Xanax (Alprazolam) Addiction Treatment for Veterans

Xanax (alprazolam) is a prescription medication classified as a benzodiazepine. It is primarily used for the short-term treatment of anxiety disorders and panic disorders. Benzodiazepines, such as Xanax, are central nervous system (CNS) depressants, which means they help to calm an overactive nervous system, resulting in feelings of calmness, relaxation, or drowsiness.

Although benzodiazepines like Xanax can be effective, they are known to cause physical dependence. Withdrawal symptoms can appear after as little as 4 to 6 weeks of continuous use. 

The risk of dependence increases with higher dosages and prolonged use, potentially leading to addiction in some individuals.

Military veterans are particularly at risk for long-term benzodiazepine use and its associated health consequences. The risks are even greater for veterans who are also prescribed opioids, as well as for older adults and individuals with conditions such as PTSD, dementia, and chronic respiratory diseases. In these populations, the potential harms of benzodiazepine use may outweigh the benefits.

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

Numerous Veterans have encountered significant levels of stress, trauma, and anxiety during their military service, which can profoundly impact their mental health. Historically, in an attempt to alleviate symptoms of anxiety and insomnia linked to post-traumatic stress disorder (PTSD), healthcare providers often prescribed benzodiazepines like Xanax. However, recent studies have shed light on an alarming correlation: the use of benzodiazepines is strongly associated with an exacerbation of PTSD symptoms and an increase in trauma-related anxiety.

As our understanding of mental health evolves, it has become increasingly clear that the potential risks of these medications often overshadow any short-term benefits they might offer. Benzodiazepines, including Xanax, do not provide relief for symptoms associated with trauma-related anxiety, nor do they effectively treat or prevent the onset of PTSD.

For individuals grappling with these mental health challenges, benzodiazepines can pose significant risks, further complicating their recovery. The evidence underscores the need for alternative therapeutic approaches that are more effective and safer for Veterans dealing with the aftermath of their service-related experiences.

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

Although detoxification serves as a crucial initial phase in the journey toward recovery from addiction, it should not be viewed as a standalone solution. Many individuals find that they need extended and varied therapeutic interventions to attain enduring recovery.

For veterans facing challenges with Xanax addiction, there are numerous effective treatment pathways available. These options can range from inpatient rehabilitation programs to outpatient therapy and support groups, each designed to address the unique needs of veterans and help them regain control of their lives.

Comprehensive treatment plans often include counseling, medication-assisted treatment, and holistic approaches to ensure a well-rounded recovery experience.

These include:

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

Many individuals begin their recovery journey with a medically supervised detoxification process. This initial phase is crucial as it allows for the safe management of withdrawal symptoms under the care of healthcare professionals.

After successfully completing detox, patients typically transition into more comprehensive and long-term treatment options, such as inpatient rehabilitation programs. These programs provide an immersive environment where individuals can receive targeted therapy, counseling, and support, all aimed at addressing the underlying issues related to addiction and fostering lasting recovery.

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

As a Veteran, if you’re facing challenges with Xanax dependence or addiction, remember that effective support is readily available to guide you to a brighter future! 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.