That’s the year the Federal Drug Administration (FDA) approved alprazolam, a prescription medication intended for treating panic disorders. The FDA approves drugs with relative frequency, and approving a new drug to treat panic disorders seems harmless on the surface.

However, the FDA’s approval of alprazolam marked a major moment in the lead-up to the current prescription drug crisis. Alprazolam is the generic name for Xanax, which is one of the most prescribed psychiatric medications in the United States.

Xanax is used by thousands of Americans either to treat a mental illness, like anxiety disorders and insomnia, or to achieve a relaxed and tranquil state. The drug is the most popular in the drug class known as benzodiazepines, or “benzos” for short. The Recovery Village’s survey of 399 people also showed Xanax as the most popular benzo. Of the 133 people who said they have taken a benzo at some point in their life, 63 percent said that they have used Xanax. Valium received the next-highest percentage, around 44 percent, with Klonopin (35 percent) and Ativan (30 percent) following.

As the use of Xanax continues to rise in the 21st century, so does the risk of more and more people losing their lives to prescription drug dependency. But how did Xanax become so popular? Why has 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, so taking Xanax helps mitigate those feelings by boosting the effects of the chemical called gamma-aminobutyric acid, 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. According to a CBS News report, there were 46,000 prescriptions for the anti-anxiety drug in 2010.

The increased awareness of anxiety disorders, which affects nearly 20 percent of Americans, has contributed to the growing use of Xanax. As more people recognized the symptoms of this type of mental illness in themselves or in their loved ones, more people voiced their concerns to their doctors and likely received a Xanax prescription.

Vice published an article titled “This is Why Xanax is Blowing Up in America.” The work from 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. Rather than big pharma making a big push, the article states that the changing political and cultural climate has 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 eventually requires a larger dose to achieve the same calming effects that a person felt the first few times they took the drug. Increasing the dosage and continuing to regularly take the drug can lead to a dependence, which results in withdrawal symptoms occurring when someone goes a length of time without taking any doses.

The NBC television affiliate in Naples, Florida, reported a story in 2018 about a resident, Christy Huff, who struggled with a Xanax addiction. Huff told her doctor about experiencing sleeping trouble and 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.”

Xanax is deadly, too, as are many other popular benzos. The Chicago Tribune reported that benzos, including Valium and Ativan, accounted for around 7,000 of the 23,000 deaths in 2013 that were caused by prescription drug overdoses.

The New Xanax Generation

Xanax, and benzos in general, are not new drugs. The first benzo was Librium and it was introduced in the 1960s. Valium, which was the drug featured in the hit 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 just recently spiked upward in the United States, and more people than ever before are using these drugs at extreme levels. The National Institute on Drug Abuse (NIH) reported that 8,791 died in 2015 due to benzos. By comparison, only 1,135 people in 1999 died due to overdose caused by this class of drugs.

There is a disparity, though, in the use of some benzos depending on a person’s age.

A large majority of The Recovery Village’s survey respondents between the ages of 18-24 — around 85 percent of that age group — said they have taken Xanax at least once. Every other age demographic had a lower percentage of those who have taken the drug. Elderly respondents — defined as above age 55 — were much lower, at just 33 percent.

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.

Why is Xanax a popular drug among teenagers and young adults? Its calming effects help people suffering from 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 writes in the article titled “Anxious Teenagers Buy Xanax on the Dark Web.”

Are parents 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 benzodiazepine use is “extremely prevalent” in the United States, and likewise for recreational benzo use. 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 the U.S. Adults’ awareness of increased benzo use — and specifically Xanax 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.

Just because a drug is in pill form, comes in a bottle and receives a doctor’s blessing does not make that drug risk-free. Raising awareness of the negative effects Xanax can have and its addictive tendency for all age groups could help deter the dangerous use of the medication in the future.