Alprazolam, more commonly known by its brand name Xanax, is a prescription benzodiazepine (or “benzo”) used to treat anxiety and panic disorders.1 It is the most widely prescribed benzo.12 Alprazolam and other benzodiazepines can lead to physical dependence and withdrawal, even when used as directed.1 Dependence is when your body gets used to a substance so that you will have withdrawal symptoms if you suddenly reduce or stop your dose.10 Dependence isn’t the same thing as addiction, but it often goes along with it.10 [callout-default] Clinical trials have shown benzodiazepines to be very effective for about 2 to 4 weeks.13 But many doctors prescribe them more often and for much longer periods.13 This long-term use further increases your risk of dependence and addiction, even when you take the benzos how your doctor told you.13 Benzodiazepines are also the most widely used in unhealthy ways.12 It’s common for people to misuse alprazolam with other drugs of abuse.14 Opioids and alcohol are most often the main drugs of choice—around 1 in 5 people who abuse alcohol also misuse benzos.14 Combining alprazolam with alcohol, opioids, or other benzos is dangerous and increases your risk of overdose, as these substances work together to enhance sedation (drowsiness) and respiratory depression (slowed breathing).14 [/callout-default] Signs and Symptoms of Alprazolam Withdrawal Acute withdrawal symptoms of alprazolam and other benzos may include:1,5,11 Nausea. Headache. Hallucinations (seeing, hearing, or feeling things that aren’t there). Sweating. Sleep troubles (insomnia). Feeling irritable. Tremors (shakiness). Fast heart rate. Seizures. When you stop using alprazolam, the symptoms you originally took the drug for may also return.4 For example, if you took alprazolam for insomnia, you may have insomnia again, and if you took it for anxiety, you may have anxiety again. These are called rebound symptoms.4 Rebound symptoms may be worse than your original symptoms and can last up to a few weeks.4 Alprazolam Withdrawal Timeline In general, alprazolam withdrawal symptoms can begin 6 to 8 hours after your last dose and may last for about a week.11 But this can vary depending on:9,11 How much you take. How long you’ve been taking it. If you have other physical or mental health problems. If you use other substances. Using benzos with other substances, especially other benzos, opioids, or alcohol, can be very dangerous and even fatal without the right medical care.9 Can you Die from Alprazolam Withdrawal? While death from the withdrawal of alprazolam and other benzos is rare, some withdrawal symptoms can be serious and need prompt medical care.9 Alprazolam also tends to have more severe withdrawal symptoms than other benzodiazepines.7 Possibly dangerous withdrawal symptoms include:7 Fast heart rate (tachycardia). Delirium (sudden, severe confusion). Psychosis (not being able to tell what is and isn’t real). Suicidal thoughts. Seizures. How to Stop Taking Alprazolam Safely Before trying to quit alprazolam on your own, talk to your doctor. Your doctor can assess your withdrawal risks, help decide the right level of care to fit your recovery needs, and create a tapering plan. Tapering means taking smaller doses of a drug over time before stopping for good. Tapering can help reduce your risk of having withdrawal symptoms.7 As mentioned, alprazolam withdrawal can be dangerous, especially if you take high doses or use other substances.9 Seizures and other severe symptoms can happen with no warning and need prompt medical care.9 Inpatient medical detox can help you manage these symptoms while keeping you as comfortable and safe as possible.9 During detox, clinic staff check your progress and may give you prescription medicines to help ease symptoms. They will also create a tapering plan for you, which may include switching to a longer-acting benzo with a lower risk of misuse.9,10 Finding Alprazolam Withdrawal Treatment You don’t have to go through alprazolam withdrawal alone. Professional medical detox can help you manage symptoms and keep you safe and comfortable. American Addiction Centers is one of the leading providers of addiction treatment, with detox centers across the nation. If you or someone you know is addicted to alprazolam or other benzodiazepines, we’re here to help. Call one of our knowledgeable and compassionate admissions navigators day or night at [phone] to learn more about your treatment options. [vob] [sources-default] National Alliance on Mental Illness. (2021, September). Alprazolam: Xanax. Drug Enforcement Administration. (2020, April). Drug fact sheet: Benzodiazepines.. Peppin, J. F., Raffa, R. B., & Schatman, M. E. (2020). The polysubstance overdose-death crisis. Journal of Pain Research, 13, 3405–3408. Lerner, A., & Klein, M. (2019). Dependence, withdrawal and rebound of CNS drugs: an update and regulatory considerations for new drugs development. Brain Communications, 1(1). World Health Organization. (2009). Clinical guidelines for withdrawal management and treatment of drug dependence in closed settings. Greenberg, M. I. (2001). Benzodiazepine withdrawal: Potentially fatal, commonly missed following benzodiazepine cessation, withdrawal symptoms make take up to 2 weeks to develop. Emergency Medicine News, 23(12), 18. Ait-Daoud, N., Hamby, A.S., Sharma, S., & Blevins, D. (2009). A review of alprazolam use, misuse, and withdrawal. Journal of Addiction Medicine, 12(1), 4–10. Lann, M.A., & Molina, K.D. (2009). A fatal case of benzodiazepine withdrawal. American Journal of Forensic Medicine and Pathology, 30(2), 177–179. Substance Abuse and Mental Health Services Administration. (2015). TIP 45: Detoxification and substance abuse treatment. National Institute on Drug Abuse. (2018, January). Principles of effective treatment: a research-based guide (third edition). American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Arlington, VA: American Psychiatric Publishing. Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM principles of addiction medicine (Sixth edition). Philadelphia, PA: Wolters Kluwer. Guina, J. & Merrill, B. (2018). Benzodiazepines I: Upping the care on downers: The evidence of risks, benefits, and alternatives. Journal of Clinical Medicine, 7(2), 17. Schmitz, A. (2016). Benzodiazepine use, misuse, and abuse: A review. The mental Health Clinician, 6(3), 120–126. [/sources-default] ...