Alprazolam Addiction: Signs, Risk Factors, and Treatment

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Alprazolam (Xanax) is a prescription anti-anxiety medication used to treat anxiety, panic disorders, and other related mood disorders. The medicine is in the benzodiazepine class of drugs. Benzodiazepines enhance the impact of a neurotransmitter in the brain, called gamma-aminobutyric acid (GABA). GABA reduces specific brain nerve-impulse transmissions, acting as a sedative by slowing down the central nervous system (CNS).1,2 Misusing an addictive substance, such as alprazolam, can cause you to develop substance use disorder (SUD). Alprazolam addiction can negatively affect your mental and physical health, and it can be difficult to break the cycle of compulsive alprazolam abuse without professional treatment.

Alprazolam Addiction Symptoms and Signs

When used as directed by a health care provider, alprazolam can help alleviate excessive anxiety, panic, or other mental health symptoms.3 However, some people may attempt to misuse alprazolam to become intoxicated.4

Some signs that your loved one may be misusing alprazolam may include:3

  • Headaches
  • Fatigue, sleepiness
  • Dizziness
  • Irritability
  • Poor concentration
  • Change in sexual functioning
  • Urinary problems
  • Joint pains
  • Changes in weight
  • Constipation
  • Nausea

The severe side effects of alprazolam use include:3

  • Difficulty keeping your balance
  • Challenges with coordination in movement
  • Speech problems
  • Confusion
  • Hallucinations
  • Elevated liver enzymes
  • Yellow appearance to your eyes or skin (i.e., jaundice)
  • Shortness of breath
  • Skin rash
  • Seizures

If you notice your friend or family member experiencing some of these effects, they may be struggling with alprazolam abuse or alprazolam addiction. Knowing where to turn next can be confusing and overwhelming, but we can help. Give us a call at 800-681-1058 (Info iconWho Answers?) to speak to a compassionate treatment support specialist about rehab options.

Alprazolam Addiction Diagnostic Criteria

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) classifies an alprazolam addiction as sedative, hypnotic, or anxiolytic use disorder.2 In order for you to be diagnosed with a Xanax addiction, you must demonstrate at least two of the following signs within the past year:2

  • Using higher or more frequent alprazolam doses than you intended
  • Struggling to stop using or cut back on the amount of alprazolam you use
  • Spending a significant amount of time obtaining, using, or recovering from alprazolam use
  • Continuing to use alprazolam despite adverse mental and physical health effects
  • Experiencing relationship problems due to alprazolam use
  • Giving up hobbies, responsibilities, or activities to use alprazolam
  • Finding it challenging to meet school or work tasks due to alprazolam use
  • Having intense cravings or urges to use alprazolam
  • Using alprazolam in physically dangerous situations, such as while driving
  • Needing higher doses to achieve the desired effects (tolerance)
  • Experiencing alprazolam withdrawal symptoms when you suddenly reduce or stop use

Additionally, someone struggling with problematic alprazolam abuse may engage in a behavior known as “doctor shopping,” in which they attempt to get several alprazolam prescriptions from various healthcare providers.

Alprazolam Tolerance, Dependence, and Withdrawal

You can develop alprazolam tolerance, particularly when taking the medication for a long time.1,2 Tolerance happens when your body becomes used to the effects of a substance.2 It can result in needing a higher dose of the medication to achieve the desired effect. This can be dangerous as it may increase the risk of alprazolam overdose.

Dependence can develop even when taking alprazolam as prescribed. However, misusing alprazolam can significantly increase the speed and severity of physiological dependence. When you become dependent on this medication, you may experience symptoms of withdrawal when you suddenly quit or reduce alprazolam use.

Symptoms of alprazolam withdrawal may include:3

  • Poor concentration
  • Difficulty sleeping
  • Anxiety
  • Problems with memory
  • Twitching, shaking, or other unusual movements
  • Prickling or burning sensations in extremities
  • Hallucinations
  • Suicidal or homicidal thoughts
  • Dissociation, or feeling disconnected from reality

Health care providers guide people in alprazolam withdrawal through a tapering-off process. Tapering-off means you gradually reduce the amount of alprazolam you take. The tapering process can help people who use this medication for medical reasons to manage potential symptoms of withdrawal. When withdrawal symptoms are severe, medical detox is often required for the body to safely rid itself of this benzodiazepine.

Alprazolam Addiction: Who is at Risk?

Certain factors can place a person at a higher risk of developing an alprazolam addiction.2 For example, a history of alcohol or other types of substance abuse can raise one’s risk of misusing alprazolam. Commonly, teens or adults in their early twenties use this medication socially for its euphoric effects.1 Infrequent use may progress into a more frequent pattern of misuse.

Some people use alprazolam to counter the unwanted effects of other addictive substances, such as central nervous system (CNS) stimulants like cocaine or methamphetamine.1 Other people may misuse alprazolam to potentiate the impact of different drugs to produce a more intense high.

Combining addictive drugs or alcohol with alprazolam can raise your risk of addiction.2 A polydrug use pattern can increase your risk of developing potentially hazardous or life-threatening health problems as well.

Other risk factors for alprazolam use may include:5

  • Poor parental monitoring in childhood
  • Family history of drug and alcohol use
  • Parental substance use
  • Mental health disorders, such as depression, anxiety, or bipolar disorder
  • Childhood sexual abuse
  • Family rejection of gender identity or sexual orientation

Alprazolam Addiction Treatment


Often, the first step on the continuum of care for alprazolam addiction is withdrawal management or detox. Alprazolam detox constitutes a series of medical interventions to safely clear alprazolam and any other substances from your system.4

Withdrawal management can take place in several settings depending on the severity of alprazolam withdrawal symptoms.4 For more severe symptoms, residential facilities or inpatient hospitalization can offer support and comfort through the withdrawal process, as well as medications and 24/7 oversight in the event of a medical emergency. People with mild Xanax withdrawal symptoms may find that some outpatient treatment facilities can manage their needs, providing regular assessments by medical professionals.

Regardless of the type of detox facility you choose, once you complete alprazolam detox and achieve a medically-stable, substance-free state, you’ll want to transition into a rehab program where you can learn coping strategies, drug refusal skills, stress management, and other strategies to help you obtain and maintain sobriety in the long run.

Inpatient and Outpatient Alprazolam Addiction Treatment

Treatment does not end at detox or withdrawal management. Rather, in order to create lasting changes, such as quitting alprazolam use, you’ll need to enter a form alprazolam addiction treatment program. Rehab occurs in one of two main settings: inpatient and outpatient.

Inpatient treatment involves living at the center for the length of the program, which may last from 30 to 90 days, sometimes longer. It is the most structured and intensive treatment setting and is a great option for people who:

  • Have a severe alprazolam addiction
  • Have a polydrug addiction
  • Have a co-occurring mental health condition, known as a dual diagnosis
  • Have previously dropped out of outpatient
  • Don’t have a sober support system at home
  • Don’t have reliable transportation to an outpatient clinic

Conversely, outpatient treatment allows for more flexibility with scheduling since you continue living at home while attending treatment at a facility during the day. These programs range in time commitment from just a few hours per week to several hours per day (partial hospitalization or intensive outpatient).

While every treatment program is going to have different rules, routines, and philosophies, most alprazolam addiction treatment programs include therapeutic services, such as:

  • Family therapy
  • Group counseling
  • Psychotherapy
  • Behavioral therapy
  • Medication management
  • Skills training
  • Mutual support groups
  • Relapse prevention planning

An assessment and accurate diagnosis can help you get matched with the right level of care.4 While some people may need the structure of inpatient or residential treatment, others may thrive in an intensive outpatient program. Treatment professionals can help you get connected with the program that works best for you.

Reaching out for help may seem overwhelming. Fortunately, specialists can help. Call 800-681-1058 (Info iconWho Answers?) to speak with a treatment specialist about your choices in alprazolam use recovery.


  1. Longo, Lance P, and Brian Johnson. (2000, April 07) Addiction: Part I. Benzodiazepines–Side Effects, Abuse Risk and Alternatives. American Family Physician, vol. 61, no. 7, pp. 2121–2128.
  2. American Psychiatric Association. (2013). Substance-related and addictive disorders. Diagnostic and statistical manual of mental disorders (5th).
  3. U.S. National Library of Medicine. (2021, May 15). Alprazolam. MedlinePlus.
  4. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A review of alprazolam use, misuse, and Journal of Addiction Medicine, 12(1), 4–10.
  5. Centers for Disease Control and Prevention. (2020). High-Risk Substance Use Among Youth.
  6. Miller, W. R., Forcehimes, A. A., & Zweben, A. (2019). Treating addiction: A guide for professionals 2nd The Guilford Press.
Ruben Bermea, LPC
Licensed Professional Counselor, Author
Ruben Bermea, LPC, is a Licensed Professional Counselor who has had the privilege of serving Texans as they navigate personal and mental health challenges. Ruben has provided therapy to clients in inpatient, residential, private practice, and community mental health settings. His personal and professional interests include the intersection between technology and mental health, the impact of misinf