If you have ever been prescribed a medication to treat anxiety or stress, it may very well have been alprazolam (Xanax, Xanax XR, Niravam). Fast acting and with few side effects, alprazolam is one of the most commonly prescribed drugs on the market.

However, alprazolam is also highly addictive. Because euphoria can be a side effect, it has also become a popular party drug, especially among teenagers. When alprazolam is used illicitly, it is often combined with opioids and alcohol. This can be deadly. According to the U.S. Substance Abuse and Mental Health Services Administration (SAMHSA), emergency room visits related to alprazolam are increasing, climbing from more than 57,000 in 2005 to nearly 124,000 in 2011.

It is important to be aware of the dangers associated with alprazolam and to be familiar with signs of its misuse.

What is alprazolam?

Alprazolam is a sedative often taken for far longer than the short-term use for which it was developed. Alprazolam belongs to a class of drugs called benzodiazepines, which are central nervous system depressants. By reducing nerve activity in the brain, benzodiazepines create feelings of calmness and well-being. Most users of alprazolam begin to experience these effects within 20 minutes of taking the medication. This is what makes alprazolam so appealing and also why it has become such a problem. People who are prescribed alprazolam can build up a tolerance to it over time. In order to continue to feel its effects, they may start taking more than their prescribed dose. Meanwhile, people who are using drugs recreationally are attracted to alprazolam for its quick high. Both of these circumstances can lead to dependency and addiction that can be both psychological and physical.

Alprazolam abuse can also affect employee behavior, costing employers thousands of dollars. This is due to increased absenteeism, lost productivity, negative interpersonal actions that impact work and increased resource allocation to deal with ineffective workers.

Signs of possible dependency or addiction in the workplace include:

• Inconsistent arrival and departure times, extended lunch periods, unexplained absences and increased absenteeism
• Lost productivity
• Inconsistent performance
• Increased resource allocation to deal with ineffective workers

• Negative interpersonal interactions that impact teamwork

Signs of dependency and addiction include:

• Being unable to cope without the medication
• Symptoms of withdrawal between doses
• Tolerance to the effects of the drug
• Unsuccessful attempts to stop taking the drug

Withdrawal symptoms include:

• Anxiety, tension or panic attacks
• Heart palpitations
• Nausea, vomiting and diarrhea
• Depression
• Sensitivity to light or sound
• Memory loss
• Hallucinations
• Changes in personality
• Seizures

Because of the severity of alprazolam withdrawal, anyone who has developed a dependency or addiction should never try to quit on their own. Medical supervision is essential. Most people abusing alprazolam will have a greater chance at recovery and stopping their abuse of the drug with assistance from a professional.

Minimize the risks for abusing alprazolam and all prescription medications by:

• Taking them as directed
• Keeping them in a safe place where they cannot be found by others; especially if adolescents, teenagers and young adults reside in the home
• Safely disposing of leftover medications when they are no longer needed:
  • Mix medicines (do NOT crush tablets or capsules) with an unpalatable substance such as kitty litter or used coffee grounds.
  • Place the mixture in a container such as a sealed plastic bag.
  • Throw the container in your household trash.

Some medications should be flushed. Click here for a list of medications that qualify. If you are throwing out an empty bottle, scratch out all information on the prescription label to make it unreadable.

Medicine take-back programs are also a good way to dispose of drugs you no longer need. Contact your city or county government’s household trash or recycling service or your pharmacist to find out if your community has a medicine take-back program. You can also find information by visiting the U.S. Drug Enforcement Administration’s website.

[Janet Lubman Rathner]