Short-term harms of Xanax
These effects appear within hours of taking the drug and can occur even with medical use, but they get worse with larger amounts or when it is mixed with other substances:
- Drowsiness, lethargy, and slowed thinking and speech.
- Poor balance and coordination, and a higher risk of falls.
- Memory gaps, so the person does not remember events or conversations that took place while the drug was working.
- Slowed reactions, which make driving or operating machinery a real danger.
- Dizziness, headache and dry mouth in some people.
Long-term harms of Xanax
With continued use over weeks and months, especially in amounts larger than prescribed, harms build up that affect the body, the mind and daily life:
| Area | Possible harms |
|---|---|
| Memory and concentration | Impaired attention, information processing speed and memory, a large part of which improves after stopping. |
| Mood | Emotional numbness or depression, and mood swings as the drug level rises and falls. |
| Anxiety | Rebound anxiety between doses that can become worse than the anxiety the drug was started to treat. |
| Sleep | Disrupted sleep architecture, and rebound insomnia when the drug runs low. |
| Movement | Poor balance and more falls and fractures, especially with advancing age. |
| Dependence | Growing tolerance and physical dependence that make abrupt discontinuation dangerous. |
Why is mixing Xanax with alcohol or opioids fatal?
Xanax alone rarely stops breathing in a healthy adult, but the picture changes completely when it is combined with other depressants. Alcohol and opioids, including tramadol and heroin, suppress the breathing centers in the brainstem, and Xanax multiplies this effect.
US Centers for Disease Control and Prevention data showed that the great majority of benzodiazepine-related overdose deaths also involved opioids. For this reason, the US Food and Drug Administration added an explicit warning against combining the two classes.
What is the danger of counterfeit Xanax pills?
Counterfeit pills are made that look exactly like Xanax in shape, color and printed markings, and they circulate outside pharmacies. US reports have found that these pills may contain fentanyl or unlicensed benzodiazepines far stronger than alprazolam, without the person taking them knowing.
The result is that the person thinks they are taking a familiar medication, while they are actually taking a substance of unknown strength that can cause loss of consciousness or stopped breathing from the very first time. The contents of any medication not dispensed by a pharmacy on prescription cannot be trusted.
Psychological and behavioral harms of Xanax
Relying on the drug weakens a person's ability to face anxiety in other ways, leaving them more vulnerable to it.
In some people it causes recklessness, irritability or aggression instead of calm, which is called a paradoxical reaction.
Depression may appear, or existing depression may get worse, with long-term use, and needs a psychological assessment.
Declining performance at work and school, strained family relationships, and legal problems when it is obtained without a prescription.
Why is Xanax more dangerous for older adults?
Older adults' bodies clear sedative drugs more slowly, and they are more sensitive to their effect on balance and attention. That is why benzodiazepines in this group are linked to more falls and hip fractures, and to mental confusion that may be wrongly mistaken for the start of dementia.
If an older family member has been taking Xanax for a long time, do not stop it for them. Have their doctor review whether it is still needed and set a gradual reduction plan if necessary.
What is the effect of Xanax on pregnancy and breastfeeding?
Alprazolam crosses the placenta and reaches breast milk. Use late in pregnancy may cause the newborn lethargy, muscle weakness, difficulty feeding, or withdrawal symptoms after birth. Even so, abrupt discontinuation is dangerous for both mother and fetus, so any change must be the doctor's decision.
Xanax and teenagers
Some teenagers get Xanax from the home medicine cabinet or from friends, assuming it is safe because it is a medication. But the brain at this stage is still developing, dependence forms faster, and mixing with alcohol or counterfeit pills is common in this age group. Keeping sedative medications locked away is a simple and important preventive step.
Accidents and injuries linked to Xanax
One harm many people overlook is that Xanax raises the risk of accidents in indirect ways. Slowed reactions and poor attention make driving after taking it a danger to the person and to others, and this effect can last for hours after the person thinks they are back to normal.
Poor balance also increases falls on stairs or in the bathroom, and memory gaps may lead a person to take the pill again because they forgot they already took it, so the effect doubles unintentionally. That is why doctors advise against driving or operating machinery until the person knows how the drug affects them.
Which Xanax harms improve after stopping?
| Harm | What happens after safe discontinuation |
|---|---|
| Drowsiness and slowed reactions | Improves relatively quickly once gradual reduction is complete. |
| Memory and concentration | Improves gradually over months in most people. |
| Rebound anxiety | Settles over time, and the original anxiety needs to be treated in other ways. |
| Sleep | Gradually returns to normal, and cognitive behavioral therapy for insomnia helps a great deal. |
| Social impact | Improves with recovery and family support, although repairing relationships takes time. |
Signs of Xanax poisoning: call an ambulance (123) immediately
- Deep sleep from which the person cannot be woken by calling or shaking, or loss of consciousness
- Slow, shallow or irregular breathing, especially if they have been drinking alcohol or using opioids
- Blue lips or nails and cold skin
- Severe confusion, very slurred speech and inability to stand
- Seizures or an epileptic fit, especially within days of stopping suddenly
Call an ambulance on 123 immediately, place the person on their side so they do not choke, and stay with them. Do not try to wake them with water or coffee. Keep the medicine box or any pills you find to give to the doctor.
Call the ambulance 123