Let’s start with a word of caution: Most folks don’t realize that the two most dangerous substances in the world to withdraw from are benzodiazepines and alcohol. Detoxing from drugs like Xanax should never be attempted without medical supervision. We offer the facts below not as medical advice but rather as guidance.
Most people will start to feel symptoms within 12 hours, and symptoms will peak within 3-4 days. Residual and lingering symptoms of withdrawal can last for months.
The most serious (but more rare) side effect is convulsion – and these can be life threatening. More common side effects are psychological in nature, and are very unpleasant. Problematically, many people take Xanax to manage anxiety. During withdrawal, anxiety and feelings of panic are very likely to spike.
Xanax increases the activity of GABA in the brain, which results in a calming effect on an anxious mind. Over time, the brain responds to this increased GABA activity by lowering the amount of available GABA. At this point, the patient will need to take a larger dose of Xanax to feel the same effects – and at this point, if the user tries to stop taking Xanax completely, they will experience withdrawal pains.
The best way to break an addiction to Xanax is through a medically monitored period of tapering down the dosage. This can take many months, but is safer and far less unpleasant than a "cold turkey" detox.
The pace at which the dosage is reduced will depend on the length of the dependency, with longer dependencies requiring a slower reduction. Some suggest reducing the dosage by 0.25mg every two weeks, but individual recommendations must come from a doctor familiar with your case and your medical history.
The advantage of a very long and slow tapering down is that it allows your brain time to adjust to the decreasing dosages of medication, and to begin producing more GABA to compensate. The symptoms of withdrawal are caused by this GABA insufficiency, so allowing the brain to "keep up" with the tapering, alleviates the severity of the symptoms.
By tapering very slowly, you avoid severe symptoms of withdrawal, and most users report minimal discomfort. An additional advantage is that by controlling for withdrawal symptoms, you are better able to gauge your need for the medication. If you were initially prescribed Xanax for panic – and you detox quickly – you will feel panic, but you won’t know if you are feeling panic as a symptom of withdrawal, or as a symptom of a still active panic disorder.
If you have been taking the medication as prescribed for anxiety or panic, then once you have tapered down off of the drug you will have no need for any addiction treatment. You were dependent physically, but not addicted psychologically – and the risk of relapse is very low.
If you abused the medication to get high, you will likely need addiction therapies to help you stay drug free.