Xanax: Withdrawal, Tapering, and Detox Timeline
Xanax (alprazolam in its generic form) is a benzodiazepine medication used to treat anxiety and panic disorders and sometimes used to treat epileptic seizures. Benzodiazepines are a class of drugs that are commonly misused, as the National Survey on Drug Use and Health (NSDUH) estimated that close to 2 million people were using tranquilizers for nonmedical reasons in 2014.
This article will discuss what Xanax is, a timeline for Xanax withdrawal, and how Xanax withdrawal can be treated.
How Xanax Works
Xanax works on the neurotransmitter gamma-aminobutyric acid, or GABA. Within the body and brain, GABA acts as a kind of natural tranquilizer, helping to reduce anxiety and lower stress. Xanax increases the presence of this chemical messenger and acts on other neurotransmitters that enhance pleasure. In so doing, Xanax helps a person to feel relaxed and happy.
Regular use of Xanax can build a person’s tolerance to the drug, which will mean that they will need to take more of it to keep feeling the desired effects. Chronic use or misuse of Xanax can also cause dependence, as the brain becomes accustomed to the drug making changes to its circuitry and begins to rely on its presence. After a dependence has formed withdrawal symptoms may occur if Xanax use is suddenly stopped or decreased.
Benzodiazepine withdrawal can be life-threatening without medical oversight. Therefore, individuals are encouraged to seek help. They should not stop taking Xanax suddenly on their own.
Timeline for Xanax Withdrawal
Benzodiazepine withdrawal usually starts within about 12-24 hours after the last dose, with the bulk of the symptoms lasting around a week to 10 days on average. There are usually three main stages of benzodiazepine withdrawal:
Early withdrawal symptoms (1-4 days):
- Rebound anxiety
- Insomnia
- Irritability
- Restlessness
- Mood swings
- Fatigue
Acute withdrawal (4-10 days):
- Muscle aches
- Tremors
- Tension
- Sweating
- Anxiety
- Nausea
- Dry retching
- Panic attacks
- Racing heart rate or palpitations
- Hypertension (high blood pressure)
- Headaches
- Depersonalization (detachment from self)
- Hostility and aggression
- Mental confusion
- Short-term memory loss
- Abdominal pain
- Dysphoria (trouble feeling pleasure)
- Hallucinations and perceptual changes
- Sensory hypersensitivity
- Sleep disturbances
- Weight loss
- Diarrhea or constipation
Late withdrawal (10 days to a few weeks or more without treatment):
- Drug cravings
- Depression
- Trouble falling and staying asleep
- Suicidal thoughts
- Anxiety
Since Xanax works by artificially increasing levels of GABA and dopamine in the bloodstream and suppressing the central nervous system (CNS), when it is removed, the brain can experience a kind of rebound as it attempts to regain its natural balance. When this occurs, levels of these neurotransmitters can dip dangerously low and cause the CNS to become overactive. Seizures and psychosis are extreme reactions to this and may even be life-threatening.
Mitigating Factors in Xanax Withdrawal
There are several factors that play a role in both the duration and severity of the withdrawal syndrome and the potential side effects, including:
- Length of use
- Amount being used
- How Xanax is being consumed
- If Xanax is being misused with other substances
In addition, a person’s overall physical and mental health also factors into the withdrawal process. The presence of co-occurring physical and mental health issues can complicate withdrawal and prolong the overall timeline.
Medical Detox for Xanax Dependence
Since Xanax withdrawal can be difficult and even dangerous without proper care, medical etox is the optimal choice. During medical detox, an individual will likely stay in a specialty facility for an average of 5-7 days. Depending on the person and their specific circumstances, detox may be slightly longer or shorter in duration.
Vital signs can be closely monitored during medical detox, and trained professionals can ensure that the person remains safe and comfortable. The World Health Organization (WHO) publishes that diazepam (Valium) is often used during benzodiazepine detox to help taper individuals off of Xanax and other benzodiazepines safely. During a taper, the drug dosage is slowly and safely lowered over a set amount of time, in a secure and closely monitored environment, to keep withdrawal symptoms from being as significant.
Other medications may also be helpful during Xanax detox to treat specific symptoms, including:
- Sleep aids.
- Antidepressants.
- Beta blockers.
- Over-the-counter medications (e.g., acetaminophen, ibuprofen, bismuth sulfate).
Once the physical side effects of Xanax withdrawal are managed during medical detox, the psychological symptoms that may linger a little longer can then be addressed. Medications and therapies as part of a comprehensive treatment program directly following detox are the optimal course of action.
Benzodiazepine Treatment in Hollywood, FL
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