solve the underlying problem, because anxiety is part of a broader picture of who we want to be, and why.” Working with a therapist, either one-on-one or in a group setting, can help a person address and work through the problems which led them to drug misuse.

Treatment for Xanax addiction (as a benzo addiction) will also involve working with healthcare professionals in an inpatient setting to wean the user off the drug. The addict will be monitored to ensure that they are decreasing their usage at a healthy rate to avoid relapse. In addition, healthcare professionals will help a person work through the physical symptoms and monitor the progression of detox to check whether everything is progressing as it should be.

Take Action Against Xanax Overdose or Addiction

If you are struggling with Xanax addiction or know someone who is, Avenues Recovery is here to support you. Our dedicated team specialize in addiction rehabilitation and can talk you through the different recovery options available. Always remember that the past doesn’t determine the future, and it’s never too late to turn your life around. Contact us today to start your recovery journey!