How to Stop Taking Xanax
ARTICLE SUMMARY: The safest way to stop using Xanax is by scheduling a planned taper under medical supervision. This article reviews what you can expect during the withdrawal process and the best way to end physical dependence on benzodiazepines.
TABLE OF CONTENTS
- Psychoactive Effects
- The Definition of Withdrawal
- Withdrawal Side Effects
- Can I Just Quit?
- Do I Have a Drug Problem?
- How Do I Stop?
- Medical Detox
- Tapering Guidelines
- Detox at Home
- Cold Turkey
- Where to Go for Help
Xanax is the brand name for the prescription medication, alprazolam. It is widely prescribed for treating panic attack and anxiety disorders. It is a type of benzodizaepine drug. Further, Xanax is called a “psychoactive” drug because directly affects the central nervous system by decreasing abnormal excitement in the brain (psychoactive literally means “active in the mind”).
Because it produces calming effects, Xanax can easily become a drug of choice that can lead to dependence or even addiction. Because of this, Xanax is assigned as a Schedule IV drug under the Controlled Substance Act, enforced by the Drug Enforcement Administration. Moreover, a study published in the medical journal, Addictive Behaviors showed that up to 44% of chronic benzodiazepine users become dependent on their medication.
So, unless you’ve JUST started taking it, you won’t be able to just quit Xanax cold turkey. Xanax dependence can develop within 1-2 weeks after regular use and long-term Xanax use can cause:
- Extreme physical dependence.
- Tolerance to the medication.
In fact, it’s hard to quit Xanax without experiencing debilitating side effects. What is withdrawal from Xanax like? Learn what to expect and how to stop taking Xanax below. Then, ask your questions about Xanax at the end.
The Definition of Withdrawal
According to this Wiki definition, drug withdrawal is a set of predictable symptoms that occur when you significantly lower or stop doses of a psychoactive drug. But why does withdrawal happen?
Over extended periods of time, your body becomes accustomed to the levels of alprazolam in the system. It has to adapt in order to function, So, the brain, body and central nervous system adapt to the depressant effects of Xanax by increasing excitement in the brain. But once you stop taking Xanax, your body needs time to adjust to functioning without it. This period of time is called, “withdrawal”.
Withdrawal Side Effects
Withdrawal-related effects generally manifest 18 hours to 3 days after your last dose of Xanax. Even if you don’t have an addiction to Xanax, you can experience these symptoms when you stop taking Xanax.
You can develop a physical dependence on Xanax after only taking the drug for a few weeks. Withdrawal effects may be worse if you’ve taken Xanax long-term. The common side effects that occur when you stop taking can include a number of adverse side effects, such as:
- Gastrointestinal upset
- Increased pulse
- Increased blood pressure
- Panic attacks
Can I Just Quit?
You can quit taking Xanax (alprazolam) at any time, but there are many reasons why you shouldn’t abruptly stop Xanax, especially if you’ve been taking it for more than a few weeks. Xanax is in the benzodiazepine class of drugs and alprazolam can cause strong withdrawal symptoms such as seizures, twitching, aggressive behavior or blurred vision.
Instead, it’s best to stop taking Xanax and withdraw under medical supervision and to gradually reduce or taper your dose of alprazolam over the course of a few weeks. In other words, while some people can quit Xanax cold turkey, it is difficult and may not be possible for everyone.
Do I Have a Drug Problem?
If you are worried that you may have a substance use problem, then you need to check out your state. First, take a look into the Diagnostic and Statistical Manual of Mental Disorders, also known as DSM-V. This manual combines cognitive, behavioral, and psychological symptoms to diagnose addiction.
There are 11 criteria listed in this manual:
- Using Xanax in huge amounts, and/or for a longer period than instructed.
- Unsuccessful efforts to reduce Xanax dosage.
- Spending more time in using, obtaining, and/or recovering from Xanax effects.
- Experience craving when you stop taking Xanax.
- The constant use of Xanax affects your work, school, or your home responsibilities.
- Continue to use Xanax no matter the consequences.
- Experience withdraw symptoms when the dose is lowered or abruptly stopped.
- Diminished effects with continued use of the same amount of Xanax (tolerance).
- Taking Xanax in physically hazardous situations.
- Drastic reduction of important social, occupational or recreational activities due to Xanax use.
- Continued use despite persistent or recurrent physical or psychological problems caused by Xanax.
If you are not satisfied with the results, you may also check out this NIDA screening tool.
How Do I Stop?
The safest way to stop taking Xanax is to consult a doctor and follow his or her instructions. There are currently no known effective and safe medical treatments to help ease the symptoms of Xanax withdrawal, although clonazepam can be substituted for other benzodiazepines.
Gradually reducing your dose over weeks or months is the best way to stop taking Xanax. A doctor can give you an appropriate dosing schedule so that you can safely taper yourself off of Xanax. If you go to a clinical detox center, you should continue to be evaluated for withdrawal symptoms every as you taper down. Outpatients should be evaluated daily for at least the first week, or as your condition indicates. General tapering guidelines for Xanax include the following recommendations:
- The tapering schedule will depend on the presence of co-morbid medical or psychiatric conditions.
- If hospitalized, Xanax can be tapered by 10% per day.
- Outpatients should not be tapered any more rapidly than by 10% every three to five days, or 25% per week.
Xanax can be hard to quit, but medical care can make the detox process more easer to cope with. Below is a list of the medical detox steps:
This step requires completions of paper work as well as assessment. Expect to be asked to take a drug test, and to go though an interview process which include insurance submission or payment information. This procedure helps medical clinicians plan your threatment program.
The medical trained staff will examine your psychical and psychological condition. During this step, nurses will get medication prescriptions that will help you manage symptoms of withdrawal.
3. Tapering Schedules
Tapering schedules are uniquely made in accordance with doctor’s orders for each individual. Generally, the doses are not reduced by more than 25% in a one week period. During this step, you may experience withdrawal. So, learn all Xanax withdrawal symptoms by time of their apperance, and be prepared.
4. Transition to Treatment
Medical detox is only one step of dealing with substance use problem. You need to learn how to live without drug, and treatment program is the answer for that. It will help you stay and maintain sober. Walking this step is up to you. This is your choice, and no one can force you enroll into a rehab program.
The general rule of quitting any benzodiazepin is slowly reducing the daily dose over a period of weeks or months. According to the FDA approved label for Xanax, patients who were using Xanax from 3-4 months were able to taper to zero dose, while patients with higher doses than 4 mg had more difficulties to zero their dose.
However, every tapering protocol should be supervised by a medical clinician. Dr. Heather Ashton wrote the Ashton Manual that provides very useful tapering schedule for Xanax. Some of the instructions include:
- Divide the appropriate Xanax dose in 3 daily periods.
- Calculate the appropriate diazepam substitute (6 mg alprazolam = 120 mg diazepam)
- First, you lower the night dose by 0.5 mg and add 10 mg diazepam.
- Then, you lower the night dose by another 0.5 mg and add 20 mg diazepam.
- Then, you lower the morning dose by 0.5 and add 10 mg diazepam.
- Then, you lower the morning dose by another 0.5 mg and add 20 mg diazepam.
- Then, you lower the afternoon dose by 0.5 and add 10 mg diazepam.
- Then, you lower the afternoon dose by another 0.5 mg and add 20 mg diazepam.
- You follow this protocol until Xanax is completely replaced by diazepam.
- Then, you start a tapering protocole for reducing diazepam.
- Each interval should last 1-2 week.
You may think that this tapering protocol is complicated, and hard to manage, but remember that there are many successful stories that now live a benzo-free life.
As we already mentioned, slowly lowering the daily dose of Xanax is the safest way to quit this medication. The guidance from any doctor is replacing short-acting benzodiazepin with a long-acting one. According to the World Health Organization , the established protocol for benzo withdrawal stabilization is to put the patient on an appropriate dose of diazepam.
Besides tapering schedule, these are the most common medications used to manage withdrawal:
- A short half-life benzodiazepine(s).
- Phenytoin or barbiturates to control seizures.
- Propranolol to control tremors and heart rhythm, and to prevent migraines.
- Medications to manage psychosis (chlorpromazine hydrochloride, pentobarbital, phenobarbital, or haloperidol).
Detox at Home
Detox at home is possible, but dangerous. You may experience hard and severe withdrawal where 24/7 medical assistance is needed. Keep in mind that medical staff can offer emotional as well as psychological support that will help you avoid triggers and prevent relapse.
Moreover, any home detox requires doctor’s permission and a tapering schedule. This is important because detox at home is not for everybody. For instance, people who deal with hard addiction, people with poor health, and/or people with specific medical condition may not be eligible for home detox.
Stopping Xanax suddenly can be risky. If left untreated, benzodiazepine withdrawal can trigger a delirium with hallucinations, changes in consciousness, profound agitation, autonomic instability, seizures, and even death. Doctors always recommend Xanax dosage be gradually tapered or substituting a long-acting medication for a short-acting one – this helps you avoid uncomfortable and potentially dangerous withdrawal effects. Stopping alprazolam suddenly can also cause a Xanax relapse if you feel the need to take Xanax to avoid withdrawal symptoms.
If you haven’t taken Xanax for a long time and have only recently started Xanax dosing, it may be possible to quit cold turkey. However, if you have a strong physical dependence on Xanax or have developed tolerance to Xanax you should never try to quit suddenly, as benzodiazepine withdrawals can be fatal in extreme cases. Always speak to a doctor before changing your Xanax dosage or quitting Xanax entirely.
Where to Go for Help
Struggling with substance abuse is a serious problem that may wrack your life. The sooner you address your problem, the better. There is no shame of asking for help. In fact, the National Survey on Drug Use and Health reported that an estimated number of 618,000 people aged 12 or older were diagnosed with a tranquilizer use disorder, including Xanax in the past year. Moreover, the same report claimed that about 2 million people were current misusers of tranquilizers. The numbers break down by age category:
- 121,000 adolescents aged 12 to 17.
- 536,000 young adults aged 18 to 25.
- 1.3 million adults aged 26+.
But, this is not the end…
The CDC report on Emergency Department Visits Involving Non-medical Use of Selected Prescription Drugs 2004-2008 found out that the benzodiazepine with the highest number of ER visits was alprazolam, and it was the most prescribed benzo in the US in 2008. To be more exact, 44 million Xanax prescription were made that year.
Are you still going quiet about your substance use problems? It a high time to start acting, and solve your problems. The main places where you can find addiction services include:
- Addiction rehabs
- Licensed psychologists
- Licensed psychiatrists
- Medical detox clinics
- Medical doctors
If you are dealing with an addiction, a rehab program can help you find all underlying causes to your issues. You will need to choose between two types of programs: inpatient or outpatient.
Inpatient programs provide 24/7 medical supervision because patients live in the facility. The most common services are:
- Individual therapy
- Group therapy
- Educational classes about addiction and recovery
- Medication management
- Regular routine establishment
Outpatient programs offer similar services, but there is no constant medical care because patients come and go for a few hours, several days weekly. Patients continue with their everyday-life responsibilities.
You deserve a second chance in life! So, don’t be afraid to start living a substance-free life. Take your life in your hands.
Before quitting Xanax, make sure to have these three supports:
1. Motivation to change. If you like to start over, you need to want the change for yourself, and only for yourself. Find the motivation that will help you turn your life around.
2. Educational resources. Learn all information on how can you beat addiction safely. Gather medical resources by contacting your prescribing doctor, a pharmacist, or rehab staff. The resourses will help you anytime.
3. Surrounding support. Your family and friends need to be all-in for your willingness to change, and they must be supportive. Otherwise, you recovery will be hard to walk on.
Still have questions about stopping Xanax? Please leave us your questions, comments, or experiences below. We respond to all questions personally, and will try to have you an answer or reply ASAP.
Reference sources: Federal Bureau of Prisons: Detoxification of Chemically Dependent Inmates
DailyMed: Xanax XR
PubMed Health: Alprazolam
PubMed: Detoxification from benzodiazepines: schedules and strategies
PubMed: 4 Physical Detoxification Services for Withdrawal From Specific Substances
Photo credit: Pete Prodoehl