What type of drug is Xanax?
Is Xanax an opiate or benzo? For medical professionals, this may seem like an unusual question. From the point of view of doctors and nurses, it is clear that Xanax is not in the opioid class of drugs or medications. However, for members of the public, the distinction may not be as clear.
Xanax happens to be in the class known as benzodiazepines, or commonly known as benzos. Benzodiazepines also include medication such as Valium, Klonopin, Ativan, and Librium.
There are many other drugs in this class, including Rohypnol, a benzo used for insomnia in other countries and illegal in the US. Rohypnol is also known on the street by the name, “ruffies.” This dangerous date rape drug causes drowsiness and blackouts.
Xanax-like drugs tend to cause temporary amnesia in addition to sleepiness and sedation.
In fact, all benzodiazepines have the potential to cause blackouts related to anterograde amnesia and retrograde amnesia. Long-term memories can be erased from before the drug was taken and after the effects have begun to wear off.
For most Benzos, however, the dosage to achieve these types of amnesia is quite high. One benzo that is used commonly in the US in hospitals that causes amnesia at normal dosages is Versed, or midazolam.
This drug is given before certain procedures, such as colonoscopies. In the case of Versed, the amnesia is a desirable effect because the patient can be awake and assist in positioning during the procedure and report discomfort, yet, they will most likely not remember the experience.
Is Xanax an opiate like heroin or fentanyl?
While both Benzos and opioids cause sleepiness and unexpected nodding off to sleep, they are very different drugs. Part of the confusion, in addition to the effects of sleepiness and sedation, common to both drug classes, is the forensic nature of the two drugs.
When we read articles about drug seizures or overdoses, it is not uncommon to read or hear about Xanax and an opioid in the same case. When heroin or fentanyl is the cause of an overdose, Xanax happens to be the most common secondary drug found in the victim’s system.
Xanax is often found together with other street drugs, such as cocaine and methamphetamine. In fact, dealers often sell Xanax and cocaine together because it can help a drug user to come down and get some rest after a long run of using coke or meth and being awake for long periods of time. Unfortunately, cocaine and Xanax are also often found together in overdoses.
What about benzos and alcohol? How dangerous is this combo?
Similarly to benzos and coke, benzos and alcohol are another common combination. Mixing alcohol and Xanax may seem unusual because of their similar effects. Both are sedatives. In fact, benzos are often referred to as “alcohol in a pill.” Drug counselors typically say this to their recovering alcoholic clients to warn them not to replace alcohol with a prescription for alprazolam.
Drinking on Xanax is very dangerous and can easily lead to Xanax and alcohol death due to respiratory depression. Xanax plus alcohol is a combination that should be avoided to prevent tragic Xanax alcohol overdose.
A near-tragic story about Xanax and alcohol.
Years ago, I was at a wedding and ran into an old friend whom I had not seen for years. We sat and talked for a while, and I realized that he was getting more and more drunk as the evening passed. He started to slur his words and forget his train of thought.
At first, it did not make sense to me that my friend was getting drunk so quickly for the amount he was drinking. Then, I noticed that, every so often, he would pop a pill from a bottle in his pocket. I asked him what the pills were. They were Xanax.
When I realized that he was mixing Xanax with alcohol, I went to the bartender and asked him firmly to stop serving my friend. The bartender gave me an angry look and did not speak at all.
Fortunately, my friend survived that night of drinking on Xanax. He did pass out and I had to arrange for him to get a ride home with some other friends. Today, that friend no longer drinks or uses any drugs.
What about Xanax for alcohol withdrawal or for opioid withdrawal?
While it is possible that Xanax could be used to make the withdrawal from quitting alcohol safer and more tolerable, it is rarely, if ever, used. Librium is another benzo that is commonly used it detox facilities to facilitate withdrawal from alcohol, because has a long half-life and is considered to have less of an addictive quality.
When it comes to opioid withdrawal, benzos are not usually necessary, but they can help early on with the detox process. With both alcohol and opioid detox, the doctor must be careful not to continue the benzodiazepine for too long, so the patient does not develop a physical dependence on it.
Are doctors who prescribe Xanax psychopaths?
Once, I was in a lecture at a medical convention and the doctor on stage lecturing about addicting prescription drugs made a statement that any doctor who prescribes Xanax is a psychopath. When he said it, there was an uncomfortable murmur from the crowd of doctors in the room.
I believe that many of the doctors present were thinking that they prescribe Xanax to some patients for anxiety and the patients benefit from it. It’s hard to imagine that the entire room of hundreds of attendees were all a bunch of psychopath doctors. When the lecturer said, “I don’t know why any of you would prescribe Xanax,” a doctor next to me said quietly, “maybe because it works.”
Is Xanax a narcotic? What does the word “narcotic” mean?
The word narcotic can be confusing because its meaning has changed over time. The origin of the word is Greek and its original meaning refers to something that causes sleepiness. If this were our working definition, Xanax would definitely be a narcotic.
There was a time in the past when narcotic referred more to opiates. When you said the word narcotic, people would think of heroin users on the streets, shooting up in a dark alley.
Currently, the word narcotic refers to all drugs of abuse, including prescription and street drugs. In a police department, the narcotics division investigates all drug-related crimes, not only crimes involving heroin or drugs that make people sleepy.
Is Xanax a controlled substance?
Alprazolam, the generic name for Xanax, is a controlled substance in the United States. All strengths of Xanax, from the Xanax 0.25 mg tablets to the 2 mg white Xanax bars, are considered to have abuse potential by the federal government.
The scheduling system for controlled substances goes from 1 to 5. Schedule 1 is a category containing drugs that the government has determined to have no medical use. This can be confusing, since cannabis is designated schedule 1, yet many states consider it to have medical use and allow for it to be recommended by doctors and doled out by dispensaries.
Another anomaly in the scheduling system is cocaine. Because cocaine has limited medical use as a topical anesthetic, it is a schedule 2.
Schedule 2 drugs have high abuse potential. Each level beyond 2, from 3 to 5, is considered to have less abuse potential. Most opioids are schedule 2. Suboxone, the drug used to treat opioid addiction, is a schedule 3.
For all the concern over Xanax and people being addicted to Xanax, it is only a schedule 4. Xanax is not considered to have a very high abuse potential by the US federal government.
Why is Xanax not as highly controlled as most opioids?
There is not really an alprazolam high for people who abuse Xanax. The Xanax feeling is that of having the rough edges of life smoothed over, and all anxiety being tolerable or even absent. Symptoms related to anxiety, including OCD symptoms, may be lessened while on a benzo.
The pleasurable feeling of euphoria that many people report having with opioids and psychoactive stimulants does not occur with Xanax and other benzodiazepines.
While there are certainly people who misuse Xanax and even people who do get addicted to it, Xanax is not a highly addictive drug. It does not have the same effect on the reward center of the brain compared to highly addictive drugs, such as heroin and cocaine.
What are some signs of Xanax abuse?
If you are concerned that someone in your life is misusing Xanax and you believe that they may be addicted to Xanax, there are some signs to look for. While nodding off to sleep at unusual times, such as at the dinner table, is common for people using opioids, it is not too common with Xanax overuse.
More likely, you will notice that a person who has taken too much Xanax will have slower reflexes and appear to be functioning mentally at a much slower rate than normally.
Look for a slowing of the thought process and glazed eyes.
It is as if you can see their mental processes working in slow motion. The gears in their head turn slowly in such a way that you can almost imagine hearing them grind away as the person in front of you tries to explain that they are not drugged.
You may also notice that their eyes have the appearance of being glazed over. They will also appear to be very relaxed, with no stress about anything.
Does it bother people to see other people not feeling the usual stress of modern life?
A patient once confided in me that when they took excessive Xanax, it was to completely wipe out all anxiety. This patient explained that they felt their family was upset by it because people seem to get angry when someone is not feeling the stress of life as they feel it.
Could there be truth to this, that we, as a society, view Xanax and similar drugs, with anger and suspicion because we do not like the idea of people going through life without the high level of stress that most of us feel?
Psychotherapy and other medical treatments for anxiety must be considered.
Still, the concern over Xanax misuse is justifiable, because most people can learn to handle anxiety without the need for medication. And, people who do need medical treatment for anxiety can learn to manage their symptoms by taking Xanax, or another benzo, as prescribed, in conjunction with psychotherapy.
Additionally, there are other medications that can help with the management of anxiety long-term. For example, anti-depressants, such as Lexapro and Paxil, can help with anxiety symptoms. Doctors should keep in mind that Xanax alone is not always the best plan for treating chronic anxiety disorder.
Is Xanax use harmful?
There are reports that long-term use of Xanax can cause damage to the brain. On social media, there are vocal groups protesting the use of Xanax and other benzos because of serious dangers that go beyond what the FDA-approved literature reveals.
While it is questionable that Xanax causes serious harm to the central nervous system, it is true that it can cause serious psychological and physical dependence. The longer a person takes Xanax, the more difficult it can be to stop taking it.
Xanax withdrawal symptoms include seizures.
Stopping Xanax suddenly, without tapering down gradually, can be life-threatening. Quitting Xanax too fast can cause a seizure.
Some detox programs use anti-seizure medications to help patients quit Xanax without having to go through a prolonged tapering process. Interestingly, while opioids are much more dangerous than benzos, opioid withdrawal is less dangerous than benzodiazepine withdrawal.
Taking Xanax can also be harmful in the sense that it is sedating and affects reflexes. Driving under the influence of Xanax is dangerous. Mixing Xanax with other drugs, including alcohol, is very dangerous.
Should benzodiazepines be outlawed?
If you have a loved one who is struggling with Xanax addiction, you may think that the best solution is to take all benzos off the market and make them illegal. However, before we start fighting to outlaw Xanax, we should acknowledge that it does have important medical uses, as do many other benzodiazepines.
There are people who have severe anxiety disorders who function well while taking Xanax. In some cases, there are adults who have taken the medication for decades without any issues. For many people who take Xanax as prescribed, it improves their quality of life and improves their overall functioning.
While we should be aware that Xanax is a drug with abuse potential, if we are concerned that a person is addicted to Xanax, we should consider the possibility that there are other drugs involved as well. While Xanax is not an opioid, it may be combined with opioids to potentiate the effects of the opioid, making the high more intense.
How can we help people addicted to Xanax?
People who abuse alcohol will mix in Xanax for the same reason, to get higher than they would with alcohol alone. Harm reduction for people who misuse Xanax should include education.
By informing Xanax users of the dangers that can occur by mixing Xanax with other drugs and alcohol, as well as the dangers of taking too much Xanax, we may help them to make better decisions. While cutting back on Xanax may not resolve all of their drug use issues right away, it is a step in the right direction.
Other ways to help include offering to take the person to a medical visit, taking them to a recovery meeting, helping them find a good recovery podcast, or even taking them to a detox program.
Anxiety is a real medical condition.
We should also acknowledge that Xanax is a prescription drug that is often prescribed for legitimate medical conditions. Anxiety disorders are real medical conditions.
People who have severe chronic anxiety can not simply “snap out of it.” Medical treatment and therapy are often required to treat anxiety. If you suffer from anxiety and you find it difficult to function in your daily life, consider seeing your doctor to find out more about medical treatment options that are available.