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Snorting Xanax: Side Effects and Dangers

Snorting Xanax is a method of use that’s growing especially popular. Generally, snorting a drug will cause a faster, more intense high. With Xanax, that may not always be the case, as there is little scientific data on whether or not snorting Xanax creates a faster or stronger effect than taking it orally. However, it is clear that snorting Xanax can cause numerous problems, including damage to the nasal cavity and throat.

Alprazolam (Xanax) is a sedative and hypnotic medication that is chemically classified as a benzodiazepine, or “benzo,” Xanax is generally prescribed to:1

  • Reduce anxiety.
  • Relieve panic attacks.
  • Treat diagnosed panic disorder for up to 10 weeks.

Some people may take Xanax as a sleep aid; however, this use of the drug is not approved by the United States Food and Drug Administration.1

Statistics from the Substance Abuse and Mental Health Services Administration (SAMHSA) indicate that the number of Americans ages 12 and older who are seeking help for misuse of Xanax and similar drugs has been steadily increasing. SAMHSA survey responses have revealed the following:2

  • In 1998, the percentage of substance abuse treatment admissions related to benzos was 1.3%. In 2008, the percentage rose to 3.2%. In 2017, this percentage climbed to 7.1%.
  • About 22,400 people were admitted for treatment for benzo abuse in 1998. More than 60,000 were admitted for treatment in 2008 and 286,000 in 2017.

At the peak of benzodiazepine prescription writing in 2013, nearly 50 million prescriptions for Xanax were written in the U.S.; Alprazolam was previously the most prescribed psychiatric medication in the U.S. (until sertraline surpassed it in 2016).3,4

Xanax abuse is part of a massive trend in prescription drug abuse across the country that affects teens and adults alike. Benzos such as Xanax have a high potential for abuse and dependency. Overdose from Xanax alone is rare, but the chance of a fatal Xanax overdose sharply increases when the drug is combined with other drugs which cause respiratory depression.5

Because tolerance to Xanax’s effects builds rather quickly, some people who misuse the drug find that the originally taken oral doses no longer provide the same high with continued use. These people may turn to other methods of administration in the hunt for a benzo high. Sometimes they inject the drug, but often they snort it.

Xanax Addiction Risk

If a person has been misusing Xanax for a long time, there’s a high likelihood they’ll become addicted to it. Research on Xanax addiction has revealed some associations that might indicate a higher risk profile for dependence.6 Risk factors include:
Xanax addiction can cause insomnia

  • History of substance use problems.
  • Chronic pain.
  • Being in recovery from alcohol addiction.
  • Certain mental health issues, such as:
    • Anxiety
    • Depression.
    • Insomnia.
    • Paranoia.

Signs and Symptoms of Withdrawal

Suddenly discontinuing Xanax use can result in headaches, anxiety, irritability, insomnia, gastrointestinal upset, sweating, and rapid heart rate. In users who have been taking large doses of the drug for a long period of time, abrupt withdrawal from Xanax may result in marked agitation and life-threatening seizures. Other potentially dangerous withdrawal developments may include:1,5

  • Nausea and vomiting.
  • Delirium.
  • Psychosis.
  • Grand mal seizures, in which a person might experience violent muscle contractions or lose consciousness.

Misconceptions About Snorting Xanax

Many Xanax users believe that crushing the pills and snorting them will cause a faster, more intense high. They may have reason to believe it: Alprazolam is a small, fat-soluble molecule—the kind that easily crosses mucous membranes in the nose and gets to the bloodstream.However, there is only limited scientific data about whether Xanax actually does create stronger or faster effects by being snorted. One small study sponsored by a pharmaceutical company showed that users of intranasal alprazolam experienced a faster rate of onset of the effects, and that using Xanax this way increased its likelihood of being abused.Further, other benzos that are used more commonly for emergency treatment of seizures are often administered through the nose using special preparations designed for this purpose.9,10

there is only limited scientific data about whether Xanax actually does create stronger or faster effects by being snorted.

On the other hand, animal studies of the related drug diazepam show no faster or stronger effects when it is snorted versus taken orally.11 Further, Xanax is designed to be taken orally, and the tablets contain cellulose and other suspension chemicals that could damage nasal mucous membranes.

While snorting Xanax seems to be an increasingly prevalent method of illicit administration, doing so could damage the nasal cavity and throat with unclear benefit to the user in terms of the high they experience. The user might get high in the same amount of time and to the same extent as they would if they’d taken Xanax orally, but with additional health risks. Fortunately, mucous membranes in the nose can recover if a user of Xanax stops snorting it.12

Getting Help for Addiction

Medical supervision during withdrawalFor someone who’s become dependent on Xanax to function physically and mentally, trying to abruptly stop on their own could give rise to severe side effects. Unmanaged withdrawal for benzos such as Xanax may be associated with potentially lethal complications (i.e., seizures); a supervised medical detoxification may be necessary.

Recovering from compulsive Xanax misuse safely and effectively may require a substance rehabilitation facility that specializes in treating benzodiazepine addiction. Under the supervision of qualified addiction treatment professionals, a recovering individual may forego some of the risks of a severe, uncomfortable, or complicated withdrawal.

Treatment Programs for Addiction

Inpatient treatment requires staying at a rehab center or treatment facility for a certain period of time. Due to the risk of unpleasant and potentially severe Xanax withdrawal symptoms, the relatively intensive treatment interventions found in an inpatient setting could be needed to minimize the likelihood of dangerous outcomes. A high clinical suspicion of significant physiological dependence, and associated elevated risk for severe withdrawal complications, as well as previous failed attempts to quit using Xanax in an outpatient setting could all indicate that an inpatient treatment setting may be most appropriate.

In certain instances, individuals with relatively mild Xanax withdrawal symptoms may be adequately managed in an outpatient treatment setting. If this is a feasible option, it may not only lower the cost of treatment but also minimize interruptions in family and work obligations.

Treatment for Xanax abuse may focus on gradually reducing the person’s dose over time (or first substituting a longer acting sedative agent to initiate a taper) to ease them off of the drug.

Treatment for Xanax abuse may focus on gradually reducing the person’s dose over time (or first substituting a longer acting sedative agent to initiate a taper) to ease them off of the drug. After this process, behavioral therapies are emphasized heavily to help former users adjust maladaptive patterns of thoughts and behaviors to better avoid relapse.5 Because withdrawal and cravings can be unpleasant, some people recovering from a Xanax addiction find that a treatment facility focused largely on comfort and privacy offers them the best foundation for recovery. Others might opt for specialized treatment that accommodates the need for privacy and the desire to remain active in the workplace throughout the duration of residential treatment.

These private, comfort-centric programs are called luxury, or executive, programs. They tend to offer residents many amenities, including Internet access, pools, and spa services. Traditional treatment facilities can offer the same quality of treatment but may not be as focused on comfort or able to offer as full a range of therapeutic recreational activities.

Sources

  1. United States Food and Drug Administration. Drug Labeling – XANAX.
  2. Center for Behavioral Health Statistics and Quality. (2018). 2017 National Survey on Drug Use and Health: Detailed Tables.
  3. Grohol, J.M. (2018). Top 25 Psychiatric Medications for 2013. Psych Central.
  4. Grohol, J.M. (2018). Top 25 Psychiatric Medications for 2016. Psych Central.
  5. Ait-Daoud, N., Hamby, A. S., Sharma, S., Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med, 12(1), 4–10.
  6. Kan, C.C., Hilberink, S.R., Breteler, M.H. (2004). Determination of the main risk factors for benzodiazepine dependence using a multivariate and multidimensional approach. Compr Psychiatry, 45(2), 88-94.
  7. Bitter, C., Suter, K., Surber, C. (2011). Nasal Drug Delivery in Humans. Topical Applications and the Mucosa. Current Problems in Dermatology. 40 (2):20–35.
  8. Reissig, C.J., Harrison, J.A., Carter, L.P., Griffiths, R.R. (2015). Inhaled vs. oral alprazolam: subjective, behavioral and cognitive effects, and modestly increased abuse potential. Psychopharmacology (Berl);232(5):871–883.
  9. Wermeling, D.P. (2009). Intranasal delivery of antiepileptic medications for treatment of seizures. Neurotherapeutics, 6(2), 352–358.
  10. Agarwal, S. K., Cloyd, J. C. (2015). Development of benzodiazepines for out-of-hospital management of seizure emergencies. Neurol Clin Pract, 5(1), 80–85.
  11. Kaur, P., Kim, K. (2008). Pharmacokinetics and brain uptake of diazepam after intravenous and intranasal administration in rats and rabbits. International Journal of Pharmaceutics, 364(1), 27-35.
  12. Wang, J., Bu, G. (2002). Influence of intranasal medication on the structure of the nasal mucosa. Chin Med J (Engl), 115(4), 617–619.

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