Xanax is a brand name for the drug, alprazolam, which belongs to a group of drugs called benzodiazepines, which act on the brain and nerves (central nervous system) to produce a calming effect. The minor tranquilizer is used to treat anxiety and panic disorders, and according to medicalnewstoday.com is the single most prescribed psychiatric medication in the United States. Lately, there has been some controversy over the use of Xanax and concerns about the addictive nature of the drug that has been referred to by some people as a “six pack in a pill.”
“There is a time and place for most medications,” explains Dr. Ronald Hunt, a practicing physician in the area of family medicine at Beaumont Hospital, “but, I generally don’t prescribe Xanax. It’s been termed the ‘crack of psychiatry’ for good reason.” However, it can be very helpful to reduce anxiety when prescribed for short-term use, if a patient is anxious about a medical test or an airplane flight, he admits.
Included in the “benzo” drug family of drugs are Klonopin, Tranxene, Librium, Ativan and Valium, to name a few. Dr. Hunt describes Valium, known for its calming effect, as an “oldie but goodie.” The drug was the inspiration for a song by the Rolling Stones, called “Mother’s Little Helper.” Out of all the benzodiazepines, however, Xanax gets more people in trouble, Dr. Hunt reports, adding that people can become physically dependent on it in as little as three to four weeks.
Dr. Hunt remembers when he was a young medical student in the 80s, and Xanax was just getting introduced into the market. “Drug reps would come to the hospital raving about the drug and how people never get in trouble with Xanax,” he says, “but that was a bunch of hogwash.” Xanax affects the same area of brain that alcohol does, and it is very difficult for people to stop taking it. Withdrawing from both alcohol and Xanax can be life-threatening and should be done in a controlled setting such as a hospital or specialty clinic. Having previously worked at Sacred Heart, a rehab clinic in Memphis, Michigan, he witnessed people going through withdrawal from Xanax. “It’s horrible,” he says.
At his own practice, Dr. Hunt rarely prescribes long-term use of Xanax and it should never be used as a sleep aid, because it will actually cause a more disturbed sleep. “It changes the brain and not in a good way,” says the doctor. “It changes the brain transmitters and should never be stopped abruptly.” Ambien, which is a sleep aid, is not a benzodiazepine drug, but has a similar effect. “It’s habit-forming and changes the brain chemistry within a few weeks.”
The opiate epidemic has been highly publicized and when opiate narcotics are taken with benzodiazepine drugs, the withdrawal is even worse. There is also an increased risk of overdose. “We don’t just have a horrible opiate problem, we have a benzodiazepine problem,” says Dr. Hunt, adding that benzodiazepine and narcotics should never be prescribed together.
Alternatives
With all the controversy surrounding benzodiazepine drugs, there are safe alternatives that can be used to relieve anxiety and stress. Talking to a therapist and learning relaxation techniques is one alternative, Dr. Hunt advises. The use of SSRI (selective serotonin reuptake inhibitor) drugs, such as Zoloft or Prozac, are another option. “They don’t work for everybody but they’re safe for treating a long-term struggle with anxiety.” The American Academy of Family Physicians, of which Dr. Hunt is a member, actually recommends the use of an SSRI over benzodiazepine. But, it can take four to six weeks for the drug to become effective. “Xanax can be used sparingly for a week until the other medication starts working,” says Dr. Hunt. Beta blockers can also help relieve anxiety, and antihistamines such as Benadryl can help. “There are a lot of safe options. One thing won’t work for everyone. There is no safe, quick fix.”
Doctors need to be cautious when prescribing medications, according to Dr. Hunt. “Physicians can do a lot of good with a prescription pad, but they can also do a lot of harm. Some do more harm.”
About Dr. Hunt
Dr. Ronald Hunt received his undergraduate degree from the University of Michigan in Ann Arbor and his medical degree from Wayne State University School of Medicine in 1986. After completing his family medicine residency at St. Joseph Hospital in 1989, Dr. Hunt joined the faculty at St. Joseph Hospital and served as Director of Undergraduate Education. In 1995, he helped create the Family Medicine Residency Program at McLaren Hospital, Flint where he served as the Associate Program Director for 19 years. He joined the Beaumont faculty in 2016. His academic appointments include Associate Professor, Michigan State University College of Human Medicine; and Clinical Assistant Professor, Wayne State University School of Medicine.
“Xanax has been termed the ‘crack of psychiatry’ for good reason.”
Dr. Ronald Hunt
