Long-Term Effects Of Xanax (Alprazolam) Abuse

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

March 26, 2019

When Xanax is used for a prolonged time period, it changes the way that the brain and body function. Some of these changes may be permanent, persisting even after someone has stopped taking Xanax. This can depend on the extent of abuse: how much was taken and for how long.

Long-term effects of Xanax (alprazolam) abuse may be:

• Memory problems: Some individuals experience memory loss or confusion while taking Xanax. In most cases, this is resolved when they stop taking the drug. However, Xanax and several other benzodiazepines are linked to an increased risk of Alzheimer’s disease and dementia.
• Suicide: In individuals who suffer from depression, Xanax may increase the chance of suicidal thoughts and actions. In those who are not depressed, long-term Xanax use can still lead to suicidal thoughts.
• Depression: Prolonged Xanax abuse can cause or worsen depression. This is likely related to how Xanax affects the regulation of excitement in the brain.
• Mania: Some people who are already depressed experience mania when taking Xanax. Mania is a state of excitement, delusions, and euphoria that occurs along with depression in bipolar disorder.
• Constant Sedation: Xanax depresses the central nervous system, slowing down activity in the body and brain, such as breathing and heart rate. Someone who abuses Xanax is likely to always have the drug in their system, causing them to be less active or responsive.
• Paradoxical Symptoms: When someone abuses Xanax, they may experience symptoms that Xanax normally prevents, such as anxiety, nervousness, and insomnia.
• Rebound Anxiety: Xanax is a short-acting drug, which means it wears off quickly. For some people, this may happen between doses, and anxiety symptoms that arise in this time period may seem worse than they were before Xanax was taken.
• Seizures: The way that Xanax works in the brain can cause fluctuating levels of brain activity. Over time, this may upset and unbalance the brain to the extent that seizures occur.
• Liver Damage: Though rare, liver damage has been reported by some individuals taking Xanax. In most cases, the damage reverses when someone stops taking the drug, but it can be worsened if someone combines Xanax with alcohol.
• Post-Acute Withdrawal Syndrome (PAWS): Some individuals who abuse benzodiazepines like Xanax experience withdrawal symptoms long beyond the expected withdrawal time frame. This may include depression, anxiety, and panic attacks and can appear weeks, months, or even years after stopping Xanax use.

Risk Of Xanax Overdose

When someone uses Xanax for a long time, it can build up in their system. The higher and more frequent doses they take, the more likely this is to occur. In addition, people who abuse Xanax likely take more than the maximum daily limit. When the amount of Xanax present in the body becomes too high, it causes an overdose, which may be mild, severe, or even fatal.

Many individuals who abuse Xanax (alprazolam) do so with alcohol or other drugs. This also raises the risk of Xanax overdose, as combining substances increases the level of toxicity within the body. Mixing Xanax with other central nervous system depressants such as alcohol, opioids, or other benzodiazepines is especially dangerous.

Xanax Tolerance, Dependence, And Addiction

Xanax (alprazolam) is generally prescribed as a short-term medication. The body builds a tolerance to most benzodiazepines like Xanax within a few weeks. Once this happens, the drug is less effective. Since the maximum daily dose of Xanax is only 4 mg, there is not much room to increase dosage to counteract tolerance.

If someone does increase their Xanax dose, or continues to take the drug for more than several weeks, they are likely to develop a physical dependence on it. Physical dependence means that the body has become so accustomed to the effects of Xanax that it relies on the drug to help it function. The result is withdrawal symptoms if a person stops taking Xanax.

The same thing can happen in the brain with prolonged Xanax use. As Xanax increases the effects of gamma-aminobutyric acid (GABA), the brain becomes less effective at regulating activity because it expects Xanax to do it. This is how addiction develops. When a person stops taking Xanax, the brain needs time to adjust and become effective again, so they may experience psychological withdrawal symptoms during this time.

Because tolerance develops so quickly, doctors may prescribe a long-acting benzodiazepine after several weeks to replace Xanax. Xanax is often abused because of its immediate effect, so this may reduce the chance of abuse. Many doctors also create a tapering schedule to help individuals wean off of Xanax. This can reduce or even alleviate withdrawal symptoms.

Treatment For Xanax Addiction

Most treatment programs for Xanax addiction begin with medically assisted detoxification. This keeps a person stable as they go through the withdrawal process. Withdrawing from benzodiazepines can be fatal and prevents many people from trying to stop or reduce their Xanax use. With the help of medical professionals, it is possible to safely detoxify.

After detox, an individual suffering from Xanax addiction may work with a therapist to create a treatment plan that meets their needs and goals. This will likely include methods of undoing the long-term effects of Xanax that have damaged their physical and mental health.

Treatments components such as counseling, behavior therapy, yoga, recreation, and nutrition work to heal the whole person. Exploring the root of Xanax abuse and adjusting unhealthy thoughts and behaviors is vital to preventing relapse and moving someone toward recovery.