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What are Xanax Bars?

Xanax (alprazolam) is a medication commonly used to treat anxiety, depression, and insomnia. It often comes in long, skinny tablets called Xanax “bars.”

The generic form of xanax is alprazolam. Alprazolam is a benzodiazepine. This is a class of powerful tranquilizer medications commonly prescribed for anxiety and panic attacks.10, 12 They are also sometimes used to treat insomnia and seizures.

Xanax is sometimes referred to as “Xannies,” “Zannies,” or “benzos.” Some other street names include “bars,” “planks,” “bricks,” and “Zanbars.”

While being a controlled substance, Xanax is also the most prescribed psychiatric medication in the United States.12 One study suggests around 48 million Xanax prescriptions are written each year.1

Because of how available it is, Xanax is widely misused. Concerns over a Xanax “epidemic” have been growing in recent years.7

Some facts about Xanax:

  • Xanax is the most prescribed benzodiazepine medication.1 
  • Nearly 5% of Americans between ages 18 and 80 filled a prescription for Xanax or other benzodiazepines in 2008.9
  • One report found that Xanax misuse-related emergency room visits were highest than all other benzodiazepine medications.2 
  • Another report found these visits doubled between 2005 and 2010.7
  • Xanax is often misused with other drugs like opiates and alcohol.1
  • Xanax is the fifth most common drug involved in fatal overdoses in the US.1

Xanax is a highly addictive substance, even more than other benzodiazepines.10 It should never be taken without a prescription.

Read on to learn more about the effects and dangers of Xanax use. 

How Does Xanax Make You Feel?

Xanax is a powerful sedative. It depresses the Central Nervous System (CNS), and slows down the brain, creating a calming effect in the person taking it. 

A person who takes Xanax will feel physically and mentally relaxed. They might also feel quiet, sleepy, and confused.

Some people have also reported a feeling of euphoria when taking Xanax.

Because it is a depressant, people often use it after partying the night before to sleep.

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How are Xanax Bars Made?

Xanax bars are made by pressing by taking the powder form of alprazolam and compressing it into tablets. These tablets are then scored and imprinted “XANAX 2 mg.” 

This is done with a pill press machine. 

Because ownership of pill presses is legal, anyone can make counterfeit Xanax.3 This is often laced with fentanyl and other additives, making it more deadly.

Why Do People Misuse/Use Xanax Bars?

Xanax bars are not the only form of Xanax. Legally prescribed Xanax can also come in different-colored oval pills, which vary in dosage.4

Xanax oval tablets are available as:

  • 0.25 mg: white, scored, imprinted “XANAX 0.25”
  • 0.5 mg: peach, scored, imprinted “XANAX 0.5”
  • 1 mg: blue, scored, imprinted “XANAX 1.0”

People like taking Xanax bars because they are the most potent form of Xanax. One Xanax bar is a two-milligram dose. 

For perspective, the maximum recommended dose for Xanax is four milligrams.15 This dose is supposed to be taken gradually throughout the day. 

People also like to misuse Xanax bars because they are easily broken into fourths. This makes them more convenient than other forms. 

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What are the Side Effects & Risks of Xanax Bars?

The body absorbs Xanax rapidly, with side effects emerging within the first hour of dosage.

In clinical trials, the following side effects were recorded: 

  • Sleep issues (both insomnia and drowsiness)
  • Fatigue
  • Lowered libido
  • Sweating
  • Impaired coordination
  • Nasal congestion
  • Xerostomia (dry mouth)
  • Nausea 
  • Vomiting
  • Stomach pain
  • Loss of appetite
  • Memory loss
  • Loss of focus
  • Constipation 
  • Diarrhea
  • Migraines
  • Blurred vision
  • Dizziness
  • Swelling in hands and feet

In clinical trials, the following risks were recorded:

  • Hypotension (low blood pressure)
  • Tachycardia (rapid heart rate)
  • Insomnia
  • Unintended weight gain or loss
  • Muscle spasms
  • Sexual dysfunction
  • Depression
  • Aggression and hostility (rare cases)

While inconclusive, some evidence suggests children born to mothers taking Xanax are at increased risk for abnormalities.1

The risks from Xanax misuse include addiction, coma, and death via overdose. 

People who misuse Xanax bars often take them with alcohol or opiates. In this case, side effects are intensified, and risk of death is significantly higher.13

Can You Overdose on Xanax Bars?

It is easy to overdose on Xanax bars.

The maximum recommended dose for Xanax is four milligrams. Each Xanax bar is two milligrams, so anything over two bars is an overdose.15

Symptoms of Xanax Overdose 

Possible symptoms of a Xanax overdose include:

  • Inability to stay awake
  • Shallow breathing
  • Slurred speech
  • Slowed reflexes
  • Rapid or irregular heart rate
  • Hallucinations
  • Chest pain
  • Confusion
  • Depression
  • Tremors
  • Unusual talkativeness
  • Joint discomfort
  • Coma

What to Do if You Overdose on Xanax

Overdoses of Xanax by itself are rarely fatal. However, Xanax is often misused in conjunction with opiates and alcohol.10 In these circumstances, an overdose can be extremely dangerous. 

In addition, compared to other benzodiazepine medications, a Xanax overdose is more toxic. so immediate attention is required.5 

If you suspect you or someone you know has overdosed on Xanax, seek medical help immediately.

Are Xanax Bars Addictive?

Xanax bars are highly addictive. Multiple studies have found Xanax has the highest potential for misuse out of all the benzodiazepine medications.1, 10

Symptoms of Xanax Misuse & Addiction

Here are some signs that someone may be abusing Xanax bars:

  • Keeping xanax pills around at all times (often in little baggies)
  • Missing work or family obligations 
  • Secretive behavior and dishonesty
  • Sleeping all the time
  • Decreased sex drive
  • Mood swings
  • Personality changes
  • “Doctor shopping” (to obtain new prescriptions)
  • Constantly appearing disoriented and sluggish

Treatment Options for Xanax Addiction 

The first step in treating xanax addiction is a medical detox. This means using drugs to manage withdrawal symptoms. 

Professionals recommend tapering off Xanax gradually by replacing it with another (less potent) benzodiazepine.1

Because seizures and depression are typical withdrawal symptoms, anti-seizure medication and antidepressants may also be used.6

After detoxing, treatment should involve therapy to treat the drivers of addiction. 

Usually, these are mental health disorders such as depression and anxiety, which Xanax is often (ironically) prescribed to treat.14

Approaches such as cognitive-behavioral therapy (CBT) and motivational enhancement therapy have been used to successfully treat these conditions. 

These therapies can also take two forms:

  1. Inpatient therapy — The patient lives full-time in a rehab center.
  2. Outpatient therapy — The patient goes to receive treatment during the day but lives at home. 

One important note: Xanax is often misused in conjunction with other drugs like opiates or alcohol. 

In one study of those treated for addiction to benzodiazepines and another drug, over one-third received outpatient care. The remainder received either inpatient care or detox treatment.11

The same study found nearly half of those in treatment had a psychiatric disorder.11

Xanax Detox: Withdrawal Symptoms & Timeline

Withdrawal symptoms for Xanax can begin within hours of the last dose. 

Some of the symptoms, such as delirium and psychosis, are different from other benzodiazepine medications.1

Other symptoms of xanax withdrawal are common to other benzodiazepines but more severe. 

These include:

  • Rebounding anxiety 
  • Panic attacks
  • Seizures
  • Insomnia 
  • High blood pressure 
  • Elevated heart rate

Xanax withdrawal can last between 10 and 14 days.

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Resources

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Ait-Daoud, Nassima, et al. “A Review of Alprazolam Use, Misuse, and Withdrawal.Journal of Addiction Medicine, vol. 12, no. 1, 2018, pp. 4–10. Drug Abuse Warning Network. “National Estimates of Drug-Related Emergency Department Visits .Web.archive.org, U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES: Substance Abuse and Mental Health Services Administration , 2006. Ganim, Sara. “Counterfeit Drugs: Pill Presses Seized in Record Numbers | CNN.www.cnn.com, 2017. Highlights of Prescribing Information.Labeling.pfizer.com, 2021. Isbister, Geoffrey K., et al. “Alprazolam Is Relatively More Toxic than Other Benzodiazepines in Overdose.British Journal of Clinical Pharmacology, vol. 58, no. 1, 2004, pp. 88–95. Kaendler, SH. “Carbamazepine Shows Promise in Benzodiazepine Withdrawal.Inpharma Weekly, no. 799, 1996, p. 10., https://doi.org/10.2165/00128413-199107990-00024. Kuehn, Bridget M. “ED Visits for Sedatives Increase.JAMA, vol. 312, no. 4, 2014, p. 328. Law: More Anxiety over Drug Overdose Deaths: Impact of Benzodiazepines.Pharmacy.uconn.edu, University of Connecticut School of Pharmacy, 2020. Olfson, Mark, et al. “Benzodiazepine Use in the United States.JAMA Psychiatry, vol. 72, no. 2, 2015, p. 136. Schmitz, Allison. “Benzodiazepine Use, Misuse, and Abuse: A Review.Mental Health Clinician, vol. 6, no. 3, 2016, pp. 120–126. Substance Abuse and Mental Health Services Administration, Center for Behavioral Health Statistics and Quality. “Admissions Reporting Benzodiazepine and Narcotic Pain Reliever Abuse at Treatment Entry.The TEDS Report: Admissions Reporting Benzodiazepine and Narcotic Pain Reliever Abuse at Treatment Entry, 2012. Susman, Jeffrey, and Brian Klee. “The Role of High-Potency Benzodiazepines in the Treatment of Panic Disorder.The Primary Care Companion to The Journal of Clinical Psychiatry, vol. 07, no. 01, 2005, pp. 5–11. Warner, Margaret. “National Vital Statistics Reports.www.cdc.gov, 2016. Xanax (Alprazolam): Uses, Dosage, Side Effects, Interactions, Warning.RxList, RxList, 11 Mar. 2021.Xanax Dosage Guide.” Drugs.com, 2021.

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