Xanax (which is the trade name for the benzodiazepine known as alprazolam) is a commonly prescribed drug that is used in the treatment of depression and anxiety disorders. This drug has other uses as well. It also sometimes gets used to help with chemotherapy since it helps to control nausea. When used as prescribed, it can be effective at reducing the severity of symptoms and can help a person live a more functional, enjoyable life. When misused, however, Xanax can become an extremely dangerous drug that can cause everything from confusion to coma.
If you or your loved one is struggling with Xanax misuse, getting professional treatment is essential. Xanax can be misused in a number of ways, so here is what to look out for with snorting or injecting this drug and what to expect from a treatment option like a detox program. Granite Recovery Centers provides medical detoxification for people who do not need immediate medical intervention, are not a danger to themselves, and are capable of self-evacuation in the event of an emergency.
A Brief History of Xanax
Benzodiazepines were discovered by Dr. Leo Sternbach in the 1960s. Their synthesis led to Upjohn Laboratories (now a part of Pfizer), which released alprazolam in 1981. The drug was initially approved to help reduce the severity of anxiety and panic attacks. After just two years, alprazolam (trade name: Xanax) became one of the most popularly prescribed drugs in the United States. Today, it is America’s most commonly prescribed benzodiazepine.
Chemical Make-up of Xanax
Xanax is a popular drug because, well, it works, and it has a rather interesting chemical structure that makes this so. It is a chemical analog of triazolam, but it lacks the chlorine atom in the ortho position of the 6-phenyl ring. Its molecular formula is C17H13ClN4 and has an average molecular mass of 308.765. Xanax’s structure is crystalline, and it is insoluble in water but soluble in alcohol.
When taken together, Xanax can amplify the effects of alcohol because of its solubility. They are both depressants that slow down activity in the body’s nervous system. The presence of ethanol in alcohol is a likely contributor that elevates the maximum concentration of Xanax in the bloodstream.
This enhances the “buzz” a person gets from drinking alcohol. It also amplifies the side effects of alcohol consumption. This combination forces the liver to work overtime as it has to break down both Xanax and alcohol. Together, they can make a person feel extra sleepy since depressants have a sedative effect on the central nervous system. They can also lead to mood changes, including aggression, rage, and hostile behavior. With alcohol added into the mix, a person’s inhibitions might be lowered, causing them to do things that they would not normally do.
Other potential side-effects include:
- An impaired memory
- Blacking out
- Low blood pressure
- Blurred vision
Long-term combined use might result in:
- Weight and appetite changes
- Lowered sex drive
- Long-lasting cognitive and memory impairments
- Liver damage or failure
- Depression (or worsened depression)
- Personality changes
- Stroke or heart disease
- Other chronic health conditions
An overdose can be life-threatening. If you suspect you or someone you know has overdosed or is experiencing suicidal thoughts, you can call the National Suicide Prevention Hotline at 800-273-8255. Of course, if this is an emergency situation, you first need to dial 9-1-1 and let the responder know what type of medical emergency this is.
Many people who misuse Xanax do so by snorting it rather than just taking it orally. Why is this the case? That is all due to the rate of onset. Swallowing benzodiazepines can result in the body building up a tolerance, so users often make the switch to snorting them when this happens. While snorting drugs like opioids can result in a stronger and quicker high, this is not necessarily the case for Xanax.
With Xanax, most tablets are rapidly released into the bloodstream in the same amount of time that it would take regardless of whether they are orally ingested or snorted. When an extended-release tablet is crushed and snorted, the high might be rather fast, but the peak of its intensity seems to be the same regardless of whether it is snorted or swallowed. Extended-release Xanax has a coating that contains the chemicals that create the rapid release, and crushing it removes the extended-release mechanism. This makes the effects come all at once, not over an extended period of time.
That is not to mention that Xanax contains cellulose and other suspension chemicals that can destroy the mucous membranes in the nasal passages. Mucosa does absorb nutrients and chemicals quite rapidly, and snorting a crushed-up drug like Xanax allows the user to bypass the digestive system (especially the liver and the stomach, where Xanax would normally be broken down). There is a layer of epithelial cells in each mucous membrane that covers a layer of connective tissue. The epithelial cells can endure a lot of trauma, but repeated use of something like Xanax can cause degradation. The cells in the membrane also have cells that are ideal for absorption.
Preparation involves chopping Xanax tablets up into a fine powdery substance. It looks a lot like cocaine and is sometimes even sold as such, which has dangers in and of itself. The truth is that the nose was simply not designed for inhaling powders. Just one single use of a drug like Xanax can cause lung infections, swelling in the inner linings of the nose, compromised respiratory tracts, and nasal blockages. Xanax itself is not the problem here, but rather, it is the additional substances that have been added to the powdery mix that cause contamination.
Chief among these contaminants include:
- Boric acid
- Talcum powder
- Powdered detergents
Short-term effects of snorting are at least typically minor, but they still have the potential to be painful. A lung infection certainly requires medical attention, and, of course, psychological help is a necessary step in moving forward from any type of drug use.
There are, however, some long-term effects that are of concern. Extended use of any snorted drug has the potential to cause damage to the nasal passages and airways. Blood vessels might become constricted, and some drugs have even been known to cause necrosis. One case that was documented by the Iranian Journal of Otorhinolaryngology involved a woman who snorted meth for three years, presenting with a perforated septum, swelling of the sinuses, and necrosis.
Long-term damage caused by snorting drugs like Xanax can be massive. Decreased blood supply to the nose is quite common with long-term use, which is what leads to a perforated septum. This absolutely causes aesthetic physical damage (which is quite painful), but it can be surgically reversed. Internal damage, though, is a lot harder – if not downright impossible – to repair.
Xanax can also be injected, and its effects range from painful to dangerous. Intravenous drug users often develop conditions like cutaneous infections, abscesses, ulcers, bacteremia, and endocarditis. Most horrific among the effects of injecting drugs are severe tissue ischemia and necrosis.
Immediately after someone injects Xanax, they might feel intense burning and pain around the injection site, which can be followed by arterial area edema and cyanosis. This typically happens within a few hours. Severe necrosis can lead to amputation of the infected limb. Xanax itself can potentially cause vasoconstriction, and the additives found in Xanax might cause thrombosis or vasospasm. Microparticles from the drug mixture are able to act as emboli.
When someone is admitted to the hospital for these effects, the typical treatment plan does not involve surgery (unless, of course, necrosis has progressed to the point of amputation being necessary). Doctors use a combination of limb elevation, pain management, and heparin. Anticoagulants, corticosteroids, and vasodilators are also sometimes used to help the symptoms subside. If the person has developed compartment syndrome as a result of ischemia and edema, emergent fasciotomy might be required in order to keep the limb, thereby avoiding amputation, which is almost always a last resort for doctors.
Injecting Xanax should seem terrifying, but for some users, it comes across as the ideal way to get Xanax into the bloodstream fast. When a person shoots up Xanax, they are increasing their chances of overdosing. Xanax is designed to be absorbed within the liver first and foremost, breaking Xanax down into a manageable, safe dosage. Injecting Xanax could lead to a person getting it directly into their bloodstream, meaning that the digestive system does not get the chance to break down and metabolize the chemicals in Xanax like it needs to. This can lead to an overdose.
Injecting a central nervous system depressant like Xanax increases the likelihood of respiratory failure. Mixing it with other central nervous system depressants can exponentially increase this likelihood. Alcohol and opioids are two of the most commonly mixed-in depressants.
When anything at all gets injected into the body, a person runs the risk of developing abscesses, sores, Hepatitis C, and AIDS. Heart and organ issues can develop too. Since Xanax is not water soluble, people who shoot it up will dissolve it in alcohol first, which is inherently dangerous. When Xanax does not get fully and properly dissolved in the body, it can lead to blocked blood vessels, which can trigger a heart attack, stroke, or other types of cardiovascular problems.
As is the case with snorting Xanax, injecting it does not seem to provide a very powerful high. Bypassing the liver might give a quick high, but it is not considered a strong one.
Treatment for Xanax Use
Xanax use treatment is available and, quite honestly, a major step in getting on the road to sobriety. Treatment does not just address the addiction itself; it can help a person work through comorbidities like depression and anxiety. If inpatient treatment is not a viable option due to work or family obligations, there are programs available like partial hospitalization and an intensive outpatient program.
Whatever path you choose, treatment for Xanax involves a lot of work. Physically, emotionally, and mentally, treatment can be a difficult process to undergo. However, it can help save you or your loved one from a variety of painful – and deadly – conditions.
Snorting or injecting Xanax has a serious list of painful consequences. Many people assume that these methods will give them faster and stronger highs, but that is not necessarily true. While some of the effects will be more immediate, they lack potency and endurance. Still, taking either of these routes can result in permanent damage, not excluding death. Taking the difficult but necessary steps toward sobriety can help you or your loved one become safe, happy, and healthy.