Drugs that interact with brain chemicals are said to be psychoactive, and these mind-altering substances work by stimulating, suppressing, or changing the way that chemical messengers are sent around the central nervous system. Drug tolerance occurs when the brain starts to accept the changes being made to its chemical makeup as a matter of course; therefore, the same dosage of the drug will no longer be effective. The brain can learn how to regulate itself with the presence of a drug when it is taken repeatedly, and tolerance can form.
Once drug tolerance is established, the dosage will need to be increased. Higher levels of the drug are needed to interact with brain chemistry in the same way. Since Xanax is a benzodiazepine drug (alprazolam), it stimulates the activity of GABA (gamma-aminobutyric acid) in the brain. GABA is one of the brain’s neurotransmitters that is involved in the stress, or fight-or-flight, response. It helps to slow down functions of the central nervous system that are hyperactive during stress, such as respiration, blood pressure, and heart rate. Body temperature, muscle tension, and the feeling of being on edge or hyperalert are reduced.
Xanax is prescribed to treat anxiety and panic disorders. Tolerance to the drug can build up quickly even when the medication is taken for medicinal purposes and in the correctly prescribed dosage.
Xanax tolerance can be recognized by the following:
Xanax is one of the most prescribed benzodiazepines and also one of the most misused, per the U.S. Drug Enforcement Administration (DEA). When Xanax dosage is escalated, or the drug is taken in between doses or in ways other than it was intended, this is drug abuse.
Xanax may be abused for a variety of reasons, including for recreational use, to produce a pleasant high. Misuse of Xanax can increase the rate of tolerance more quickly as can personal factors, including metabolism and other genetic and biological aspects.
Drug tolerance to Xanax can form from both recreational and medicinal use. Once tolerance is established, the drug will no longer be effective in regular doses.
The manufacturer of Xanax, Pfizer, warns that it is only meant to be taken for the short-term management of panic or anxiety symptoms. Taking Xanax regularly, even for a relatively short period of time, can cause drug tolerance and physical dependence to form.
Dependence on Xanax happens with chronic use and can cause potentially life-threatening withdrawal symptoms if use is stopped suddenly, the U.S. Food and Drug Administration (FDA) warns. Irregular heart rate, hypertension, elevated body temperature, anxiety, depression, tremors, insomnia, hallucinations, psychosis, and potentially fatal seizures can all be side effects of benzodiazepine withdrawal.
Xanax is considered a highly addictive drug, as well. The National Survey on Drug Use and Health (NSDUH) reports that in 2016, more than 600,000 people in the United States struggled with drug addiction involving a tranquilizer medication. Escalating dosage due to drug tolerance raises the odds for developing dependence, suffering from dangerous withdrawal symptoms, and experiencing addiction.
Once it is clear that a Xanax tolerance exists and the drug is no longer effective in lower doses, it may be time to switch medications, find alternative treatments, and moderate use. Since withdrawal symptoms from Xanax can be extreme and hazardous, it is not a drug that can be stopped cold turkey, or suddenly. Instead, it will need to be tapered down over a period of time and slowly weaned out of the body.
Medical detox is the optimal option for Xanax withdrawal due to the potential for life-threatening withdrawal symptoms. It provides a safe space where the drug can process out of the body with the aid of medication to manage withdrawal symptoms.
Xanax is a short-acting benzodiazepine medication. During detox, it can be switched out with a longer-acting tranquilizer medication that can stay in the system longer and may be effective in lower doses than Xanax.
Alternatives to medication may be explored, as Xanax is meant to be used for short-term management of anxiety or panic disorders. It is optimally used in conjunction with behavioral therapies and counseling as well. Talk with your medical and/or mental health professional to devise the best course of action.
Again, once tolerance has formed, use shouldn’t just be stopped suddenly. Benzodiazepine withdrawal can be fatal if the drug use is abruptly ceased, especially in the case of short-acting drugs like Xanax that are taken in high doses for an extended amount of time.
In a medical detox program, benzodiazepine doses can be tapered down slowly over a set time period to allow the brain time to reset. The brain will begin to regulate its chemical makeup and learn how to balance without the medication.
Detox on its own is not sufficient to achieve recovery. A drug abuse and addiction treatment program can teach healthy stress coping mechanisms and methods for managing anxiety and enhancing relaxation.
Once a Xanax tolerance exists, the drug is no longer beneficial in low doses. It can be a good idea to find alternative methods to manage anxiety and panic symptoms. Tolerance can often encourage medication misuse and abuse. The National Institute on Drug Abuse (NIDA) reports that over 10,000 people died from an overdose involving a benzodiazepine drug like Xanax in 2016 in the United States. If you develop a tolerance to Xanax, whether through legitimate medical use or recreational use, talk to your doctor. You should not attempt to stop taking the drug on your own. A taper under medical supervision is necessary.
(January 2013). Benzodiazepines. U.S. Drug Enforcement Administration. Retrieved October 2018 from https://www.deadiversion.usdoj.gov/drug_chem_info/benzo.pdf
(2018). Xanax Alprazolam Tablets. Pfizer. Retrieved October 2018 from https://www.xanax.com/
(September 2016). Xanax. Alprazolam Tablets. U.S. Food and Drug Administration. Retrieved October 2018 from https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf
(September 2017). Key Substance Use and Mental Health Indicators in the United States: Results from the 2016 National Survey on Drug Use and Health. Substance Abuse and Mental Health Services Administration. Retrieved October 2018 from https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR1-2016/NSDUH-FFR1-2016.htm
(August 2017). Benzodiazepine Withdrawal Syndrome: Presentations and Emergency Department Management. EmDocs. Retrieved October 2018 from http://www.emdocs.net/benzodiazepine-withdrawal-syndrome-presentations-emergency-department-management/
(August 2018). Overdose Death Rates. National Institute on Drug Abuse. Retrieved October 2018 from https://www.drugabuse.gov/related-topics/trends-statistics/overdose-death-rates