Withdrawal & Detox from Xanax (Alprazolam) Addiction
This Page was last reviewed and changed on May 21st 2022
Addiction to Xanax is almost always accompanied by a physical and psychological dependence; this makes breaking free very difficult. It is never recommended that you stop taking your medication suddenly as there is a risk of severe withdrawal symptoms. To ensure your complete comfort as well as to lessen the severity of the withdrawal process, it is recommended that you detox in a special facility under the careful supervision of medical staff.
Xanax addiction is as damaging to a person as any other addiction. Likewise, beating Xanax addiction requires withdrawal and complete detoxification. It requires gradually reducing the amount of Xanax being used until there is none remaining in the system. This is the only way the body can begin to heal itself of the damage done by the drug.
You have multiple options for Xanax withdrawal and detox including self-treatment, outpatient care, and professional treatment at a residential rehab centre. You are strongly encouraged to avoid the self-treatment option. It is far safer to be treated by doctors and nurses in one of the other settings. To that end, we are here to help you get started on the road to finding and enrolling in a good treatment programme.
Xanax Withdrawal Syndrome – An Overview
Xanax withdrawal syndrome is a set of symptoms that present themselves when a person using Xanax, or another benzodiazepines, begins reducing the amount of the drug being used. It is considered a syndrome because the symptoms occur together and are associated with the same cause. That said, not every Xanax user experiences the same withdrawal symptoms. They vary from person to person.
Because withdrawal symptoms can occur in various stages, a Xanax user is not considered suffering from Xanax withdrawal syndrome until all the primary symptoms are manifested. At that time, additional symptoms can present themselves, though they do not have to. Xanax withdrawal syndrome can be short-lived or protracted, depending on how the patient’s body responds.
Cases of protracted withdrawal include acute symptoms that are often severe. The danger of protracted withdrawal is that it can be fatal if some of the more severe symptoms are not managed by medical professionals. And even then, protracted withdrawal can produce some symptoms that linger for years after official treatment has concluded.
Xanax withdrawal syndrome is not something to be taken lightly. Symptoms can be mild and very manageable, but this is unlikely. Most Xanax users require professional treatment to get through the darkest hours of withdrawal successfully.
Xanax Withdrawal Symptoms
Symptoms related to Xanax withdrawal are similar to the symptoms caused by other benzodiazepines, like Ativan and Valium. Under a detox scenario, you could expect the symptoms to begin within 6 to 12 hours of your last dose. Withdrawal symptoms will likely manifest themselves rather quickly once they start.
The most common withdrawal symptoms are the following:
It is not possible to say beforehand how severe any one person’s symptoms will be. Xanax users respond differently to withdrawal, so what might be severe for one user could be mild to moderate for another. The one thing we can say is that the most severe withdrawal symptoms are associated with sudden withdrawal. For this reason, Xanax detox at UK rehab centres is done gradually.
Causes of Xanax Withdrawal
The causes of Xanax withdrawal are all traced back to the body having to deal with less of the drug after becoming dependent on it. The Xanax addict has reached a point where his or her body and mind are dependent on having a steady stream of the drug to deal with. Take that steady stream away and the body will naturally react.
As a benzodiazepine, Xanax effects a neurotransmitter in the brain known as GABA. It also affects GABA’s primary receptor. This is what causes the calming and relaxing effects of the drug. In essence, the increased availability of GABA produces a sedative effect that relaxes the mind and body alike. As this is not a normal condition, the brain tries to counteract by triggering increased production of another brain chemical known as glutamate.
Where GABA is one of the most powerful inhibitory chemicals in the brain, glutamate is one of the most powerful excitatory chemicals. The more GABA is made available due to Xanax use, the more the body tries to compensate with glutamate. What was once a balance between the two chemicals now becomes an imbalance because of the introduction of Xanax.
During withdrawal, the imbalance in the two chemicals is that which induces symptoms. Falling levels of Xanax lead to lower levels of GABA, yet it takes the body a while to adapt and produce less glutamate. The excess glutamate that remains in the meantime triggers withdrawal symptoms.
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How Long Do Xanax Withdrawal Symptoms Last?
One of the biggest challenges of treating Xanax addiction is not knowing how long withdrawal symptoms will last. Some other drugs exhibit withdrawal symptoms that are fairly easy to predict. Not so with Xanax. General withdrawal symptoms that do not get too severe can be over in 4 to 5 days. Acute or protracted symptoms can take much longer. In some people they don’t peak for 10 or 15 days, then take another week or two to subside.
There have been cases of protracted benzodiazepine withdrawal syndrome in which symptoms have lasted for months or years. Fortunately, most cases of years-long withdrawal symptoms do not include all the symptoms listed above. You are looking at just one or two of those symptoms while the others subside in a few weeks.
Patients who exhibit only general withdrawal symptoms within the first three or four days are at risk of also exhibiting rebound symptoms. Rebound symptoms are defined as symptoms that Xanax was intended to alleviate. For example, you may have been prescribed Xanax to relieve panic attacks. If you were to suffer rebound symptoms, the feelings of panic you experience would be equal to or greater than the original feelings of panic that the Xanax were prescribed for.
Managing Withdrawal Symptoms
Experts strongly encourage Xanax users to get professional help for detox and withdrawal. This is because managing withdrawal symptoms is not an easy thing to do. Xanax is challenging because of its relatively short half-life, which is about 11 hours or so for most people.
Even when properly managed by doctors and nurses, withdrawal symptoms can be severe. Attempting to manage them yourself may be more than you can handle. It would be a shame for you to try withdrawal on your own, fail because you were unable to manage your symptoms, and go back to using Xanax just as you were before.
In a medically-supervised setting, withdrawal symptoms are managed through the following:
Strategies to make the patient as comfortable as possible.
Contributing Factors to Xanax Withdrawal
Xanax withdrawal is by no means uniform. Ask 10 recovered Xanax users about their experience in detox and they are likely to give you 10 different responses. Why? Because there are a lot of contributing factors that determine individual experience. Here are just a few of them:
Xanax is a drug that produces more severe withdrawal symptoms the longer you use it. Although there are exceptions to the rule, a person having used Xanax for 12 months will tend to have a more difficult time in withdrawal than someone who used it for just three months.
Addiction manifests itself in different ways among various users. Some people develop a more severe addiction more quickly than others. This also contributes to individual experience in withdrawal.
A person’s general health will contribute to his or her experience during detox. The healthier a person is apart from addiction the less severe withdrawal tends to be.
Previous Quit Attempts
Benzodiazepines are somewhat challenging in the withdrawal and detox arena inasmuch as repeated quit attempts tend to make each successive attempt more difficult. The more times you try to quit Xanax, the harder it gets each time.
Family history does play a role in how well a person responds to detox. People with a family history of benzodiazepine misuse tend to be more likely to misuse the drugs themselves and, when they attempt to quit, find it more difficult to do so.
Finally, patients respond to Xanax withdrawal symptoms differently. One patient may find the anxiety unbearable while another quickly descends into depression. There really is no way to know how a person will respond until withdrawal symptoms begin presenting themselves.
Psychological Withdrawal from Xanax
For some people, psychological withdrawal from Xanax is more difficult than physical withdrawal. This makes sense given the fact that the drug alters the way the mind works. Remember, Xanax increases the availability of GABA. This neurotransmitter is one of the most powerful inhibitory chemicals in the brain.
GABA’s function is to reduce brain activity – and it does so very well. That’s why it calms you down, makes you feel relaxed, and relieves stress and anxiety. As such, it has a very definite impact on the psyche. We would expect psychological withdrawal to be difficult for people already struggling with depression, anxiety, and other similar conditions.
Clinics can address psychological withdrawal in one of two ways. The first is through prescription medications; the second is through psychotherapeutic intervention. Many clinics in the UK utilise both for Xanax withdrawal.
Also note that psychological withdrawal often takes longer than the time allotted for detox. That’s why Xanax detox is followed by several weeks of rehabilitative therapy. During rehab, therapists utilise a variety of treatments to help patients overcome that psychological dependence.
There have been cases of Xanax patients still suffering some of the symptoms of psychological dependence even after rehab is complete. Although rare, such patients need ongoing psychotherapy to prevent relapse. It is yet another aspect of Xanax use that makes the drug so problematic.
Physical Withdrawal from Xanax
The physical withdrawal from Xanax is what produces most of the symptoms talked about earlier in this guide. Physical withdrawal is a direct result of the body having to get used to not having its expected level of Xanax in the system. Physical withdrawal is also a result of physical dependence.
A person dependent on Xanax finds it difficult to function if the drug is not taken on a regular basis. This is due to the body’s natural ability to adapt. If you have taken Xanax for more than 4 to 6 weeks, your body has already learned how to adapt to having the chemical in your system. You may even find you need to take more for the drug to keep working. Now you have entered the arena of tolerance.
If you take the Xanax away, your body is now left having to compensate for something that is not there. This causes a conflict, which presents itself as physical withdrawal. Your body will adapt once again, but it takes time. Your withdrawal symptoms will only fully subside once your body has adapted itself to once again not depending on Xanax.
If you are a Xanax user, ask yourself this question: do I suffer even mild withdrawal symptoms between doses? If your answer is ‘yes’, then your body has already developed some level of dependence. Now is the time to seek professional help. Continuing to use Xanax this way will only increase your dependence on the drug. The longer you use, the more difficult it will be to eventually stop using.
Substance Use Disorders and Detoxification
We want you to know that the need for detoxification is not limited only to Xanax and Ativan. Detox is nearly universal to all substance use disorders for one simple reason: being fully ‘cured’ from a substance use disorder is only accomplished when you stop using. And once you stop using, detox occurs all by itself.
We tend to think of detox as a bad thing given how uncomfortable and potentially dangerous it can be. But when you look at from the perspective of regaining and maintaining your overall health, detox is actually a good thing. The word itself denotes something positive.
To detoxify is to remove toxic substances. Xanax certainly qualifies as one of those substances. Furthermore, long-term Xanax use is more destructive than helpful, so detoxing from this dangerous drug is also a positive thing. Hopefully, you see it that way.
On the outside chance that you are suffering from some other substance use disorder even though you’re reading a guide relating to Xanax, please know that detox and withdrawal are equally important for you. Overcoming whatever substance you are misusing starts here. Without detox and withdrawal, your body will never be free of the substances that are now controlling it.
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Xanax detox can be conducted at home, in an outpatient clinic, or at a residential rehab centre. We agree with experts who strongly caution against attempting to detox at home. Why? Because the withdrawal symptoms associated with detox can be potentially life-threatening if not properly managed. The risk is too great to try this alone.
Should you decide to try to detox at home anyway, please do not do so in isolation. Ask a family member or friend to stay with you until all your symptoms subside. You are going to need someone on hand to help you deal with the panic attacks, anxiety, and physical discomfort. You definitely want someone there to call emergency services should a life-threatening situation arise.
Detoxing in an outpatient setting is medically supervised and assisted. Doctors, nurses, and therapists work together to devise a treatment plan that is then implemented under the watchful care of the entire treatment team. Patient health is also monitored throughout, allowing for quick intervention in the event of an emergency.
By far the best option is detoxing in a residential rehab centre. The residential environment involves around-the-clock care from start to finish. Detox at a residential clinic is also medically supervised and assisted. Moreover, patients are treated by medical professionals whose only focus is detox and rehab.
In a residential setting, the patient’s every need is taken care of. Patients are fed, housed, and made comfortable throughout. They are constantly monitored for possible complications. And should any complications actually rise, medical personnel are always on hand to deal with them.
How to Detox Safely?
Over the years, medical science has determined that the safest way to detox from Xanax is to do so gradually. Though it is possible to quit cold turkey, doing so is dangerous. The drugs relatively short half-life means the onset of withdrawal symptoms can be sudden and severe and, as a result, life-threatening.
The gradual approach to detox is one that starts with a maintenance dose of Xanax or a substitute drug that is then gradually tapered over time. How gradually tapering is depends on a variety of factors including the patient’s overall health and his or her response as measured by withdrawal symptoms.
The tapering approach to withdrawal is sometimes referred to as ‘medically assisted’ withdrawal. The term is applied because doctors, nurses and therapists utilise medical interventions based on the disease model of addiction. If you were to try detox and withdrawal by joining a local support group and participating in 12-step work, your quit attempt would not be medically assisted regardless of the earnestness of your desire.
If there is any downside to the gradual approach it is the fact that withdrawal can take a lot longer for some people. But compared to the potential risks of quitting cold turkey, it’s better to take a few weeks to withdraw safely than attempt to withdraw in 4 to 5 days and potentially reap devastating consequences.
Withdrawal Timeline and Length of Detoxification
Differences in the way people react make it impossible to offer a black-and-white timeline for Xanax withdrawal. There are some general guidelines that seem to work well for most cases, though. This is what the average patient could expect:
General symptoms begin occurring within 6 to 12 hours of the patient’s last full dose.
General symptoms continue for one to four days, gradually intensifying over time.
Acute symptoms also begin appearing during this time; they may peak anywhere between days 10 and 15.
Following peak, acute withdrawal symptoms gradually begin to subside.
Most withdrawal symptoms are completely subsided at the 15-to-21-day mark.
Some symptoms, like cravings, can continue for weeks or months.
There are cases of protracted withdrawal symptoms that continue for months or years. This is why psychotherapeutic rehab following detox is so vitally important. Mental health professionals use the rehab period to address these lingering withdrawal symptoms. Indeed, rehab could mean the difference between long-term abstinence and relapse.
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Xanax Detox Protocol
In medical terminology, a protocol is a set of rules or guidelines clearly defining how a given condition should be treated. Medical science has come up with a well-defined detox protocol for Xanax and other benzodiazepines. That protocol begins with a complete physical and psychological evaluation.
Patients are evaluated in order to determine the severity of their addictions, any underlying conditions that may need to be treated, their overall health, and a number of other circumstances that may impact withdrawal. Doctors are also on the lookout for co-occurring disorders like depression and clinical anxiety. Co-occurring disorders can make withdrawal more difficult to treat.
Xanax detox protocol also dictates accommodating patients in an area separate from those patients that have already completed withdrawal. Attempting to treat them together could have a detrimental effect on both. Patients in detox are integrated into the larger group once withdrawal is complete.
The written detox protocol then goes on to list various symptoms and behaviours and how they should be addressed. For example, if a patient grows angry or aggressive, the protocol dictates that caregivers remain calm and reassuring, listen to what the patient has to say, acknowledge the patient’s feelings, and avoid challenging the patient.
Having a defined protocol makes treating Xanax patients easier. It also makes withdrawing from Xanax easier inasmuch as caregivers know what to do to ensure the safety and welfare of the patient without making matters worse.
Medical Detox for Xanax Use
Undergoing detox at an outpatient or inpatient clinic gives a person the opportunity to withdraw with medical assistance. We call this ‘medical detox’. Unlike attempting to quit at home, going through withdrawal at the clinic gives you access to all the tools you need to succeed.
As you already know, medical detox begins with a complete physical and psychological evaluation. The withdrawal itself is facilitated through a gradual tapering using prescription medications. Throughout withdrawal, over-the-counter medications are used to address some of the more uncomfortable symptoms.
Aside from what doctors and nurses are doing, therapists are also on hand to provide psychotherapeutic treatments. These treatments are every bit as medical as the use of prescription and OTC drugs. In short, the entire treatment team utilises medically-proven treatments to bring the patient through withdrawal safely and effectively. The patient can then progress to rehabilitative therapy.
Xanax Detox Medications
Rehab clinics are known to use a number of different medications to facilitate a better withdrawal from Xanax. Right off the top, a doctor may turn to other benzodiazepines with a longer half-life than Xanax. Diazepam (Valium) immediately comes to mind. There are other benzodiazepines at a doctor’s disposal as well.
The idea behind using longer-acting benzodiazepines is to make withdrawal easier by lengthening the effects of the drug. In theory, this reduces the severity of withdrawal symptoms between doses. This sort of therapy works well for some patients but not as well for others.
Some doctors prefer to steer clear of benzodiazepines so as to not complicate matters. They might choose SSRI antidepressants instead. Some of these medications can mimic the effects of Xanax while still allowing the body to gradually withdraw. They can be remarkably effective in addressing anxiety and depression as well.
Medications generally used to treat insomnia might also be used. Examples include Ambien, Lunesta, and Sonata. These medications may not help some patients who are having an especially challenging time with panic attacks or anxiety. Furthermore, they can complicate matters if withdrawal takes too long. Patients can come out the other end not being able to sleep without the additional medication.
Another option is an anti-seizure medication like carbamazepine. This is a drug that is often used to treat epilepsy. However, it is also a good medication for bipolar disorder because of its ability to control a person’s mood. Some people find that it helps in controlling some of the psychological symptoms of Xanax withdrawal.
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Gradual Dose Reduction for Xanax Withdrawal
Xanax is one drug you do not want to try to quit cold turkey. The risks associated with quitting that way are just too high. Therefore, doctors prefer gradual dose reduction. Also known as tapering, doctors have a couple of choices to work with.
Direct tapering calls for using Xanax itself. The doctor will assess how much Xanax is currently being used by the patient at the start of withdrawal, then prescribe a maintenance dose accordingly. From there he or she will gradually taper the amount of Xanax being administered and track the withdrawal symptoms that follow. The doctor will continually reduce the dosage until no more is being given.
The second option is something known as substitute tapering. This is an option for patients at risk of showing especially severe withdrawal symptoms. In order to make substitute tapering work, the doctor must first decide on what drug will be used in place of Xanax.
A common choice is diazepam (Valium). Both Xanax and diazepam are benzodiazepines, but diazepam has a much longer half-life. This means that the effects of the drug last longer than Xanax. Here’s what would happen in a substitute tapering scenario with diazepam as the substitute drug:
The doctor would first determine how much diazepam is necessary to equal the amount of Xanax being used.
The doctor would then gradually increase diazepam while decreasing Xanax commensurately.
Once the patient is receiving no more Xanax, the tapering process can begin.
Lower doses of diazepam are gradually given until no more of the drug is being administered.
Both kinds of tapering have their advantages and disadvantages. It is up to the doctor to determine which modality is appropriate for the individual patient. Substitute tapering tends to be a bit more challenging because it can be difficult to find the right balance between the substitute drug and what would otherwise be a maintenance dose of Xanax.
Psychological Interventions for Xanax Withdrawal
There are some drugs for which psychological intervention is reserved until after detox is complete. Xanax is not one of them. Xanax has such a profound effect on both the thoughts and emotions that many recovering addicts find it exceedingly difficult to get through withdrawal without some sort of psychological intervention.
Note that psychological interventions for Xanax withdrawal are observed in many different forms. Doctors and nurses are trained in how to interact with Xanax patients by addressing them calmly, speaking to them rationally, and reassuring them as they go through withdrawal. Although such interactions are not formal psychotherapy, they are psychological interventions nonetheless.
Therapists are also on hand to provide psychological intervention. They use more standardised treatments, like cognitive behavioural therapy (CBT). The treatments often end up being very important to the patient’s recovery. You will not get these treatments at home, which is yet another reason we recommend seeking Xanax withdrawal and detox in a residential clinic.
Psychological interventions are especially important in cases of acute withdrawal symptoms. Acute withdrawal can produce more pronounced feelings of panic, anxiety, and agitation. It can result in hallucinations and suicidal thoughts. And when acute withdrawal becomes protracted, things get even more serious. Psychological interventions are key to stabilizing patients even under the most stressful circumstances.
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Pharmacological Interventions for Xanax Withdrawal
Pharmacological interventions are those interventions that utilise medications. We have already discussed prescription medications like other benzodiazepines, SSRI antidepressants, and anti-seizure medications. Whenever one of these drugs is used during withdrawal, it is to ease the severity of withdrawal symptoms so as to mitigate the danger of withdrawal.
The goal of pharmacological intervention is never to transfer a person’s Xanax addiction to another drug. The goal is to eventually wean the person so that no substances are being used at all. As such, doctors have to be very circumspect about the prescription medications they utilise.
Beyond prescriptions, pharmacological interventions also include over-the-counter medications. A nurse might administer an analgesic to address headaches. Another patient might be given an over-the-counter drug to counteract nausea and vomiting. Still another might need a mild sleeping pill to combat chronic insomnia.
The point of using these over-the-counter medications is to make the patient more comfortable during withdrawal. The more comfortable a patient is, the less stressful withdrawal will be. More comfort and less stress equal a greater chance of completing withdrawal successfully.
Possible Complications from Xanax Withdrawal
Every detox and withdrawal scenario carries with it certain risks. Complications can always occur. Xanax withdrawal is no different.
Doctors and nurses always have to be on the lookout for signs of the following potential complications:
Heart Palpitations – A common side effect of Xanax withdrawal is increased heart rate and respiration. The increased heart rate can lead to palpitations, which can later lead to cardiac arrest. Therefore, medical personnel constantly monitor the patient’s heart rate throughout the entire withdrawal process.
Seizures – Although rare compared to the number of people who undergo Xanax withdrawal, seizures do occur from time to time. They can range anywhere from the mild to serious, lasting from a few minutes to 10 minutes or longer. The biggest dangers associated with seizures are respiratory arrest, cardiac arrest, and accidental injuries.
Hallucinations – There is always a chance during Xanax withdrawal that a person will develop hallucinations. These hallucinations are almost always visual, but they can be auditory or tactile in rare cases. Hallucinations can be dangerous in that they can prompt people to behave in dangerous ways.
Psychosis – Xanax withdrawal always carries with it the risk of psychosis. Medical science defines psychosis as the inability of a person to think rationally. Xanax-related psychosis can last anywhere from a couple of days to years.
Suicidal Thoughts – Doctors and nurses are especially concerned when patients develop suicidal thoughts during withdrawal. This is a serious complication for obvious reasons.
Cognitive Decline – Lastly is cognitive decline. Xanax can decrease cognitive ability by itself, but any loss in such ability can be exacerbated during the withdrawal process.
Does the risk of complication justify not trying to kick a Xanax habit? No. Consider this: all the complications associated with Xanax withdrawal can also be experienced by the patient who continues to use the drug. In short, you are just as much at risk if you keep using Xanax – and maybe even more so. The drug could even kill you.
Xanax Addiction Treatment and Rehab
Xanax addiction treatment and rehab are available throughout the UK at outpatient and residential clinics. We are here to help you access it. Please contact UKAT on our 24-hour helpline if you or someone you love is struggling with Xanax. We are here to help you figure things out and connect you with the appropriate treatment facility.
Frequently Asked Questions
How much Xanax causes withdrawal?
Xanax withdrawal is not necessarily dependent on the amount of the drug a person has used. While it is true that long-term use of higher doses can make for a more difficult withdrawal, a person can become addicted to the drug even in small doses if taken long enough. Any addiction will produce withdrawal once the addict stops using.
Can Xanax withdrawal kill you?
Though we do not like to talk about it, Xanax withdrawal can absolutely kill you. You can experience acute withdrawal symptoms that become protracted symptoms over time. These can include increased heart rate, seizures, and suicidal thoughts – all of which can be fatal.
What helps Xanax withdrawal?
There are three things detox clinics use to help patients get through Xanax withdrawal. These are prescription medications, over-the-counter medications, and psychological interventions. A gradual approach to withdrawal is also a tremendous help.
When Does Xanax withdrawal start?
The average user begins seeing early onset symptoms within 6 to 12 hours of the most recent dose of Xanax. Some patients may show symptoms earlier; others may hold out longer.
Why does Xanax withdrawal cause seizures?
Where GABA is one of the most powerful inhibitory chemicals in the brain, glutamate is just the opposite. It excites the brain. Seizures during withdrawal are caused by a combination of too little GABA and too much glutamate. The brain is overly stimulated, and seizures occur as a result.
How do you detox Xanax from your body?
Experts say the safest way to detox from Xanax is to gradually reduce the amount of the drug being used. A 10-to-15-day withdrawal schedule sems to be the preference among doctors.
What can I expect from Xanax withdrawal?
Xanax withdrawal is likely to be an endurance event. You can expect to be uncomfortable, tired, and lethargic. Expect withdrawal symptoms to begin peaking anywhere from day 5 to day 15, gradually subsiding thereafter. Finally, remember that one or two withdrawal symptoms may linger for months or even years afterward.