Relaxing to DeathPosted: October 14, 2011
Can Xanax, the extremely popular prescription drug that soothes anxiety, make a mess of your life? Yes, it can — and not only because it’s highly addictive. It can easily kill you if you take too much of it. Frighteningly, we are seeing that more and more as people are dying… or driving so unsafely that they might kill others.
Xanax is old — it was first marketed in 1981 — but boy, has our society had a hard time learning to deal with it safely. The federal Centers for Disease Control and Prevention recently issued a report announcing that Xanax has become one of the leading causes of drug overdose in the state of Florida, where fatal overdoses of prescription drugs are now four times as common as those caused by illicit drugs such as heroin and cocaine. (A news story in the St. Petersburg Times reported that Xanax is turning up along with alcohol in the blood of an alarming number of people arrested for driving “under the influence.”) According to a recent report from the Substance Abuse and Mental Health Services Administration of the US Department of Health and Human Services, benzodiazepines are more commonly used for “recreational” purposes than opioids — and among them, Xanax is the most frequently misused. Three decades after its introduction, what we have with Xanax looks to be a major problem in the making.
SOMETHING TO BE ANXIOUS ABOUT…
Xanax (or alprazolam, its generic name), an antianxiety medication, is a controlled substance for which doctors in the US wrote 37.5 million prescriptions last year, nearly 40% more than five years ago. Why does a 30-year-old drug experience such a radical surge in popularity? It is prescribed as a treatment for panic attacks and generalized anxiety disorder, but many people who have no particular medical condition take it episodically, on an as-needed basis, simply as a way to get through life’s usual stressful situations — such as disagreements with a spouse… a presentation or performance review at work… flying in stormy weather. And many doctors are only too happy to let fly Xanax prescriptions for these uses.
Regular readers of Daily Health News know well how concerned I am about our society’s propensity to try to solve problems with pills. I spoke to Ihsan Salloum, MD, professor of psychiatry at the University of Miami, who told me that in his private practice he treats many patients with anxiety disorders and panic disorders… and he said that he simply won’t write prescriptions for Xanax. There are many alternatives that work well and are far safer, he said, and in his view, “the benefits of taking Xanax aren’t worth the risk.”
WHY SO DEADLY?
Dr. Salloum noted that as a member of the benzodiazepine class of drugs, which also includes Ativan, Klonopin and Valium, Xanax works its magic against anxiety by enhancing the brain’s production of gamma-amino butyric acid (GABA), sort of a natural tranquilizer — which explains why the side effects of Xanax include drowsiness, clumsiness, difficulty walking, slurred speech and loss of libido. Xanax is faster-acting than Klonopin and Valium and has a shorter half-life, which means people may need to take multiple doses over the course of the day to maintain their equanimity. A patient may be prescribed, say, two to four pills a day and end up taking even more as his body acclimates to the drug. It takes just a few months for physical dependence to develop, Dr. Salloum said, and with dependence comes a myriad of difficulties when it comes to withdrawal. There’s also a psychological dependence at play, a particular problem with anxious people who end up being anxious about their anxiety, taking more pills — and ending up with a problem that spins out of control.
I asked Dr. Salloum about the magnitude of problems in Florida, and he noted that not only is the use of Xanax very widespread in that state — its connection with DUI arrests is easy to explain because taking Xanax and alcohol together intensifies the effects of both. In addition, taking too much Xanax (or taking it in combination with other drugs such as narcotics) can cause severe reactions, including respiratory depression, cessation of breathing — it can even cause the heart to stop beating. Another major problem: In older people, the drug is especially prone to impair balance. “Research has shown that benzodiazepine drugs are to blame for many falls in the elderly,” said Dr. Salloum.
Dr. Salloum said that if you are reaching for an extra Xanax each time you feel cause for anxiety — don’t! While there are several antidepressants that have been FDA-approved for the treatment of anxiety disorders, they don’t have the same immediately soothing effect that Xanax has. Where does that leave you if you are prone to episodic anxiety? Dr. Salloum suggests learning other ways to calm yourself down, such as breathing exercises, yoga, meditation and the like.
So once again we seem to have wound our way back to the same conclusion — not only does taking a pill to make a problem go away not always work, in this case it makes the problem worse. If you are in the habit of taking Xanax for your anxiety, you’ve got reason to look for an alternative!
Source: Ihsan Salloum, MD, professor, department of psychiatry, University of Miami Miller School of Medicine.