Xanax (Alprazolam) Addiction Treatment for Veterans

Xanax (alprazolam) is a prescription benzodiazepine medication used for the short-term treatment of anxiety disorders and panic disorders.^1,2 Benzodiazepine medications are central nervous system (CNS) depressants, meaning that they help calm an otherwise over-excited nervous system and make people feel calm, relaxed, or sleepy.^1,2

Benzodiazepines like Xanax are widely acknowledged to cause physical dependence, with withdrawal effects possibly seen within as little as 4–6 weeks of continued therapy. The risk of dependence increases with higher doses and when benzos are taken longer term, and can cause addiction in some.³

Military Veterans are at high risk for longer-term benzodiazepine use and associated health consequences.⁴ Benzodiazepine use carries a larger risk for Veterans who are co-prescribed opioids, elderly, and those with PTSD, dementia, and chronic respiratory disease. In these populations the risks of harm from a benzodiazepine may outweigh the benefits.³

What Is Xanax and What Is it Used For?

Despite the risks, Xanax can be useful for the rapid control of certain symptoms (severe anxiety or panic attacks, seizures, alcohol or benzodiazepine withdrawal). Anxiety and insomnia are other common indications in which benzodiazepines are used.³

Although benzodiazepines can be helpful for improving symptom in the short term (i.e., period of less than 4 weeks), over the long term, they can also worsen anxiety and insomnia and convey significant risks that can increase with long-term use.^5,6

Adverse outcomes of long-term benzodiazepine use can include:^3,7

• Cognitive decline.
• Falls.
• Motor vehicle accidents.
• Benzodiazepine dependence.
• Opioid-benzodiazepine overdose.

Xanax, PTSD, and Trauma-Related Anxiety

Many Veterans may have been exposed to high levels of stress, trauma, and anxiety during their service. In the past, a doctor may have started them on Xanax in an effort to combat symptoms of anxiety and insomnia related to post-traumatic stress; however, recent research has revealed that benzodiazepines like Xanax are actually strongly associated with worsening PTSD symptoms and trauma-related anxiety.^3,8

Today, the risks associated with their use tend to outweigh potential short-term benefits. Benzodiazepine medications do not improve symptoms of trauma-related anxiety and are ineffective for PTSD treatment, as well as preventing PTSD, and benzodiazepines like Xanax can be harmful for people struggling with these conditions.^3,9

Xanax and Opioid Use

In 2016, a Food and Drug Administration (FDA) review found that the growing combined use of opioid medicines with benzodiazepines or other drugs that depress the central nervous system (CNS) has resulted in serious side effects, including slowed or difficult breathing and deaths. The FDA’s data review showed that physicians have been increasingly prescribing them together, and this has been associated with adverse outcomes.¹⁰

This has resulted in efforts at a national level to make the public aware of the dangers of taking these two medications. However, in 2021, nearly 14% of overdose deaths involving opioids also involved benzodiazepines.¹¹

Xanax Misuse and Polysubstance Use

Xanax and other benzodiazepines have a known risk for misuse and addiction. Addiction is chronic but treatable condition that is characterized by continued use of a substance despite the negative physical, emotional, psychological, or social consequences.¹³

Even taking benzodiazepines as prescribed may put patients at risk for misuse of their medication.¹ The impact of PTSD on day-to-day life can be incredibly debilitating and some Veterans may attempt to self-medicate with drugs or alcohol to alleviate symptoms,¹ which can lead to someone having co-occurring disorders. Co-occurring PTSD and substance use disorders are present in roughly 40% of both civilians and Veterans.^14,15

It’s relatively rare that someone will misuse Xanax on its own. Benzodiazpines like Xanax are typically secondary drugs of abuse and are often used with other substances, such as alcohol or opioids (i.e., polysubstance use). 

Benzodiazepines like Xanax are used to enhance the euphoric effects of other drugs; reduce the unwanted effects of drugs, such as insomnia due to stimulant use; as well as to alleviate withdrawal. People who misuse benzodiazepines like Xanax in combination with other substances take higher doses than those misusing only benzodiazepines.

Xanax Misuse Effects

Adverse effects that have occurred with benzodiazepine misuse includes abdominal pain, amnesia, anorexia, anxiety, aggression, ataxia, blurred vision, confusion, depression, disinhibition, disorientation, dizziness, euphoria, impaired concentration and memory, indigestion, irritability, muscle pain, slurred speech, tremors, and vertigo.¹

Severe adverse reactions that may occur with misuse includes:

• Seizures.
• Difficulty breathing.
• Delirium.
• Paranoia.
• Suicidal thoughts.
• Coma.

Benzodiazepine misuse can be fatal, however, death is more often associated with polysubstance use (especially when combined with opioids, alcohol, or other CNS depressants).¹

What Happens When You Stop Taking Xanax?

When someone suddenly stops taking Xanax or abruptly reduces their dosage they may experience withdrawal symptoms.^1,18 Withdrawal symptoms can vary in type and severity depending on several factors, including:¹

• Frequency of use.
• Amount used.
• Length of time Xanax was used.
• Concurrent use of other substances, like alcohol, opioids, or other prescriptions medications.
• The individual’s physical and mental health.

Is Xanax Withdrawal Dangerous?

Xanax withdrawal can potentially be life-threatening^.1 In particular, seizures that can occur during withdrawal from Xanax¹⁹ can lead to significant adverse outcomes including brain injury, coma and death.²⁰

Additionally, the physical and psychological discomfort from unmanaged withdrawal can lead to someone resuming Xanax use (or other substance use) to avoid these feelings.19[RK2] 

In order to safely manage withdrawal, medically supervised detox is beneficial for individuals with Xanax addiction.¹⁹ In medical detox people are monitored round-the-clock to ensure their safety and comfort. In the event that a medical emergency were to arise, healthcare professionals can respond right away.

Can You Quit Xanax Cold Turkey?

Because of the risk of potentially life-threatening withdrawal symptoms, attempting to quit Xanax cold turkey can be very risky, and you should not attempt to stop using Xanax without medical supervision.¹⁹

Treatment Options for Veterans with Addiction

While detox is an invaluable first step on the road to recovery, it is not a substitute for more comprehensive treatment.²¹ Often individuals require longer-term treatment in order to achieve lasting recovery.²¹ Veterans struggling with addiction to Xanax have several effective treatment options. These include:

• Inpatient/residential treatment.
• Outpatient treatment, which may include partial hospitalization programs (PHPs) and intensive outpatient programs (IOPs).

Often, individuals will start with a medically supervised detox and then move into more long-term care such as inpatient programming. In these treatment environments, Veterans will receive evidence-based addiction-focused healthcare in group and individual settings that can include:²¹

• Cognitive behavioral therapy.
• Dialectical behavior therapy.
• Eye movement desensitization and reprocessing (EMDR) therapy.
• Rational emotive behavior therapy (REBT).
• Adjunctive holistic treatment, such as yoga, mindfulness, exercise, etc.
• Support groups.

There is no one-size-fits-all approach to addiction treatment and recovery, and Veterans may find that a combination of several different approaches may be particularly helpful.²¹ Going to treatment at a facility that offers Veteran-specific treatment tracts may be especially beneficial.

Is Addiction Treatment Covered by the VA or TRICARE?

TRICARE for Veterans may cover some or all of your addiction treatment services, such as inpatient treatment, medical detox, and other proven treatments like mental health therapeutic services.²² However, coverage may vary and only apply to in-network providers so it’s important to check with your TRICARE provider to determine which services are covered.

Getting Help for Xanax Dependence and Addiction

If you are a Veteran struggling with Xanax dependence or a drug or alcohol addiction, know that there is effective help available to you. American Addiction Centers’ network of treatment centers are part of the Community Care Providers program. To find a drug or alcohol rehab near you, call our admissions navigators at 24/7. Recovery is possible and we’re here to help.