Because of the serious consequences of unregulated withdrawal from Xanax® (alprazolam) the only safe way to treat addiction is under a doctor’s supervision. Serious symptoms may include include hallucinations, delirium and seizures if the drug is stopped abruptly.
“Detox” refers to a controlled reduction in alprazolam dosage over time. Because Xanax is eliminated quite quickly from the body, this reduction can safely occur over just a few weeks. One benchmark is whether or not withdrawal symptoms arise and how severe they are. If anxiety, insomnia or other problems happen during detox, the level of Xanax can be withdrawn more slowly.
Sometimes, another, less addictive anti-anxiety drug will be given to replace Xanax during detox. This may help control rebound anxiety, panic attacks or insomnia. One combination of drugs commonly used is Klonopin (a less addictive anxiolytic) along with Tegretol (an anti-seizure drug).
Long term treatment
While the physical need for alprazolam will be gone once abstinence is maintained for 72 hours, the psychological component will still be there. Patients who took Xanax for anxiety will still have the original condition. However, since they are now considered at risk because of the previous addiction, great caution is advised when considering starting them on another benzodiazepine.
Because of this, other forms of treatment are best if they help. Cognitive behavioral modification has shown some promise in anxiety and panic attacks. For insomnia, sleep clinics are a second line treatment that can be valuable and are drug-free. Other agents, without as much addictive potential as Xanax may also find use.
If no solution can be found to treat the original anxiety problem, patients have an incentive to return to using alprazolam. They are much more likely to resume addictive behavior if this happens. If this becomes the only viable option, strict monitoring of dosage and refills is mandatory to keep patients from abuse.