Xanax carries a variety of side effects and can lead to addiction, even when it is taken as prescribed. Learn more about the signs and symptoms of Xanax abuse.

Article at a Glance:

  • Xanax is the brand name of alprazolam, a benzodiazepine drug. Alprazolam has many common side effects.
  • As a Schedule IV controlled substance, Xanax can lead to abuse, dependence and addiction.
  • Signs of Xanax addiction can be physical, psychological or behavioral in nature.
  • Taking too much Xanax can cause an overdose, which may be deadly.

An Overview

Xanax, the brand name of the generic drug alprazolam, is a prescription benzodiazepine that treats anxiety and panic. As of 2018, Xanax is one of the most prescribed medications in the United States. The drug is also a Schedule IV controlled substance, meaning it carries a risk of addiction.

Like all drugs, Xanax has some side effects. People who abuse Xanax or are addicted to it may attempt to hide these side effects. However, there are a variety of signs and symptoms that indicate Xanax abuse and addiction.

Minor Xanax Side Effects

Xanax is FDA-approved to treat anxiety. As a benzodiazepine, it reduces the activity level in the brain, making neurons in the brain less excitable. This can result in a temporary reduction of physical tension, anxiety and restlessness. However, Xanax can also bring various adverse reactions.

Common side effects of Xanax include:

  • Decreased or increased appetite
  • Weight loss or gain
  • Watering of the mouth
  • Increased or decreased interest in sexual intercourse
  • Difficulty with bowel movements
  • Cracked or dry skin
  • Abdominal cramping
  • Double vision

If you have any questions or concerns about Xanax side effects, contact your doctor to determine if you should seek treatment.

Major Xanax Side Effects

There can be major Xanax side effects as well, even when the drug is taken as prescribed. Notify your doctor immediately if you experience any of the following effects, as many of these signs would warrant medical attention:

  • Lightheadedness
  • Clumsiness or unsteadiness
  • Shakiness
  • Irritability
  • Trouble speaking or sleeping
  • Difficulty concentrating
  • Forgetfulness
  • Mental status changes
  • Diarrhea

Signs of Xanax Abuse

Many people with a Xanax addiction started with a legitimate and legal prescription. However, a person may increase their Xanax dose beyond the recommendations of a doctor and find themselves misusing the drug. Misuse can quickly lead to dependence and addiction.

There are many possible side effects that can result from Xanax abuse. These signs and symptoms can indicate to friends and family that their loved one has a harmful Xanax addiction. While some of these signs are observable physical symptoms, others are psychological or behavioral changes.

Physical Side Effects of Xanax Abuse

Xanax can have observable physical effects on the body, including sleepiness and relaxed mood. In an overdose, however, physical signs can be even more obvious and include:

  • Extreme drowsiness
  • Coordination problems
  • Decreased reflexes
  • Slowed breathing

Xanax overdose can be deadly. If you suspect an overdose, seek emergency medical attention.

Psychological Symptoms of Abuse

People abusing Xanax or other benzodiazepines can show different psychological symptoms. Many of these symptoms are changes in mood, such as:

  • Amnesia
  • Hostility
  • Irritability
  • Vivid or disturbing dreams

Behavioral Signs of Abuse

Often, a person struggling with a substance like Xanax will show changes in behavior. Loved ones may notice these signs, which can appear either slowly or suddenly. Some of these signs include:

  • Regularly skipping school or work: Keep an eye out for a sudden loss of interest in daily activities or a sudden drop in grades or performance, school or work involvement.
  • Secretive behavior: If a friend or family member goes to great lengths to keep people out of their room, they may be hiding something. The person may shut doors when someone enters the house or close and lock the bathroom door, even when not using the restroom.
  • Relationship changes: A person may shift friend groups as they seek the companionship of others who also abuse substances.
  • Doctor shopping: A person may visit several physicians to obtain more Xanax prescriptions.
  • Antisocial behaviors: By pushing away friends and loved ones, a person may be trying to avoid the detection of their addiction. If a formerly outgoing person has suddenly begun keeping to themselves, it may be a sign of drug abuse.
  • Paraphernalia: People with a moderate-to-severe Xanax addiction may crush and snort the medication to speed up its effects. Paraphernalia may include a mortar and pestle, razor blades and credit cards, rolled-up dollar bills and straws. Multiple empty pill bottles should also raise a red flag.
  • Financial problems: A person with a Xanax addiction usually searches out more of the drug, leading to changes in their financial situation. Frequent and sudden requests for money are often a sign of secretive spending, which may indicate non-prescription Xanax use. They may also borrow funds from friends and family without paying them back.
  • Legal trouble: If a person’s struggle with Xanax has reached the point where they are having run-ins with the law and require legal representation, drug abuse has become a problem. Many people do not realize that redistributing or reselling prescription medication from one individual to another is illegal. It carries similar consequences to dealing illicit drugs like heroin or cocaine.

Effects of Long-Term Xanax Abuse

When someone uses a benzodiazepine like Xanax for extended periods of time, there is a risk of long-term side effects. These can include:

  • Cognitive impairment: Multiple studies have found that long-term use of benzodiazepines is linked to developing dementia. However, some studies cast doubt on this relationship.
  • Motor vehicle crashes: Driving while taking a benzodiazepine carries risks that are similar to driving with a blood alcohol level between 0.050% and 0.079%.
  • Hip fracture: In older adults, taking a benzodiazepine can increase the risk of hip fracture by at least 50%.
  • Chemical dependency or addiction: As a controlled substance, Xanax carries the risk of abuse, dependence and addiction.

For these reasons, it’s best to take Xanax only as prescribed and only for the length of time that it’s prescribed.

Xanax Withdrawal Symptoms

When addiction is a factor, the risk of withdrawal becomes a factor as well. People with a Xanax addiction increase their chances of withdrawal if they stop taking the medication. Xanax withdrawal symptoms include:

  • Anxiety
  • Trouble sleeping
  • Restlessness
  • Agitation
  • Irritability
  • Problems with concentration and memory
  • Muscle tension or aches
  • Seizures may occur in severe cases

These symptoms begin one to two days after the last dose of Xanax and can last for two to four weeks. To avoid these symptoms, a medically supervised taper may be necessary. Medical detox in a rehab facility like The Recovery Village can help a person safely taper their dose while receiving treatment for withdrawal symptoms.

Can You Overdose on Xanax?

It is possible to fatally overdose on Xanax. In fact, Xanax is one of the top 10 drugs implicated in overdose deaths in the United States. Further, mixing Xanax with other central nervous system depressants, such as opioids, also carries an overdose risk. Benzodiazepines like Xanax are involved in 33% of prescription opioid overdose deaths.

Learning to recognize the symptoms of a benzodiazepine overdose may help you save a person’s life.

Some signs of Xanax overdose include:

  • Excessive sedation
  • Impaired mental status
  • Drowsiness
  • Slurred speech
  • Movement problems
  • Slowed breathing

Drug overdose can be fatal. If you suspect someone is experiencing an overdose, call 911 immediately. Do NOT be afraid to seek help. If you do not have access to a phone contact Web Poison Control Services for online assistance.

Xanax overdose can be difficult to spot because symptoms are similar to those of alcohol and opioids, which are commonly abused in combination with Xanax. Since these symptoms overlap with overdose symptoms of other depressants, however, you should learn to recognize them and call for medical help when necessary.

DSM-V Criteria for Xanax Addiction Severity (Mild, Moderate, Severe)

Although the DSM-5 does not specifically recognize Xanax addiction, it does recognize substance use disorders involving benzodiazepines. A substance use disorder can be mild, moderate or severe and is staged based on symptoms like:

  • Cravings
  • Needing higher doses of the drug to get the same effect
  • Loss of control
  • Losing interest in favorite activities
  • Avoiding responsibilities
  • Withdrawal symptoms when the drug is stopped

Preventing Addiction

The best way to prevent a Xanax addiction is to only use the drug when it is prescribed to you and take it exactly as prescribed. Strategies to help you prevent addiction and use Xanax responsibly include:

  • Take only the dose than your doctor prescribes; do not take a higher dose than your doctor tells you to take.
  • Take Xanax only as often as prescribed; do not take the drug more frequently than it is prescribed to be taken.
  • Take only what is prescribed to you; in addition to being illegal, borrowing or buying Xanax puts you at a higher risk of addiction.

Find the Help You Need

If you or someone you love struggles with Xanax, help is available at The Recovery Village. Our multidisciplinary team of experts can create an individualized treatment program that helps you recover from Xanax abuse and addiction. Contact us today to learn more about recovery plans and programs that can work well for your needs.

a man wearing a blue and white striped shirt.
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
a woman wearing glasses and a white robe.
Medically Reviewed By – Dr. Jessica Pyhtila, PharmD
Dr. Jessica Pyhtila is a Clinical Pharmacy Specialist based in Baltimore, Maryland with practice sites in inpatient palliative care and outpatient primary care at the Department of Veteran Affairs. Read more

ClinCalc. “Alprazolam.” Accessed January 17, 2021.

Drug Enforcement Agency. “Controlled Substances.” December 21, 2020. Accessed January 17, 2021.

Drugs.com. “Alprazolam.” November 4, 2020. Accessed January 17, 2021.

Drug Enforcement Administration. “Benzodiazepines.” April 2020. Accessed January 17, 2021.

Zhong, GuoChao; Wang, Yi; Zhang, Yong; Zhao, Yong. “Association between Benzodiazepine Use a[…]tia: A Meta-Analysis.” PLoS One, May 27, 2015. Accessed January 17, 2021.

Nader, Danilo; Gowing, Linda. “Is Long-Term Benzodiazepine Use a Risk F[…] a Systematic Review.” Journal of Addiction, January 24, 2020. Accessed January 17, 2021.

Johnson, Brian; Streltzer, Jon. “Risks Associated with Long-Term Benzodiazepine Use.” American Family Physician, August 15, 2013. Accessed January 17, 2021.

World Health Organization. “Clinical Guidelines for Withdrawal Manag[…]e in Closed Settings.” 2009. Accessed January 17, 2021.

Hedegaard, Holly; Bastian, Brigham A.; Trinidad, James P.; et al. “Regional Differences in the Drugs Most F[…] United States, 2017.”  National Vital Statistics Reports, October 25, 2019. Accessed January 17, 2021.

Gladden, R. Matt; O’Donnell, Julie; Mattson, Christine L.; Seth, Puja. “Changes in Opioid-Involved Overdose Deat[…] January–June 2018.” Centers for Disease Control and Prevention, August 30, 2019. Accessed January 17, 2021.

BMJ Best Practice. “Benzodiazepine overdose.” December 18, 2020. Accessed January 17, 2021.

VisualDX. “Benzodiazepine use disorder.” March 28, 2019. Accessed January 17, 2021.

National Institute on Drug Abuse. “What Are Signs of Drug Use in Adolescents, and What Role Can Parents Play in Getting Treatment?” January 2014. Accessed January 17, 2021.

Medical Disclaimer

The Recovery Village aims to improve the quality of life for people struggling with substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare providers.