Xanax is a common commercial form of alprazolam, a sedative medication that belongs to a class of drugs called benzodiazepines. Like other drugs in this class, it achieves its calming effects by altering the way your body uses a naturally occurring chemical known as GABA (gamma aminobutyric acid). Xanax is the most frequently prescribed mental health medication in the U.S., and in 2011 doctors issued prescriptions for the drug almost 50 million times. For a number of reasons, some mental health professionals and outside observers have started questioning the frequency with which doctors prescribe Xanax for their patients.
Basic Effects of Xanax
Inside your brain and spinal cord (known collectively as your central nervous system), GABA helps regulate the amount of activity between individual nerve cells or neurons. When activity rises above a certain normal rate, GABA levels increase and effectively “cool down” your central nervous system by slowing down neuron communication. Xanax and other benzodiazepines cause sedation by intensifying GABA’s effects on your neurons. In addition, all drugs in this class reduce anxiety, relax your muscles, make you sleepy and reduce or eliminate seizure activity. Doctors commonly prescribe Xanax for the treatment of anxiety disorders or a condition called panic disorder. When you take this medication, its effects can take hold in as little as 10 to 15 minutes. Compared to other benzodiazepines, Xanax has a relatively short window of activity and typically leaves your system in anywhere from approximately six to 20 hours.
Potential Xanax-Related Problems
Over time, your brain will try to reduce its natural level of GABA production in an attempt to offset the effects triggered by Xanax or other benzodiazepines. If you stop taking Xanax, it will take some time for your brain to reverse this process and return its GABA production to normal. In the interim, lack of the medication will produce withdrawal symptoms that can include seizures, intense headaches, diarrhea and nausea. These same symptoms can also appear in people who lower their Xanax intake, rather than eliminating their intake entirely.
Doctors try to offset any potential withdrawal-related problems by gradually weaning their patients from Xanax usage. However, withdrawal symptoms associated with the medication are severe enough that some people consciously seek to avoid them, and continue their current level of usage or increase their intake, even when their doctors tell them to cut back. This pattern of behavior can lead to a chemical dependence on Xanax, or even a full-blown addiction. Risks for these problems are heightened by Xanax’s relatively brief window of chemical activity, which can easily encourage overuse in patients trying to maintain a certain level of sedation.
Despite the known potential for Xanax dependence or addiction, doctors sometimes do several things that can increase their patients’ danger levels. First, since the drug is both cheap for patients and highly effective in treating anxiety and panic disorders, doctors prescribe Xanax much more frequently than they prescribe other types of benzodiazepines. In addition, many doctors prescribe the drug for extended periods of time; this sort of long-term use is known to increase risks for dependence and other withdrawal-related problems. Some doctors also unscrupulously or inadvertently prescribe Xanax in combination with other benzodiazepine medications such as Clonazepam, Valium or Ativan; simultaneous use of more than one of these drugs can trigger severe or fatal consequences by seriously depressing normal function in the central nervous system.
Overprescription may also result, in part, from changing perceptions in the larger culture about the nature of anxiety. Anxiety disorders are defined in the U.S. by an organization called the American Psychiatric Association, and doctors who follow these established definitions typically strictly limit the circumstances in which they will issue prescriptions for Xanax or other benzodiazepines. However, in their daily practices, some doctors don’t clearly differentiate cases of anxiety disorder from “functional anxiety,” a general feeling of worry or unease that commonly occurs in our high-speed, high-stress modern society. For a variety of reasons, these doctors make the decision to treat functional anxiety with Xanax or a similar medication, rather than choosing more conservative treatment options.
According to the Canadian Women’s Health Network, women have particularly high risks for benzodiazepine overprescription. In addition to prescribing these medications more frequently for women than for men who have the same basic symptoms, doctors also sometimes prescribe Xanax or other benzodiazepines for normal women’s life events such as menopause and childbirth. In many cases, women also remain on these drugs for longer periods of time than men.