According to research, the single dose of Xanax that will kill 50% of test animals ranges between 331-1271 mg of the drug per kilo of body weight. This amount is the equivalent of 76-292 mg, or literally hundreds of 0.5 mg tablets. If one could mathematically predict a lethal dose of Xanax in humans based on the rat data, which can’t be done, the number of doses needed to kill a human would be in the tens of thousands.
That said, using Xanax in excess poses other health risks. Driving a car or operating machinery is ill-advised while under the influence of Xanax. Also, due to the profound drowsiness it can induce, falls and other injuries are also possible. Finally, when Xanax is combined with additional intoxicating substances, particularly other CNS (central nervous system) depressants, such as opioids and alcohol, this can prove lethal.
Moreover, it is uncommon for persons to die from an overdose on Xanax independently. Still, a large portion of drug overdoses in the U.S. currently involve Xanax and one or more other potentially lethal substances.
What Is Xanax?
Xanax (alprazolam) is a benzodiazepine (benzo) commonly prescribed to treat anxiety, panic disorder, seizures, and insomnia. Benzos are prescription medications that bind to GABA receptors in the brain that increase inhibitory signaling, thereby slowing certain brain and body activities. This depressant effect helps to elicit a therapeutic calming effect for those who are using benzos.
When this substance is used for short-term treatment under a licensed health provider’s direction, it is generally considered safe. However, it can be hazardous when misused, either by taking it without a prescription or taking more than prescribed.
Signs and Symptoms of a Xanax Overdose
- Impaired coordination
- Slowed reflexes
- Low blood pressure
- Respiratory depression
- Profound drowsiness
- Loss of consciousness
Although some deaths have been reported in association with Xanax used independently, fatal overdoses are much more likely to occur with concurrent use of other CNS depressants like opioids, alcohol, barbiturates, and other benzodiazepines. Indeed, in 2017, benzos were involved in more than 11,500 overdose deaths.
A Xanax overdose may require emergency medical intervention that includes maintaining healthy blood pressure, airway management and assisted ventilation, and administration of the benzo antagonist, flumazenil.
If you suspect that you or someone you know is overdosing on Xanax or other substances, please call 911 immediately or visit the nearest emergency department.
Dangers of the Polydrug Cocktail
Polydrug intoxication, or the use of multiple drugs simultaneously, commonly includes benzos such as Xanax. Most deadly benzodiazepine overdoses involve other drugs, with a large percentage of those involving opioids like heroin and prescription painkillers.
When an individual takes other depressant drugs with Xanax, specific effects may be compounded, and a much lower dose may be lethal. This outcome is extremely alarming because an estimated 80% of all benzo abuse is done in conjunction with the use or misuse of other intoxicating substances.
Alcohol and benzos are an especially dangerous combination. Xanax, when used concurrently with alcohol, may easily result in an overdose and death. Similarly, using Xanax with opioids can increase health risks significantly. In 2017, nearly 10,000 overdose fatalities involved the use of both opioids and benzos.
According to a SAMHSA review of nearly one million benzo-related ER visits from 2005-2011, persons who combined benzos with opioids or alcohol were associated with a 24%-55% increase in the risk of a more serious outcome compared to the use of benzos alone. “Serious outcome” was defined as a required hospital admission or fatality in the emergency department.
Serious Xanax Side Effects
Although relatively rare, using Xanax even as prescribed by a health provider can result in serious side effects, including the following:
- Pronounced mood changes
- Suicidal ideations
- Impaired coordination or balance
- Problems speaking
- Shortness of breath
Using Xanax can also be hazardous during pregnancy because benzos can cross the placenta, potentially leading to fetal dependence and withdrawal.
Xanax Addiction and Physical Dependence
Aside from the risk of overdose, Xanax is also associated with the potential for abuse, physical/chemical dependence, and addiction.
People addicted to Xanax are often unable to control behaviors associated with their drug-seeking and use. They may abuse Xanax by taking it in dangerously high doses or combining with other substances that increase the risk of a lethal overdose.
Physical dependence is not the same as an addiction but is usually present in individuals addicted to benzos. Dependence involves changes in the brain and body related to Xanax use in which the person becomes unable to function with the drug, and if forced to do so, it results in unpleasant and potentially life-threatening withdrawal symptoms.
Xanax dependence can develop rapidly in a matter of weeks. Because of Xanax’s intrinsic risks—including its potential for abuse and dependency—benzos such as Xanax should only be prescribed for a brief time period.
Once an individual has developed significant dependence, it can be dangerous to stop taking Xanax abruptly or “cold turkey.” At this point, discontinuation of the drug should be guided through medical supervision and possibly pharmaceutical intervention.
Acute Xanax withdrawal symptoms may include the following:
- Impaired concentration
- Lack of appetite
- Stomach pain
- Increased heart rate
- Increased blood pressure
- Blurred vision
- Muscle cramps
Many acute symptoms of Xanax withdrawal will resolve within 1-4 weeks of cessation. However, some protracted psycho-emotional withdrawal symptoms may persist for several months and involve anxiety, depression, and sleep disturbances.
Getting Treatment for Xanax Dependence
Due to the potential risks associated with Xanax withdrawal, individuals dependent on this drug are encouraged to quit under medical supervision rather than do it alone. One approach that is very effective at reducing withdrawal symptoms and minimize safety risks is to wean people off of benzos by using a tapering schedule. In this case, the health provider may opt to prescribe a longer-acting benzodiazepine or stay with the same medication while decreasing the dosage methodically over several weeks or months.
Besides a tapering schedule and symptom management, detox programs offer around-the-clock care and support. Health professionals will monitor vital signs and watch for possible medical complications. Other drugs, including phenobarbital, anticonvulsants, and sedating antidepressants, may also be prescribed to help manage benzodiazepine withdrawal symptoms.
For persons heavily abusing Xanax and/or other substances, detox alone is often insufficient at promoting long-term abstinence. That is, detox and withdrawal management programs prepare people for more extended, comprehensive programs where they can learn how to live in recovery. Inpatient treatment provides an opportunity to live temporarily in a safe, supportive environment while attending intensive group and individual therapies throughout the day.
Just Believe Detox and Just Believe Recovery offers individualized treatment programs in partial hospitalization and residential formats. All plans include a wide variety of therapeutic services and activities, including psychotherapy, counseling, group support, substance abuse education, art/music therapy, mindfulness therapy, aftercare planning, and more.