Xanax (Alprazolam) Addiction: Signs, Effects, and Treatment Options

The 2020 National Survey on Drug Use and Health estimates that 6.2 million people ages 12 and older misused tranquilizers or sedatives in the past year.¹ This includes 1.2% of the population who misused Xanax specifically within the same year.² Taking Xanax as prescribed may put people at risk for misusing Xanax.³ Misusing Xanax may lead to addiction and increases the risk of experiencing a drug overdose.³ If you or someone you care about use or misuse Xanax, you may benefit from learning more about Xanax addiction signs, effects, and treatment.

What is Xanax (Alprazolam)?

Xanax, also known by the generic name alprazolam, is a prescription benzodiazepine medication FDA-approved to treat certain types of anxiety disorders.³ Xanax (sometimes referred to as “bars”, “bricks”, or “z-bars”) is also widely misused.³

What Are the Uses for Xanax?

Xanax is FDA-approved to treat anxiety and panic disorders with or without agoraphobia, but it may be used off-label for other uses.³

Xanax has the potential for misuse and can lead to the development of addiction.⁴ Studies have found that the primary motivations behind benzodiazepine misuse include to relieve tension, relax, or to help with sleep.⁵

Effects of Xanax

Xanax use may result in various short- and long-term effects. Xanax is a central nervous system (CNS) depressant that inhibits abnormal levels of excitation throughout the nervous system.^3,6

Short-Term Effects of Xanax

Xanax can make you feel sleepy or dizzy.³ It can also slow your thinking and motor skills.³ The most common adverse effects of Xanax include:³

• Problems with coordination.
• Trouble saying words clearly (dysarthria).
• Increased libido.
• Hypotension (low blood pressure).

Other side effects are possible.³ If you take Xanax as prescribed and experience what you believe are side effects associated with the medication, you should consult your doctor.

Long-Term Effects of Xanax

Ongoing, regular use of Xanax can result in:⁶

• Tolerance, meaning you need increasing doses to experience desired effects.
• Dependence, meaning you experience withdrawal symptoms when you stop using Xanax.

The risk of dependence and adverse withdrawal reactions increases with longer treatment duration and with a higher daily dose.³

Research looking at long-term therapeutic use of benzodiazepines suggests that other possible long-term adverse effects may include sedation, cognitive impairment (which may persist after you stop using benzodiazepines), and impaired psychomotor performance, which increases risk of falls and fractures in the elderly and motor vehicle accidents.⁷

Is Xanax Addictive?

Yes, Xanax use can result in addiction, especially if misused.^4,8 Misuse of benzodiazepines like Xanax often (but not always) involves the use of doses greater than the maximum recommended dosage and commonly involve concomitant use of other medications, alcohol, and/or illicit substances, which is associated with an increased frequency of serious adverse outcomes, including respiratory depression, overdose, or death.⁹

Signs of Xanax Addiction and Misuse

The American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM-5) categorizes addiction to benzodiazepines as “sedative, hypnotic, or anxiolytic disorder.”⁸ There are 11 diagnostic criteria for this substance use disorder, and a person needs to meet at least two of them within a 12-month period to receive this diagnosis.¹¹ These criteria include:⁸

• Taking benzodiazepines in increasing amounts or for longer periods of time than originally intended.
• Being unable to cut down on benzodiazepine use despite a desire to do so.
• A great deal of time is spent in activities related to obtain benzodiazepines, use it, or recover from its effects.
• Craving, or a strong desire to use benzodiazepines.
• Being unable to fulfill major obligations at work, home, or school because of benzodiazepine use.
• Continuing to use benzodiazepines despite having interpersonal or social problems that are likely due to benzodiazepine use.
• Giving up important social, work, or recreational activities because of benzodiazepine use.
• Repeatedly using benzodiazepines in situations where it is dangerous to do so (such as driving or operating machinery).
• Continued benzodiazepine use despite knowledge of having a persistent or recurrent physical or psychological issues that is likely to have been caused or exacerbated by benzodiazepines.
• Tolerance to benzodiazepines, as defined by a need for increased amounts of benzodiazepines to achieve the desired effects or a diminished effect with continued use of the same amount of benzodiazepines.

Can You Overdose on Xanax?

Yes, you can overdose on Xanax.

A drug overdose means that a person has taken enough of a drug to produce uncomfortable feelings, life-threatening symptoms, or death.¹⁰

Xanax overdose without the use of other substances can cause symptoms of oversedation and CNS depression such as:³

• Somnolence (sleepiness).
• Confusion.
• Impaired coordination.
• Diminished reflexes.

Most benzo overdoses are not fatal. Severe consequences, such as coma or death, are more likely to occur as a result of combining Xanax or other benzodiazepines with other substances, especially opioids and alcohol.^3,9

Taking benzodiazepines like Xanax with opioid medicines, alcohol, or other central nervous system (CNS) depressants (including street drugs) can cause severe drowsiness, breathing problems (respiratory depression), coma and death. The following symptoms are indicative of a possible overdose of Xanax combined with another substance:

• Shallow, slowed, or stopped breathing
• Excessive sleepiness (sedation)
• Loss of consciousness.

An overdose is a medical emergency. If someone is overdosing, you need to seek immediate medical attention by calling 911. If you suspect opioids may be involved and you have access to it, administer naloxone (Narcan) as soon as possible.

Fentanyl-Laced Xanax

Fake and adulterated Xanax is becoming increasingly common. Often unbeknownst to users, many of the illicit pills or tablets purchased on the street are cut with fentanyl, a dangerous and potent opioid that can increase the likelihood of a fatal overdose.¹¹

Xanax Dependence and Withdrawal

Ongoing use or misuse of Xanax can cause dependence, which can result in withdrawal symptoms when you stop using the drug.⁴ Dependence and withdrawal are potential risks even when people take the medication as prescribed, and dependence may develop after 2 or more weeks of daily use.^4*Due to withdrawal risks, people should not abruptly stop using Xanax but should gradually taper off of it under medical supervision.⁴

Withdrawal can cause mild to severe symptoms such as:

• Dysphoria. (low mood).³
• Insomnia.³
• Abdominal and muscle cramps.³
• Vomiting.³
• Sweating.³
• Tremors.³
• Convulsions.³
• Delirium.¹²
• Grand mal seizures.^3,10

Benzodiazepine withdrawal can be dangerous and people shouldn’t quit taking Xanax without first talking to their prescriber or a doctor. Medically supervised detox is also an option.¹²

Medical detox offers a safe and effective way to undergo withdrawal with proper supervision and support; it can also provide immediate medical care if necessary. It’s not advisable to detox on your own due to the risks of severe complications and symptoms, such as seizures, that necessitate immediate medical attention.¹²

Xanax Addiction Treatment

Xanax addiction is typically treated with a combined approach of education, medication, and therapy, such as cognitive-behavioral therapy.⁷ Medication generally means gradually tapering off Xanax or switching to and then tapering off a benzo with a longer half-life.¹² You should never abruptly stop taking Xanax or taper off Xanax on your own without medical guidance.⁴

If you or a loved one are struggling with Xanax misuse or addiction, know that help is available. ADCare’s professional drug rehab offers evidence-based treatments and different levels of addiction treatment to help you stop the cycle of Xanax misuse and start the path to recovery. Please call our confidential helpline at to learn more about your rehab options, such as does insurance cover rehab, rehab admissions, and rehab payment options. You can also easily right away.