The Big Benzo: Unpacking Xanax Use in America

Almost 40 years ago, the Federal Drug Administration approved alprazolam, a prescription medication intended for treating panic disorders. This approval was a major moment that played a large role in the development of America’s current prescription drug crisis.

Xanax is the brand name of alprazolam and it is the most popular drug in the benzodiazepine drug class. The drug is used by thousands of Americans to treat mental illnesses such as anxiety disorders or insomnia. People may also use it to achieve a relaxed and tranquil state.

A survey of 399 people by The Recovery Village confirmed that Xanax is the most popular benzodiazepine, or “benzo.” Of the 133 people who said they have taken a benzo at some point in their lives, 63% said that they have used Xanax. Valium received the second-highest percentage (44%), with Klonopin (35%) and Ativan (30%) following.

As Xanax use continues to rise in the 21st century, so does the risk of more and more people losing their lives to prescription drug dependency. These rising rates have led many to wonder: How did Xanax become so popular? Why has the use of the drug soared among teens and young adults in the last year, and what can be done to slow down the overdose tally?

What Does Xanax Do? How Can It Hurt You?

Xanax is a central nervous system depressant that slows down the movement of unbalanced brain chemicals. When an imbalance occurs, people can experience nervousness and anxiety. Xanax helps mitigate those feelings by boosting the effects of a chemical called GABA, which interacts with the brain to give people a relaxed and positive feeling.

Thousands of people rely on this type of medication to remove the imbalance. In 2013 alone, there were 14 million prescriptions for benzodiazepines, which is a sharp increase from 8 million in 1996. The increased awareness of anxiety disorders, which affect nearly 20% of Americans, has contributed to the growing use of Xanax. As more people began recognizing the symptoms of this type of mental illness in themselves or in loved ones, more people acquired prescriptions for benzos like Xanax.

Vice published an article titled “This is Why Xanax is Blowing Up in America.” Author Maia Szalavitz details how the rise of benzo use is not similar to opioid use because the drugs are not being marketed as much as opioids were during their rise earlier in the 21st century. According to Szalavitz, increased benzo use has not been caused by a push from big pharma. Instead, the changing political and cultural climate has simply made more people anxious.

“And Americans, regardless of the war on some drugs, have a long, storied history of turning — and turning often — to chemical solutions to cope with strange times and systemic hardships,” the article continues.

While Xanax can alleviate anxious feelings, the drug also can be quite addictive. Taking the drug consistently can create a tolerance, which requires a person to take higher doses to achieve the same calming effects as before. Increasing the dosage and continuing to regularly take the drug can lead to dependence, which results in withdrawal symptoms when someone ends use. Xanax and many other popular benzos can also lead to life-threatening overdoses.

An NBC affiliate in Naples, Florida, reported a story in 2018 about Christy Huff, a resident who struggled with a Xanax addiction. Huff told her doctor that she was having trouble sleeping, and she was prescribed Xanax to treat the issue.

“One pill at night offered her some relief, but soon she began to experience anxiety, daytime terrors and tremors,” the article states. “Then, Huff had a startling realization. When she was off the Xanax she was going through withdrawal. In just three weeks, her body was dependent on Xanax.”

The New Xanax Generation

Xanax and other benzos are not new drugs. The first benzo was Librium, which was introduced in the 1960s. Valium, which was the drug featured in the Rolling Stones song “Mother’s Little Helper,” followed as the next popular benzo. Xanax was introduced in the 1980s.

Despite the drugs being around for decades, the number of benzo prescriptions has recently spiked upward in the United States. In addition, more people than ever before are using these drugs at extreme levels. In 2017 alone, benzos were involved in 11,537 overdose deaths. In contrast, 1999 had only 1,135 deaths related to benzo use.

However, there are some key age differences when it comes to the use of benzos. A large majority (85%) of The Recovery Village’s survey respondents aged 18 to 24 said they have taken Xanax at least once. Every other age demographic had a lower percentage, and respondents above the age of 55 reported much lower rates of use (33%).

These statistics coincide with reports that Xanax use among teenagers and young adults is reaching epidemic levels.

Spectrum News in Austin, Texas, reported that the local EMS responded to 140 Xanax-related overdose calls from January 2015 to June 2017. The average age range of people who overdosed was between 11 and 17 years old. The number of overdoses was almost as high as the number of K2-related overdose calls during the same time period.

Xanax may be a popular drug for young people because its calming effects help relieve stress and anxiety. According to The New York Times, more teenagers than ever before are struggling with anxiety. Anxiety can lead to depression, and the U.S. News & World Report reported that young adults in the 18–25 age range reported more suicidal thoughts and bouts with depression from 2008 to 2010 than any other age group.

The problem isn’t limited to the U.S., either. The Guardian in the U.K. reported in early 2018 that many adolescents are using Xanax to self-medicate against mental health issues.

“Xanax has seen a sharp rise in popularity in the past year, with some experts saying it has become one of the top five drugs used by young people, alongside cannabis and alcohol,” author Dulcie Lee explains.

Many parents are aware of the prevalence of Xanax use among teenagers and young adults. The survey respondents who identified themselves as having at least one child seemed to recognize the existence of an issue. These parents were more likely than respondents who aren’t parents to say that medical and recreational benzodiazepine use is “extremely prevalent” in the United States. Additionally, parents who participated in the survey were more likely than respondents who aren’t parents to say that benzo use is already as big of an issue as prescription opioid use.

While opioid use has dropped in recent years, the number of benzo prescriptions and benzo-related overdoses continues to rise in America. Adult awareness of increased benzo use in America is a positive step. However, many teenagers and young adults might not understand the severe consequences that using Xanax could have on their mental and physical health.

Though a drug may be in pill form, come in a bottle and receive a doctor’s blessing, this doesn’t mean the drug is risk-free. Raising awareness of the negative effects that Xanax can have, and its addictive tendency for all age groups, could help deter dangerous use of the medication in the future.

Editor – Jonathan Strum

Jonathan Strum graduated from the University of Nebraska Omaha with a Bachelor's in Communication in 2017 and has been writing professionally ever since. Read more