Xanax has become one of the most prescribed medications in the United States, and recent statistics have shown more youths and children are using the medication. Parents may wonder how a powerful drug like Xanax affects the developing brain of teenagers and young adults, and what to do if there are signs of abuse and damage.
To understand the effect of Xanax on the developing brain, it is necessary to look at what Xanax is and how it operates. What we call Xanax is the brand name for the generic drug alprazolam, which belongs to a category of drugs known as benzodiazepines. Benzodiazepines are useful because they are formulated to boost the production and effects of the GABA (gamma-Aminobutyric) neurotransmitter in the central nervous system.
This neurotransmitter is responsible for regulating nervous excitation and transmissions to the brain among other tasks; this, in turn, settles nervous activity, helps a person stay calm, and aids them in controlling their moods and behavior.
Many people are born with mental health or medical conditions, whereby their brains do not produce enough of the GABA neurotransmitter. The result of this is that these people struggle to control their responses to a stress-related situation. They might experience regular panic or anxiety attacks, and they cannot manage their responses accordingly.
This is where benzodiazepines come in. When a patient consumes a benzodiazepine, the medication stimulates the brain into producing and releasing increased amounts of the GABA neurotransmitter. The patient then feels a wave of comfort and tranquility, which helps them better regulate their moods and behavior in the face of stress. For many people, benzodiazepines like Xanax are the difference between helplessness and fear, and relaxation and calm.
As such, benzodiazepines are typically prescribed for conditions that are related to anxiety and the inability of the nervous system to calm its electrical signals such as:
The speed and effectiveness of Xanax have made it “the single most prescribed psychiatric medication in the U.S.,” according to Medical News Today. A Q-and-A on CNN explains that antidepressants can take up to weeks to calm the anxiety centers of the brain, but Xanax and other benzodiazepines “produce immediate relief.”
However, this comes with some significant caveats. With time and exposure, the brain adjusts to the quick and reliable activity of Xanax, to the point that the user comes to develop a psychological dependence on the medication for not just anxiety regulation, but also general well-being. Abruptly stopping consumption suddenly causes the brain to overshoot.
Many systems and functions that had come to rely on the benzodiazepines go into a frenzy when the drug is removed, not knowing how to accommodate for the loss. This frenzy takes on the form of withdrawal symptoms, such as intense anxiety, desperation for more Xanax, high blood pressure, and trembling in the extremities.
Additionally, Xanax has a very short half-life, which is the length of time it takes for the amount of the drug in the blood plasma to be reduced by 50 percent of the original dose. While it takes less than an hour for the effects to be felt, the half-life of Xanax is 11 hours, which is quite short when compared to other benzodiazepines. In effect, the medication goes in and out of the body fairly quickly. As a result of this, most people tend to experience low-key withdrawal symptoms between their doses even though they are taking the drug as prescribed, so they tend to take more Xanax than they should, which continues and deepens the dependence on the medication for anxiety relief.
Teenagers go through one of the most active developmental stages of their lives during their adolescence. There are drastic and wide-ranging changes in their brain expansion, physical development, and hormonal activity. This can be overwhelming, to the point where schoolwork, their home life, their social world, and their romantic and sexual relationships become sources of significant stress and confusion.
To this point, more and more teenagers and youths have been prescribed benzodiazepines like Xanax to help them navigate the uncertainty of this time in their lives. Many others have started to illicitly use Xanax recreationally to self-medicate and enjoy the rush of tranquility and peace that comes from the GABA neurotransmitter boost. Additionally, some combine their Xanax with other substances, like alcohol or other medications, in an attempt to intensify the desired effects.
HuffPo explains that the earlier Xanax is used in a person’s life, the greater the chance that this primes the brain to seek out addictive experiences in adulthood. In 2016, the United States Surgeon General reported that almost 70 percent of the adolescents who tried an illegal drug before they were 13 years old would grow up to develop some form of addiction by the time they hit 20. On the other hand, for people who had their first experience with an addictive substance by the age of 17, only 27 percent struggled with addiction when they turned 20 years old.
The director of adolescent addiction treatment at Boston Children’s Hospital told HuffPo that adolescent use of benzodiazepines has “skyrocketed,” with more young people being admitted to hospitals because of the seizures induced by Xanax withdrawal.
Part of the problem is that with significant media coverage of the prescription opioid epidemic, many teenagers and young adults abuse benzodiazepines (especially ones with household names, like Xanax) because they believe that as a medication, it cannot be as harmful as heroin or infamous opioids like OxyContin and Vicodin. Because of this misconception, many increase their Xanax consumption when life stresses them out, and they increasingly abuse the medication when they feel withdrawal symptoms.
An addiction psychiatrist at Johns Hopkins University School of Medicine warned that among teenage patients he sees, benzodiazepines are surpassing opioids as the leading prescription drug of abuse. While such patients might stay away from opioids, “many of them are extreme, high-dose users” of drugs like Xanax.
Because so many adults are prescribed so much Xanax, many people in high school or even younger grow up with some familiarity surrounding the medication, and the dangers of abusing it are drowned out by ubiquitous praise for the drug’s effects. Ultimately, with so many pills to solve every ailment from steadying anxiety to promoting sleep, stressed and confused youths are tempted to go to their parents’ medicine cabinets for Xanax before they talk about their problems.
Another dimension is that for people in the later years of high school or the early years of college, experimenting with drugs or alcohol is commonly seen as a rite of passage. The peer pressure to participate in such consumption, combined with the blanket belief that Xanax is simply “good” or “harmless,” prime many young adults to develop an unhealthy relationship with the powerfully addictive substance.
With no guidelines to limit their use, many young people move quickly past the point of relieving stress or getting high, to flooding their central nervous system with waves of unnecessary neurotransmitters. This can leave a lingering imprint on the still-developing brain (still a “work in progress”) and even change its functioning and chemical structure.
It is often forgotten that the teenage brain undergoes a rapid and drastic change in a relatively short time. Even in the late teen years, the prefrontal cortex — the region responsible for decision-making, judgment, and impulse and emotional control — is still being stitched together. Having said that, the nucleus accumbens, which regulates reward and pleasure, is mostly in place by the teenage years.
This means that while a teenager or young adult might struggle to make sound decisions in the face of temptation, their brain will instinctively recognize what will feel good and pull them in that direction. This is why many teenager exhibit impulsive and risky behavior; they may know it’s not good for them, but the part of their brain that can exercise judgment is still under construction.
How does Xanax come into play here? As a benzodiazepine, the medication works by accessing the communication system of the brain and imposing itself on how nerve cells send and receive signals and process information. Every time Xanax is consumed, the nucleus accumbens releases dopamine, the neurotransmitter that controls those feelings of pleasure and reward.
This is the mechanism behind any form of drug addiction, and in a teenage brain, the effect is even more pronounced. Few experiences can compare with the chemically driven burst of pleasure, so more Xanax is taken (or combined with other substances), so much so that the body cannot produce its own dopamine.
With repeated exposure to Xanax over time, the developing brain quickly loses its ability to produce its own GABA, so a person will not be able to sleep or relax without the medication. Similarly, the neurons responsible for releasing the dopamine neurotransmitter might atrophy, so the person will not be able to feel any kind of pleasure outside of Xanax consumption. The rapid rewriting of the brain’s chemistry can also lead to memory problems and increased difficulty in cognitive functioning. Without treatment, these problems can be lifelong.
If you suspect that your child or teenager is abusing Xanax, it is important that both parents present a united front when talking about the problem. Helping your child seek treatment and rehabilitation is not about assigning blame; it is about working together.
This might mean admitting to past drug or alcohol use, or improper use of Xanax. However, the focus should be on what you want from your teenager and that your teenager’s use of Xanax is dangerous. If your child has been hiding their Xanax use or if their academic and social life has suffered because of the consumption, these will be the points to discuss even if it means enduring hurtful words and accusations.
The key is to remain calm and to always work with your teenager from a position of love and support. Expectations and goals should be realistic, such as considering that your teenager might outright deny that they’ve been abusing Xanax, or that they don’t have to listen to you because you’ve also used Xanax. Ultimately, no matter what they say, the odds are not in their favor if they continue their Xanax abuse.
When the time comes for undoing Xanax damage, there are two parts to the process: detoxification (weaning your teenager off Xanax) and therapy. Breaking physical dependence on Xanax can be a stressful experience in and of itself, so it should not be attempted without medical supervision. At a hospital or treatment center, staff can issue anti-anxiety and anticonvulsant medications (often other benzodiazepines that are more long-acting than Xanax) to ease the symptoms of agitation and insomnia until your child’s body is no longer desperate for Xanax.
Once this stage is done, your teenager should go through a therapy program. This will address the psychological issues behind the Xanax abuse, such as helping them to relearn how to control stress without benzodiazepines. This can involve developing coping strategies and changing negative thought patterns. Family involvement is a vital part of long-term rehabilitation, and group therapy sessions with all members of the family can help to undo much of the damage that Xanax abuse has caused.
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