Xanax Withdrawal Timeline
There are few drugs in existence which, once a user has become addicted, can cause a fatality during the detox process. Death during detox typically occurs once the body’s respiratory system has a cessation. The brain, acclimated with whatever substance, can experience a debilitation in its neurotransmitters (the chemicals it uses to relay messages) and consequently forget to govern certain organs. The result of which can be fatal.
Two such substances are alcohol and Benzodiazepines (sedatives like Valium and Librium used to treat anxiety and panic disorders). If you arrived here, then you probably know this article is going to focus on the most popular of Benzodiazepines (benzos for short); Xanax.
While the opioid epidemic remains fully in the spotlight, taking center stage as America’s most dangerous drug problem, benzos are having their own epidemic as well. In the shade of painkillers, however, this epidemic is but a whisper. Still, of the over 50,000 overdoses occurring annually, those which are prescription pill-related account for over half those fatalities. Of those overdoses, a third of them are attributed to benzodiazepines.
When speaking on the most prolific killer of Americans under 50—overdose—anything that contributes to it should be addressed. The relevance here is that if you are currently contemplating detoxing from Xanax (also known by its generic name, Alprazolam), then you are right to do so. Xanax can be deadly or at the very least detrimental to someone’s quality of life. Statistics validate that statement, with thousands dying per year from Xanax overdose and tens of thousands seeking treatment for a Xanax addiction.
However, we implore you to do your research, seek help, and identify the safest route possible in detoxing. As mentioned, Xanax has the potential to kill a user during withdrawals, which is why it is not recommended to quit cold turkey or without professional supervision. Despite, we know the road to recovery is rocky and ominous, so we commend you for taking a step in the right direction.
Xanax Withdrawals: What’s happening?
Alprazolam is the most popular drug prescribed to help those suffering from anxiety or panic disorders. Intended for short-term and ‘as-needed’ use, the implications of long-term Xanax use are dangerous. While no one outright decides they are going to create a tolerance, up their dosage, and frequent Xanax, the disease called addiction can have a mind of its own.
Our brain, spinal cord, and peripheral nerves form what we know as the central nervous system. Brain cells, or neurons, are responsible for governing the body. In essence, they regulate the bodily function by telling the organs what to do. The messengers they use are known as chemicals called neurotransmitters. Outside of transmitting messages for neurons, they have a complex gamut of responsibility. One such neurotransmitter is gamma-aminobutyric acid (GABA for short) and it is responsible for controlling our moods, governing our sense of calmness, and balancing out other ‘stimulating’ neurotransmitters.
Sufferers of anxiety or panic disorders are commonly believed to have an insufficiency amount of GABA, which allows their excitatory neurotransmitters (GABA is an inhibitory neurotransmitters—think of it as a downer, while the others are uppers) to run wild. Alprazolam is somewhat of a steroid to GABA, which helps the brain stimulate and produce more of it, thus balancing the chemicals and instilling a sense of calmness or relaxation.
Inversely, while Xanax is a miracle drug for some, the extended use of it destroys its efficacy. Eventually, the brain will create a tolerance and mistake Xanax for GABA entirely. This means when Xanax is removed from the situation, not only is the brain more imbalanced than before, it spirals into chaos when it tries to regain control.
Enter withdrawals. Withdrawals are the onset of your excitatory neurotransmitters going into hyper-drive without any GABA to play off. The ‘overdose’ of stimulation causes an array of symptoms that can quickly elevate due to the imbalance. You can think of it as a foot pressing down on a gas pedal in a car without brakes.
Fortunately, over time these symptoms will wane, the excitatory neurotransmitters will relax, and eventually, the symptoms will then pass. The withdrawal phase is your brain dealing with the aftershock of losing something it identified as vital to its existence, but this very shock is part of the healing process.
Xanax Withdrawal Timeline
The onset of withdrawals can occur literally an hour after the last dosage of Alprazolam entered the system, dependent on the severity of the addiction. The first wave of withdrawals are the hardest, most dangerous, and often cause relapse. This is why we recommend professional assistance when getting help with a Xanax withdrawal. They use tools and other medication to mitigate withdrawal symptoms, monitor vitals, and guide the body into its natural sleep cycle.
Stage One: (24-72 hours)
The severity in which withdrawals will affect someone in detox depends on the extent of their addiction. For some, the experience is crippling, while for others it is nothing more than a manageable discomfort. It is the first three days that former addicts often attribute as ‘hell.’
In this period, the brain spirals into shock, gridlocked in a chaotic scramble to understand why this imbalance is occurring. Some of the most common symptoms during this time are as follows:
Difficulty Sleeping, Insomnia
Xanax is sometimes prescribed specifically as a sleep aid. Its sedative and tranquilizing qualities make it an excellent drug to use when facing difficulties sleeping. Unfortunately, the kind of sleep Benzodiazepines induce is not the natural sleep the body craves. As the brain struggles to ‘turn off’ and find its way into your natural sleep pattern, the overdose of stimulation can make even moments of stagnancy unbearable.
If sleep does come, due vastly to the medicated sleep prior, as the brain attempts to call upon the REM part of the cycle, vivid dreaming can ensue (we’ll delve more into this later). Still, during this initial bout, those that have detoxed claim that sleeping can be nearly impossible. Eventually, the body’s need for sleep will outweigh the withdrawals set about by the absence of Xanax.
Increase Heart Rate, Seizures, Vomiting
It is during this time that the person detoxing is most vulnerable physically. If the dependency is severe enough, the brain can lose its functionality and forget to tell certain organs what to do. Seizures are not uncommon and long spells of vomiting can ensue. There is a reason why, in the initial phase of detox, professionals will often administer Valium to wane the addict off Xanax. This is also the time in which it is important to monitor vitals, as blood pressure and body temperature can drop, the heart can race, and the respiratory system can experience difficulty breathing.
Generally, once this period is passed, while other withdrawal symptoms can continue with vigor, the risk of death practically evaporates.
Mood Swings, Psychosis
As stated previously, when the brain experiences the initial detox shock, it is most vulnerable. Mood swings are common no matter what caliber of addiction. Without the proper production of GABA, the brain loses its tool to govern moods. Extreme agitation, depression, obsession, and aggression can develop. These moods can come and go at will, leaving the person in a state of confusion. Depending on the severity, antidepressants are sometimes prescribed to ensure that depression does not drive addicts to act irrationally.
A person detoxing from Xanax is at the highest risk for psychosis during this period. While death is clearly the most prolific evil of withdrawals, psychosis is the runner-up. In rare cases, withdrawals can cause hallucinations (both auditory and visual), delusions, manic behavior, and paranoia. This psychosis is typically short-lived, particularly when the person detoxing distinguishes that what they’re experiencing is a product of withdrawals.
Stage Two: (3-7 days)
The addict has now passed the most difficult period and the brain is making strides towards recovery. Willpower is the name of the game here, as it is in stage two that an addict can give up and succumb to their addiction. We’ll explain why.
The cycle of Xanax addiction is vicious. A patient first uses the drug to curb their anxiety. They develop dependence. Due to this dependence, without the drug anxiety runs rampant. The addict has experienced Xanax’s efficacy and proceeds to use more Xanax to put a band-aid on the overt problem; their anxiety disorder.
What occurs in this stage is essentially a plummet back into their initial disorder… except it’s worse than before. Rebound anxiety is the state the brain can fall into in the absence of Xanax and it’s more powerful than what initially brought the patient to medicate initially. This is where relapses occur, as the amplified anxiety is too much for the user to bear. Fortunately, this anxiety passes with time as the brain stabilizes its chemical structure. The difficulty is accepting that fate and being tenacious about willpower.
By now, the person in detox has most likely slept. If not, then three days without sleep poses an entirely new set of problems. However, the sleep the addict experiences is still debilitated by withdrawals. Vivid night terrors persist and sleep-anxiety can keep an addict staring hopelessly at the ceiling and crawling in their skin.
An interesting phenomenon here is often, if there are internal struggles present (we mean this philosophically), an addict will call forth memories otherwise dormant. They are usually unpleasant memories and certain events typically suppressed. It is as if the brain loses its stronghold on certain demons as it marches out against the army of this new war; Xanax addiction.
Stage 3: (2 Weeks)
In this stage, the hardcore withdrawal symptoms begin to wane, the hump has been crossed and now it becomes about sticking to the script. Day-to-day life is feasible once more.
For some, cravings never wane, they simply become more manageable. The brain has detoxed, is healing, and the lingering anxiety—which is still present during this phase—makes a Xanax bar sound delicious. Fighting through these cravings can be incredibly difficult, as the user begins to lose all the powerful withdrawal symptoms and instead marinates in anxiety (which originally brought them into contact with Xanax in the first place).
Emotional instability is still rampant here. The brain has not fully recovered and the functionality of GABA is still insufficient. Depression, irritability, aggression, extreme lethargy, and obsession can be present independently or coexist. In this phase, doctors will sometimes prescribe other non-addictive medications to assist with the emotional volatility. Quitting Xanax is fantastic but if the person is left in a hole of depression, than their propensity to act out or relapse is higher. Doctors and professionals work to engage their reward system in so that they know the right choice was made.
Stage 3: (3 Weeks)
This stage is part of the upswing. Cravings wane, sleep comes easier, and the light at the end of tunnel becomes a reality. Still, there is work to do.
The anxiety is no longer classified as the malicious and violent rebound anxiety, but simply anxiety in general. The addict must now learn how to cope with their anxiety without Xanax, which instills a sense of responsibility and helplessness that can manifest if they do not remain mentally fit. They have returned to the original problem which set them down the path of addiction and accepting that is no easy chore.
Xanax inhibits some of the other neurotransmitters that control the reward system. One such is serotonin, responsible for pleasure or our happiness. In the wake of withdrawals, depression can linger. If by week 3 the emotional volatility is still a factor, doctors will often prescribe a non-addictive medicine to give the brain a little kickstart to regulate its moods. Sometimes the person will surface from the volatility and other times they require medical assistance.
Stage 4: (4 Weeks)
The sun is out! The day is beautiful. The world is ready for the taking and the person finally begins to feel the unparalleled benefits of having beaten their addiction. Their energy levels begin to stabilize, sleep settles into a normal pattern, and now they’re tasked with managing their own anxiety and emotions.
Despite, if they made it to Stage 4, then the future is no longer grim but promising. The hard part is over and while they might deal with some residuals, it is vastly more manageable than the previous stages. It becomes a downhill battle instead of an uphill one and it is sheer willpower that will keep them moving towards sobriety.
Do Your Research
No two people are the same. While this is a general timeline derived from studies done on detoxing Xanax addicts, it does not mean this will be your or someone else’s template for quitting. Health, metabolism, and the severity of the addiction and usage are what dictate the form of withdrawals.
As stated previously, if you plan on quitting Xanax, at the very least speak to a professional to make sure you mitigate any health risks, prepare for withdrawals, and ensure that your path forward is not going to be interrupted by relapse. Remember, tens of thousands are dealing with what you are currently going through. You are not alone.
At Luminance Recovery, or rehab Orange County center can help any addict on their road to recovery. Contact us today for a new start.
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