How much xanax to sleep?

This Is Your Body on Xanax

From teen dealers selling counterfeit Xanax bars on social media to addicted college kids using the benzos to help with panic attacks or comedowns, VICE UK is investigating the rise of Britain’s counterfeit Xanax use. Read more features in this series here and watch our new film about mental health and fake Xanax, ‘Xanxiety in the UK,’ here.

The effects kick in after around 20 minutes. You’ll start to feel relaxed, maybe a bit sleepy. Depending on how much you’ve taken, you might notice changes in your perception. A bit of visual fuzziness, maybe. The effects peak around an hour later. With higher doses, you might have problems with coordination. If you’ve taken a lot, you might blackout. While you’ll still be able to function, your memory will be completely blank.

If you’ve ever taken Xanax, you know this already. But what’s actually going on inside your brain while all this is happening?

Xanax is a brand name for alprazolam, one of a group of drugs known as benzodiazepines, or benzos, which are typically prescribed for anxiety. Like all drugs taken orally, it’s absorbed into the body through the stomach, passing through the mucous membrane and entering the liver. From there, it enters the bloodstream and works its way toward your brain. The drug then passes through the blood-brain barrier, a membrane that filters out dangerous substances. Benzodiazepines, like other drugs, are able to pass through this barrier.

It’s in the brain where things get interesting. Benzodiazepines work on parts of the brain known as GABA-A receptors. Think of receptors like switches—with different switches responsible for producing different effects. GABA-A receptors are responsible for producing sedative effects. These receptors have to be switched on by neurotransmitters, which are chemicals used to carry messages around the brain. GABA-A receptors are switched on by the GABA neurotransmitter. Val Curran, professor of psychopharmacology at UCL, describes the GABA neurotransmitter as “sort of like the brakes on the brain. It calms everything down.”

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Benzodiazepines are agonists, meaning they amplify the GABA-A receptors’ effects. Other drugs, such as alcohol and sleeping pills, work in the same way, albeit with different effects. They do this by attaching themselves to the GABA-A receptors and increasing the effectiveness of the GABA neurotransmitter. So, when you take a drug like Xanax, the switch (or receptor) is flicked on to full power. GABA-A receptors are concentrated in an area of the brain known as the hippocampus, which is important for memory, and is believed to be the reason why these drugs can cause blackouts.

When prescribed by a doctor, Xanax is typically intended to treat anxiety, which can be caused by an imbalance of chemicals in the brain. In those cases, Xanax is used to correct the imbalance. That experience can be very different from that of a recreational user.

Dr. Cathy Montgomery, reader in psychopharmacology at Liverpool John Moores University, says: “If somebody’s experiencing high levels of anxiety, they have an increase in chemicals like adrenaline, which would normally make you feel more alert and awake, and a deficiency in GABA. High levels of adrenaline and low levels of GABA have a double impact of increased excitation in the brain, which people experience as anxiety. When they take Xanax, they won’t necessarily get the same type of heavy sedative effect.”

Of course, if you’re taking Xanax recreationally, a heavy sedative effect might be just what you’re after. And because you don’t have a chemical imbalance to start with, that’s just what you’ll get. Effectively, you’re creating an imbalance in the brain—the same kind of imbalance Xanax is prescribed to correct—just in the other direction. (All this without considering the fact that in the UK, Xanax is not prescribed, except privately, and black market Xanax can contain whatever active ingredients the person making it wants, as Pfizer pointed out in their statement to VICE.)

Broadly speaking, your body will try its best to maintain equilibrium in the brain. “Whatever you take, your brain will try to regulate it. It may release adrenaline to try and combat this,” says Montgomery. While you’re on Xanax, this won’t be noticeable because the drug is powerful enough to overcome your brain’s efforts to rebalance things. “When you’re taking the substance, you have enough GABA being released to prevent you from experiencing anxiety,” says Montgomery.

Xanax takes several days to leave the body completely. But the noticeable effects will wear off after a few hours. The drug first detaches itself from the GABA-A receptors in your brain and is broken down by enzymes and the liver, then eventually excreted from the body.

It’s the point at which the drug detaches from your brain’s receptors that potential problems start to arise. The sedative effects will start to wear off, but your brain is still trying to maintain its equilibrium. That can lead to a fairly horrible comedown. “It’s really the flip side of why you’re taking it,” says Montgomery. “You get a sudden increase in brain activity, which could make you feel quite anxious. You can start to feel quite agitated, insomnia—some people experience fearfulness.”

Those feelings are part of the reason why Xanax users can build up a dependency on the drug so quickly—and if they didn’t have problems with anxiety before, they may now. Montgomery says: “For regular recreational users, the reason they might keep taking it is for withdrawal symptoms that would be characterized as dysphoria. That then perpetuates use. You are then taking it to self-medicate.”

Tolerance to the anti-anxiety effects of Xanax tend to build up quite slowly, but users chasing its sedative effects can start to need higher doses within just a few days. Dr. Tony O’Neill, clinical senior lecturer in psychiatry at Queen’s University Belfast, says: “Benzodiazepines are supposed to be prescribed for a short time. The problem is you need to use larger and larger doses to have the same effect.” Recreational users, who may take the drug in large doses for sustained periods of time, can store up significant withdrawal symptoms. “Those can be horrendous,” says O’Neill. Potential symptoms include insomnia, anxiety, panic attacks, and nausea. Stopping suddenly has been known to cause seizures.

If you are going to take a drug such as Xanax, it’s important to know that repeated use can lead to withdrawal symptoms in a very short amount of time. Curran says: “I would always recommend people not to take a benzodiazepine more than three days in a row, whether it’s prescribed or not.” However, as with all drugs, the only way to avoid risks is to not take it at all. One of the most significant dangers of Xanax is that studies have tended to focus on use in prescribed doses. As for recreational use, as Montgomery says: “A lot of the answers, we don’t really know.”
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So, you’re taking Xanax for the first time. This is what you need to know

It gets you waved

The effects of taking Xanax run from the mildly wavy to the completely incapacitating. One student we’ve spoken to, James, describes the effects of Xanax as: “It makes people feel like they are living in a dream-like state not understanding the reality around them. It makes you lose touch with yourself and the people around you.”

#tattoo #xanaxplease

A post shared by Joel Rowe (@i_am_a_robot_dont_add_me_haha) on Apr 11, 2018 at 6:39am PDT

For insomnia, or getting to sleep, Xanax isn’t the best choice. Although it can be useful as a one-off, the quick tolerance build-up means increased doses are needed. There are more effective treatments for a sleep disorder, says Dr Durrani: “If you’ve got a chronic problem you should go and see a doctor, and look at alternatives like antidepressants, SSRIs and others that have a better and more lasting effect on insomnia.”

Xanax come in different varieties, with their strength in mg usually pressed onto them, such as the ‘2’ on the typical white bar. Again, unless this is prescribed, it’s difficult to know if this is accurate.

“Usually people take 0.25mg or 0.5mg or 1mg and that gives the desired effect,” says Dr Durrani, however the effect varies based on age, weight, dosage, and what else you’ve taken alongside it, as well as the quality of the Xanax.

Go slowly when taking it

Alongside the more obvious not knowing what you’re taking, there are other reasons to be cautious with how much Xanax you take.

The first is that the effects take hold fast. Xanax is one of the more potent benzodiazepines, and kicks in quickly. “Because of that high potency, and because of that short half-life, it has an immediate effect, like you would have with alcohol or opiates,” says Dr Durrani.

Second is that a bigger dose, taken frequently, can lead to an addiction that happens quicker and more severely. With an increased dose, says Dr Durrani, “the potential for harm is more, but the potential for dependence is also increased.”

Avoid mixing it with alcohol or other drugs

Combining Xanax with alcohol is common and produces more of wave. However, mixing the two can be dangerous.

Whilst there is an increased effect, this combination “can also lead to serious physical complications including death from overdose,” says Dr Durrani.

Xandy bo bandy is back

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Taking any benzo on its own reduces the risk, and Dr Durrani says that “it’s very rare, even in overdose, to see somebody dying from it.”

Yet mixing is dangerous, and “if taken in combination with alcohol or with opiates, the potential for it to cause respiratory arrest or cardiac arrest, or for that matter death, multiplies manyfold. When you see a death from alcohol or benzodiazepine overdose, when you look at it they’ve usually taken other drugs with it.”

Signs of Xanax overdose include blurred vision, slurred speech, weakness, respiratory depression, and coma.

Addiction and withdrawal happen quicker than you expect

Xanax withdrawal doesn’t just affect those with a fully-fledged addiction. “Inter-dose withdrawal” can happen when a dose wears off, bringing back heightened anxiety symptoms.

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An addiction can build up quickly, says Dr Durrani: “You may develop a dependence when using a small dose for a few weeks, but with a higher dose you can develop the withdrawal symptoms much quicker.”

These symptoms are notoriously unpleasant. One Reddit user, wunderbez, recounts his experiences: “Withdrawals were horrible. My teeth felt like they were turning in their sockets, sensitive to smell, touch, taste etc. Manic thoughts. Suicidal thoughts. Addictive behaviour. (obsessing over empty xanax bottles and counting valiums religiously.) Plus lots of other problems.”

This range of symptoms extends up to more extreme, and dangerous, seizures. “If you stop suddenly or the supply suddenly dries up, then you have serious risk of going into withdrawal seizures,” says Dr Durrani, warning that these seizures can be fatal.

If you or someone you know is struggling with drug addiction you can find out more about UKAT’s services here.

Another reason why Xanax is dangerous is because of the potential for overdose and death that can occur when it’s mixed with other substances, including alcohol.
We frequently hear news stories about celebrities combining prescription drugs with alcohol or other drugs and ultimately dying as a result.
This is a very real and unfortunately common situation with Xanax.
People will often mix Xanax with alcohol to amplify the relaxation and sedative effects of the drug, but the side effects can be deadly.
Alcohol, like Xanax, depresses the central nervous system and inhibit the activity of GABA in the brain. When Xanax and alcohol are taken together, over-sedation can occur. With over-sedation, the results can include not only the risk of dangerous accidents but also extreme respiratory depression, heart problems and the person may lose consciousness. A person who has combined Xanax and alcohol may exhibit symptoms such as drowsiness, slurred speech, a slow pulse, troubles with coordination, delirium, seizures and even coma or death.
Xanax is also dangerous because of the risk of overdose. This risk is amplified with Xanax is combined with alcohol or other drugs, but it can also happen on its own if someone takes a large dose.
To answer the question of why Xanax is dangerous, it’s key to look at several risk areas. These include the potential for addiction and dependence, long-term health risks such as memory and cognition problems, but also the dangers of mixing Xanax with other drugs. While Xanax is a drug with therapeutic benefits in some cases, it’s important for people to take it seriously and understand why Xanax is dangerous, and what the adverse effects of its use can be.

If you or someone you know needs help stopping Xanax or another drug, The Recovery Village® can help. Our addiction professionals are experts in treating addiction to benzodiazepines, other substances and co-occurring mental health conditions. Call today to start the journey to recovery.

Xanax Addiction and Abuse

Addiction to Xanax (Alprazolam)

Xanax is a powerful benzodiazepine that is often prescribed to treat generalized anxiety disorder (GAD), panic disorders and insomnia. It is extremely addictive when used long-term. Xanax is the number one prescribed psychiatric medication in the United States. Seventy percent of teens with a Xanax addiction get the drug from their family’s medicine cabinet.

Tolerance to Xanax develops quickly, requiring the user to take more of the drug to achieve the desired effects. Someone with a Xanax addiction may take up to 20 to 30 pills per day. If the user decides to stop taking Xanax, they may experience withdrawal effects, such as anxiety, restlessness, insomnia, and tremors. The onset of withdrawal symptoms is a sign that a physical dependence has developed. The development of tolerance and withdrawal are indications of addiction.

Once a Xanax addiction has taken hold, daily responsibilities, such as school, work or family, are ignored as energy is redirected towards drug seeking behavior.

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Other behavioral signs of Xanax addiction include:

  • Continued use of Xanax even though it is contributing to personal difficulties
  • Inability to stop using Xanax despite the desire to
  • Loss of interest in activities once enjoyed
  • Obsessing about obtaining and using Xanax
  • Loss of control over the amount of Xanax being consumed
  • Legal problems that are the result of using Xanax
  • Risk-taking behaviors, such as driving while under the influence of Xanax

If a user wishes to stop taking Xanax after dependence on the drug has formed, it is not recommended to quit “cold turkey” or without medical supervision. The symptoms of Xanax withdrawal are similar to those of alcohol or barbiturate withdrawal, and the severity of the symptoms can vary. If convulsions occur, withdrawal from Xanax can be deadly.

Normally, the withdrawal process involves slowly reducing the dosage of Xanax and eventually switching the user to a long-acting form of the drug for a period of time. The gradual taper of this drug helps to reduce withdrawal symptoms.

Understanding Xanax

Xanax is the brand name for alprazolam, a prescription sedative in the benzodiazepines family. Benzodiazepines were originally developed as a replacement for barbiturates. Xanax affects the brain and central nervous system (CNS). It boosts a brain chemical called gamma-aminobutyric acid (GABA), which slows down the nerve cell activity in the brain. The result is a calm and relaxed feeling.

Because Xanax is a CNS depressant, common effects of the drug include slurred speech, loss of coordination, and anxiety.

Xanax is dispensed in 0.25 mg, 0.5 mg, 1 mg and 2 mg strengths. The pills come in different shapes and colors depending on strength. The 2 mg tablets are white, green, or yellow in color and rectangular in shape. The rest are oval shaped and colored white (0.25 mg), orange (0.5 mg) or blue (1 mg). Xanax is a regulated schedule IV controlled substance.

After taking Xanax, the peak effects of the drug are typically felt within one to two hours. As an intermediate-duration drug, Xanax stays in a person’s system for 12 to 15 hours.

How Long Do Benzos Stay in the Body?
Brands Halcion Xanax Librium
Length of Action Short-acting Intermediate Long-acting
Time 2-4 hours 6-12 hours 5-30 hours

Common street names for Xanax include:

  • Xannies or zannies
  • Handlebars
  • Bars
  • Blue footballs
  • Benzos
  • French fries
  • Ladders
  • Sticks

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Xanax Effects and Abuse

Taking more than the prescribed dosage or using Xanax without a prescription is considered abuse of the drug. However, those who follow a prescription can still become addicted to Xanax.

Xanax may be abused in several ways, including:

  • Taking multiple pills
  • Injecting it
  • Snorting it
  • Taking it via blotter paper
  • Taking it with other drugs or alcohol

Xanax is typically abused because of the sense of calm and relaxation it causes in the user. Some people abuse Xanax by taking it in higher doses and combining it with other drugs or alcohol in order to achieve the desired high.

They say drugs fill a void, or at least that’s what my therapist thinks. The first time I popped a Xanax was the first time I felt relief from my anxiety disorder…There was something oddly comforting about Xanax—the way it came in many shapes and colors, like peach and blue. I enjoyed looking at the pills. They were a pretty little assortment of happiness I could feel just by holding in my hands. Although Xanax put a temporary stop to my agony, it soon introduced a new kind.

An overdose on Xanax can be fatal, especially if the drug is taken with alcohol or other drugs. Overdose can also occur if the pills are crushed or chewed, as the drug is designed to be time-released into the system. Xanax overdose symptoms include:

  • Confusion
  • Slowed heart rate
  • Extreme drowsiness
  • Difficulty breathing
  • Fainting
  • Loss of balance
  • Muscle weakness
  • Coma

Treatment for a Xanax overdose will depend on how much of the drug was taken and whether other drugs or alcohol were also taken. In the event of an overdose, medical providers may pump the stomach to remove as much of the unabsorbed Xanax as possible. Medications, such as flumazenil, may also be administered as an antidote. Doctors may insert an IV to provide necessary fluids. It is important for anyone suffering from an overdose to be honest with the emergency medical personnel about exactly what substances were taken and how much.

Common Xanax Drug Combinations

Xanax is commonly used in combination with alcohol or other pills—particularly opiates—to get a better high. Heroin users regularly consume Xanax, as do methadone users. In addition, approximately 40 percent of alcoholics regularly abuse Xanax. Alcohol is particularly dangerous when mixed with Xanax because they are both depressants, which can lead to an overdose and respiratory failure.

Xanax Statistics

thousand

Emergency room visits due to the recreational abuse of Xanax more than doubled from 57,419 in 2005 to 124,902 in 2010.

million

In 2013, 50 million prescriptions were written for alprazolam (the generic name for Xanax), up from 38 million written in 2006.

percent

Prescription rates for Xanax have been climbing at a 9 percent rate since 2008.

Xanax Addiction Treatment

Overcoming an addiction to Xanax isn’t easy, but people do it everyday. Medical detox and a treatment program can give someone addicted to Xanax their best chance at achieving sobriety. Talk with a recovery professional today for help finding a Xanax addiction treatment program.

How Long Does Xanax Last?

Alprazolam, more commonly known by its brand name, Xanax, is a medication indicated to treat anxiety and panic disorders. Xanax is in a class of medications known as benzodiazepines. It’s considered a mild tranquilizer.

Xanax helps to calm the nerves and induces a feeling of relaxation. In high doses, however, it has the potential to be abused and can lead to dependence (addiction). For this reason, it’s classified as a federal controlled substance (C-IV).

If you’re new to taking Xanax, you may be wondering how long the effects will last in your body, factors that might influence how long Xanax stays in your system, and what to do if you decide to stop taking it.

How long does it take to feel the effects of Xanax?

Xanax is taken by mouth and is readily absorbed into the bloodstream. You should start feeling the effects of Xanax in under an hour. The medication reaches peak concentrations in the bloodstream in one to two hours following ingestion.

People who take Xanax will often build up a tolerance. For these people, it may take longer to feel the sedative effects of Xanax or the sedation may not feel as strong.

How long does it take for the effects of Xanax to wear off?

One way to find out how long a drug will last in the body is to measure its half-life. The half-life is the time it takes for half of the drug to be eliminated from the body.

Xanax has an average half-life of roughly 11 hours in healthy adults. In other words, it takes 11 hours for the average healthy person to eliminate half of the dose of Xanax. However, it’s important to note that everyone metabolizes medications differently, so the half-life will vary from person to person. Studies have shown that the half-life of Xanax ranges from 6.3 to 26.9 hours, depending on the person.

It takes several half-lives to fully eliminate a drug. For most people, Xanax will fully clear their body within two to four days. But you will stop “feeling” the sedative effects of Xanax before the drug has actually fully cleared your body. This is why you may be prescribed Xanax up to three times per day.

Factors that influence how long the effects of Xanax last

A number of factors can influence the time it takes for Xanax to clear the body. These include:

  • age
  • weight
  • race
  • metabolism
  • liver function
  • how long you’ve been taking Xanax
  • dosage
  • other medications

There’s no difference in the average half-life between men and women.

Age

The half-life of Xanax is higher in elderly people. Studies have found that the average half-life is 16.3 hours in healthy elderly people, compared to an average half-life of roughly 11 hours in younger, healthy adults.

Weight

For obese individuals, it may be more difficult for your body to break down Xanax. The half-life of Xanax in people who are obese is higher than average. It ranged between 9.9 and 40.4 hours, with an average of 21.8 hours.

Ethnicity

Studies have found that the half-life of Xanax is increased by 25 percent in Asians compared to Caucasians.

Metabolism

A higher basal metabolic rate may decrease the time it takes for Xanax to leave the body. People who exercise regularly or have faster metabolisms may be able to excrete Xanax faster than people who are sedentary.

Liver function

It takes longer for people with alcoholic liver disease to break down, or metabolize, Xanax. On average, the half-life of Xanax in people with this liver problem is 19.7 hours.

Dosage

Each tablet of Xanax contains 0.25, 0.5, 1, or 2 milligrams (mg) of alprazolam. In general, higher doses will take longer for your body to fully metabolize.

The total length of time you’ve been taking Xanax will also affect how long the effects last in your body. People who have been taking Xanax on a regular basis will consistently maintain a higher concentration in their bloodstream. It will take longer to fully eliminate all of the Xanax from your body, though you may not necessarily “feel” the sedative effects for longer because you’ve built up a tolerance to the medication.

Other medications

Xanax is cleared by your body through a pathway known as cytochrome P450 3A (CYP3A). Drugs that inhibit CYP3A4 make it more difficult for your body to break down Xanax. This means that the effects of Xanax will last longer.

Medications that increase the time it takes for Xanax to leave the body include:

  • azole antifungal agents, including ketoconazole and itraconazole
  • nefazodone (Serzone), an antidepressant
  • fluvoxamine, a drug used to treat obsessive-compulsive disorder (OCD)
  • macrolide antibiotics such as erythromycin and clarithromycin
  • cimetidine (Tagamet), for heartburn
  • propoxyphene, an opioid pain medication
  • oral contraceptives (birth control pills)

On the other hand, certain medications help to induce, or speed up the process, of CYP3A. These medications will make your body break down Xanax even faster. An example is the seizure medication carbamazepine (Tegretol) and an herbal remedy known as St. John’s wort.

Alcohol use

Alcohol and Xanax taken in combination have a synergistic effect on one another. This means that the effects of Xanax are increased if you consume alcohol. It will take longer to clear Xanax from your body. Combining alcohol with Xanax can lead to dangerous side effects, including the possibility of a fatal overdose.

Withdrawal symptoms

You shouldn’t stop taking Xanax abruptly without consulting your doctor because you can have serious withdrawal symptoms. These may include:

  • mild dysphoria (feeling uneasy and restless)
  • an inability to sleep
  • muscle cramps
  • vomiting
  • sweating
  • tremors
  • convulsions
  • hallucinations

Instead, the dosage should be reduced gradually over time to prevent withdrawal. This is called tapering. It’s suggested that the daily dosage is decreased by no more than 0.5 mg every three days.

For panic disorders, the dosage of Xanax is often greater than 4 mg per day. This can lead to severe physical and emotional dependence and make it much more difficult to taper treatment. Your doctor will help you discontinue Xanax in a careful and safe way.

Takeaway

Xanax should fully clear the body in less than four days for most healthy individuals. However, there are a number of factors that could alter the time it takes for Xanax to clear the body, including age, race, weight, and dose.

If you’ve been prescribed Xanax, make sure your doctor knows what other medications and supplements you’re taking. Only take your prescribed dose of Xanax, even if you think the medication isn’t working anymore. High doses can cause dangerous side effects. It’s also possible to overdose on Xanax, especially if it’s taken with alcohol or in conjunction with opioid pain medications.

Although they’re prescription drugs, benzodiazepines such as Xanax have been associated with serious health issues, especially when it’s taken long term. It’s important to only stop taking Xanax under your doctor’s supervision. The withdrawal process can be dangerous without medical help.

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