Xanax (alprazolam)

Other names

xannies, xans, bars, (red) devils

Appearance

Tablets in various shapes, often ‘bars’ or oblongs, in various sizes and colours (white, peach, blue, red and white).

Drugs Wheel Category

Depressants

Legality

Misuse of Drugs Act (1971) - Class C.

Alprazolam is not prescribed on the NHS, but it is used in other countries to treat sleep problems and anxiety among other health issues.

Penalties for possession without a prescription are up to 2 years in prison and/or an unlimited fine. Penalties for supply are up to 14 years in prison and/or an unlimited fine.

How it’s taken

Usually swallowed. Injecting is almost always the riskiest way of taking drugs and is strongly discouraged.

Dose

People taking Xanax have reported the following dose/duration of effects, but this cannot be taken as a recommendation: duration and effects will depend on purity, your body and how its taken.

There is no guarantee of the accuracy of the contents marked on packets, as alprazolam is not prescribed in the UK. Xanax can come in pill form with contents ranging from 0.25 mg to 2 mg, but counterfeit pills may contain much more or less. If taking a 1 mg pill, break it in half. If taking 2 mg bar, break it into quarters and wait at least 2 hours between doses (these doses should not be taken as recommendations).

The spread of active ingredient in the pill could not be even which can make it difficult to judge doses.

General information on dosing.

Effects

Alprazolam is short-acting compared to other benzodiazepines (the effects can wear off quickly) effects can appear within 20-40 minutes, and last between 2-6 hours, depending on amount used and individual metabolism.

Stopping after longer term use requires a steady reduction of dose (tapering) and support: stopping suddenly and completely can be fatal. Your GP or local drug service can help with this.

Download our NEW benzo resource here.

Risks

• Use can lead to memory loss
• Can affect balance
• Tolerance develops quickly which can lead to people using more over time, increasing the risk of dependence and overdose
• Withdrawal symptoms can happen after even short periods of time
• Increased risk of overdose if mixed with alcohol, opiates (like heroin) or opioids (like methadone) or other depressant drugs
• Long term use can increase negative mental health effects
• People may act out of character e.g. aggressive
• In the UK, flualprazolam is often mis-sold as alprazolam

Harm reduction

If you choose to take Xanax then the following steps can help to reduce harm.

• Avoid mixing benzos with alcohol, prescription drugs and other drugs, especially other depressants/downers such as alcohol, diazepam and gabapentin and opioids such as heroin and methadone. All of these drugs can depress breathing resulting in a serious risk of death if mixed
• Naloxone will not reverse a benzodiazepine only overdose. If you suspect that someone has taken opiates then administer naloxone.
• Call 999 and ask for an ambulance if you see the signs of an overdose: confusion, unconsciousness (won’t wake with a shout or a shake), severe nausea and vomiting, fitting, difficulty breathing, snoring/raspy breathing, blue/pale tingeing of knees, hands and lips, slow or erratic pulse (heartbeat), pale, cold and clammy skin.
• Avoid taking benzos alone and stay with friends in case you experience negative effects.
• Sleep on your side to avoid choking in your sleep if you throw up.
• Strength can vary, even between pills from the same batch/packet if unlicensed/not prescribed, or pills which look the same. Start with a small test dose and wait at least 2 hours before re-dosing.
• It is easy to build a tolerance to benzodiazepines.
• Withdrawal symptoms can happen even after short periods of use. Avoid taking every day and take regular breaks from use.
• Avoid taking other drugs or more benzodiazepines to deal with withdrawal symptoms.
• If symptoms become distressing seek medical help and in an emergency call 999.
• Benzos impair reaction times. Avoid driving or using heavy machinery whilst under the influence.
• Remember that taking a benzodiazepine won’t simply cancel out the effects of stimulants or other drugs – it may make their effects more unpleasant and will increase the risk.
• The short-lasting effect of some benzos can encourage people to take it frequently or take more than they need. Be aware that although you may not feel the effects, the drug is still present in your body so avoid re-dosing too frequently to avoid overdose and death.

Detection time

People taking Xanax have reported the following detection time, but this cannot be taken as a recommendation; detection of any drug will depend on purity, regularity of use, other medications or drugs you have taken, your body and how it’s taken.

• Up to 5 days in urine from one time use or up to 6 weeks