TW: This article includes mentions of substance use disorder and suicidal ideation.

 

How many of us have gotten nervous before a big event and popped a Xanax? Or that ubiquitous take-a-Valium-before-you-fly thing we see in movies? Benzodiazepines (benzos, BZDs) are a class of psychoactive drugs that suppress central nervous system (CNS) activity, inducing a feeling of calm and maybe some drowsiness. Xanax and Valium are the most widely-prescribed and used benzodiazepines.

Meant mostly for as-needed use, dry-swallowing an emergency Xanax now and then is something we don’t even think about when it comes to any long-term effects. But if you’ve watched the second installment of Take Your Pills: Xanax on Netflix, you’ve already got a primer for this article. Yes – it does matter. In fact, emerging awareness is spurring further research into what dangers lurk inside those little blue Vs and yellow Xs.

 

A Brief History of Xanax & Benzodiazepine Usage in the US

Benzodiazepines were initially investigated for treatment of panic disorder, with the first BZD patented in the ‘50s, and the patent for Xanax awarded in the ‘70s. Panic disorder is a debilitating condition where, when triggered by a perceived adverse stimulus, a person quickly delves into a flight or freeze response. These are panic attacks. Panic disorder is diagnosed when these attacks happen often.

 

Panic attacks are accompanied by symptoms that compound the severity of the experience, like seeing spots, difficulty breathing/hyperventilating, tachycardia, and other bodily responses that many people describe as feeling like dying. This is accompanied by a spiral of catastrophic thinking. 

 

Anxiety attacks are similar but less severe and much more common, which is a significant factor as to how benzodiazepines became America’s favorite way to prevent or mitigate these stress responses in a near-immediate way.

Today, SSRIs are the primary approach to anxiety disorders, with BZDs like Xanax used as an in-the-moment, as-needed augmentation to the SSRIs. This is why, while these substances are controlled, the use is so widespread that you probably have several other friends with a bottle of Klonopin on-hand you don’t even know about.

If you’re into the idea of a deep-dive into how Xanax became our go-to script for chilling out, VICE has a great article delving into the complicated history of Xanax in the US.

 

The Calm Before the Storm: Xanax’s Psychoactive Benefits

We all know you don’t need to have a whole disorder to need help coping with stress and anxiety sometimes. And BZDs have got your back in that respect. Benzodiazepines basically mega-dose your brain with GABA – the body’s main inhibitory neurotransmitter. GABA calms overexcited neurons. Well, actually, it tells them to shut up and doesn’t let them talk to your central nervous system. This biologically blocks stress responses. 

 

Benzodiazepines like Xanax and Valium work in a four-fold fashion:

 

• Amnestic: They block the ability to form new memories.
• Anxiolytic: They block anxious responses.
• Hypnotic: They make you drowsy.
• Sedative: They quiet your mind. 

 

Xanax is the most widely-used BZD because its time to onset is short and so is its half-life. Meaning, once you swallow that little pill, you’ve only got to wait a few minutes to feel the full effect, and a couple hours after you take it, the effect wears off. This allows people to manage adverse stress responses in the moment without disrupting their ability to return to function for the rest of the day.

We know Americans love a good instant-gratification situation.

Other advantages of using benzodiazepines to stop your mind from spiraling are that they’ve got 70 years of history on efficacy and safety (relative to predecessor medications) behind them, they can treat a wide variety of conditions, and, while you can overdose on BZDs, there is an antidote that works for every single one of them.

 

The Dangers of Long-Term Benzodiazepine Usage

Xanax isn’t all sunshine and very calm rainbows. The FDA has recently mandated warnings on all benzo prescriptions about the dangers of addiction, dependence and withdrawal. Long-term, these are some of the scariest possibilities. More on that, later. 

 

But, there are additional things you have to consider all the time if you’ve got an Rx for Xanax, because it doesn’t play well with others – ‘others’ referring to medications, food, substances, and other health conditions.

 

If you want to see something horrific, check out the Mayo Clinic’s page on the specs of Xanax (alprazolam) – they have some very lengthy, comprehensive lists on the side effects, medication interactions, and complications associated with Xanax use. In addition to all that, Xanax can be extremely dangerous to take if you use alcohol, marijuana, tobacco, and any other substances. Plus, don’t eat grapefruit.

 

No, really.

 

The most disturbing part of this laundry list, in our opinion, is that the adverse interactions with other medications includes, like, all of the other prescriptions people take for psychological disorders, chronic pain and degenerative diseases. Millions of us are walking around every day taking our 3 or 4 pills morning and night with no idea that they could cause a pretty violent disagreement in our body at any time.

 

However, you don’t need to be taking another medication for Xanax to be a threat to your health. Just a few of the common adverse symptoms that can accompany Xanax use include:

 

• Amnestic confusion
• Disassociation
• Feelings of sadness, emptiness and discouragement
• Irritability 
• Memory loss
• Seizures
• Sexual dysfunction and low libido
• Shakiness and unsteadiness
• Slurred speech and fuzzy vision
• Trouble sleeping or exacerbated insomnia

 

And if you’re a person with any of the following conditions, there’s no way you should be taking this stuff:

 

• Alcohol use disorder/history of
• Drug dependence/history of
• Kidney disease
• Liver disease
• Lung problems
• Mania/history of
• Mental health problems/history of
• Seizures/history of

 

And, as with most things, women who are pregnant, trying to conceive, or breastfeeding should avoid Xanax.

 

Are We Sleeping on the Risks of Unchecked Xanax Prescriptions?

You could say we’re in the early stages of waking up to the fact that we need different routes to relieving anxiety than benzos. The good news is, clinicians and researchers are started to reach a page about prescribing Xanax and other BZDs. Xanax prescriptions last peaked in 2014 at nearly 30 million. By 2020, that number is well under 20 million. 

 

That’s right – we got through COVID with about 13 million less Xanax scripts than just a few years before.

 

Interestingly enough, this development wasn’t primarily brought on by newly-published clinical data, but by the opioid crisis. UC Davis’ statistical analyses have revealed that 25% of people with long-term opioid prescriptions also have a prescription for benzodiazepines. 

 

At least 16% of all opioid overdoses involved benzos, and comorbidity of BZD and opioid use makes someone 10x more likely to die of an opioid overdose than if they had OD’d on opioids alone. In addition, benzodiazepines are associated with about 30% of all intentional overdoses (read: suicide attempts).

 

Watching the gruesome tragedy that is the opioid epidemic unfold over the last decade, these revelations have made physicians much more cautious about how well they control these controlled substances. And it’s what prompted the CDC to give US Davis Health a hefty grant to dive into the relationship and dangers of concurrent opioid and benzodiazepine usage.

 

Xanax Comes with Its Own Risks for Abuse & Addiction

Speaking of things that can be as dangerous as opioids (which, by the way, are included in the myriad medications Xanax will make more lethal than they are alone), the risk for dependence and an eventual substance use disorder with benzos is pretty serious, and it doesn’t take very long to start that slow slide into addiction.

 

Dependence and addiction are largely biological mechanisms, but what complicates these risks, in medications used for psychological relief, is that mental dependence is sometimes nearly as intense as physical dependence. 

 

Think about it: psychologically, if every time you are confront with an anxiety-inducing situation, you reach for a Xanax, you become habituated to that series of actions, Pavlov-style. Plus, you aren’t teaching yourself any coping mechanisms, so you’re never prompted to face those situations or learn sustainable ways to cope. In your mind, you’re reliant on the memory of the relief from that last hit.

 

Meanwhile, physically, you’re teaching your body it doesn’t need to know how to regulate GABA production and activity to calm itself down, because every time it needs GABA, it gets it when you pop that pill. At the same time, those mega-doses of GABA eventually cause your central nervous system to become less reactive to GABA’s inhibitory function. Over time, GABA deficiencies can have devastating effects on mental health.

 

Xanax’s withdrawal symptoms can prove as dangerous as alcohol withdrawal when it comes to use disorders. Many of the symptoms of benzo withdrawal are the extreme opposite of the therapeutic benefits. Xanax withdrawal, specifically, is considered both unique and more severe than coming off of other BZDs:

 

• Hyper-alertness
• Hypertensive crisis (can lead to heart attack)
• Insomnia and nightmares
• Irritability
• Panic attack recurrence with new somatic (physical) symptoms
• Seizures
• Suicidal ideation
• Worsening anxiety

 

There’s also this weird things only Xanax seems to do, where it causes a pseudo-pheochromocytoma. This is sort of a fake hypertensive crisis. A hypertensive crisis is defined by a sudden and severe rise in blood pressure accompanied by sinus tachycardia (irregular and increased heart rate). 

 

It’s strange, though, because it’s not accompanied by the spikes in key neurotransmitters and the adrenal system the way actual hypertensive crises are. What’s scary is that these “fake” hypertensive crises are often so severe they require ICU admission. Worse, there have been no observed effective treatments for this reaction except the reintroduction of Xanax.

 

Oh yeah, and Xanax withdrawal has been known to cause homicidal ideation in people being treated for PTSD. So there’s that.

 

Are There Natural Alternatives or Complements to Benzodiazepines?

At this point, you’re probably thinking, Okay, thanks for the scare, but how am I supposed to manage my anxiety?  

 

We all need help sometimes to stop overthinking. Life is stressful; the more measures we take to help us buffer against that stress, the better. Bonus points if those measures are both effective and natural.

 

Everyone is unique and needs different things to manage their mental health, and everyone should find a plan that works best for them. But if you’re looking for a different way to achieve that balanced feeling we all strive for, whether to use in tandem with or as an alternative to that Xanax script, there are natural ways to promote healthy stress responses. MTE is one of them.

 

Plant power is a whole movement in the holistic health industry – it’s kind of our whole thing, too. MTE was formulated with 11 powerful adaptogens, nootropics and superfoods that, when taken daily, can help promote a quality of life you might not have thought a little feel-good energy shot could. And that includes supporting healthy stress responses.

 

Key players like Affron®, ashwagandha, GABA, holy basil, L-theanine, and Siberian ginseng can promote a quiet, present calm without disrupting cognitive performance or encouraging dependence. For anyone searching for more natural routes to managing their anxiety, MTE is a different way to promote stress resilience.

 

Forging a Path to More Holistic Stress Management Methods

A daily shot of MTE offers support for stress and anxious feelings with the help of natural bioactive ingredients, but it’s not a standalone route to feeling good and managing overstimulating situations. It’s best paired with other healthy habits like a nutritious diet and an active lifestyle. Think of it as a fuse, not a fix.

 

Other natural methods to give your body the resources it needs to remain stress-resilient include:

 

• Relaxation techniques: teaches your mind how to calm itself
• Thought journaling: helps you analyze and then combat catastrophic thinking
• Prioritizing sleep: gives your brain the time it needs to relax, restore and reset
• Taking up a productive hobby: can act as an active form of meditation
• Learning a skill: teaches your brain to deal with new challenges
• Realistic optimism: learning to confront, not avoid, triggering situations

 

As you’re on your journey to a more sustainable way to manage stress and anxiety, the adaptogens and nootropics in MTE can support and promote your mind and body’s abilities to form these new habits and connections.

 

• Affron®: A premium saffron extract with clinical evidence for its ability to support mood, stress and anxiety-management.
• Ashwagandha: This adaptogen is thought to help the hypothalamus-pituitary-adrenal (HPA) axis to cope with stress more productively by regulating its activity.
• GABA: That all-important, calm-your-brain-down, amino acid-turned-neurotransmitter.
• Holy Basil: Clinical evidence indicates holy basil supports anxiety management as well as diazepam (Valium).
• L-Theanine: Has been observed to increase alpha brainwaves, which are the brainwaves associated with non-drowsy relaxation.
• Siberian Ginseng: Supports anxiety-management by interacting with the HPA axis and regulating the secretion of cortisol (stress hormone).

 

These are just 6 of the 11 carefully-curated ingredients in our daily vitality drink – a little shot packed with big benefits that support increased stress resilience, mood support, balanced energy, and much more, in just a 2oz bottle. You can find more in-depth information, references and resources about these potent ingredients on our Stress page and our Wellness Blog.

 

Curious if there’s another way to help you to deal with difficult moments? Learn more about MTE’s formulation and how we’re changing the face of energy drinks. Because a productive day is about more than stimulants – it requires feel-good ingredients that promote your mind and body to perform at your best: with calm, positive focus.