The Silent Epidemic

Xanax (also known as alprazolam) is a prescription sedative in a group of medications called benzodiazepines (also known as “benzos” and “downers.”) It is the most commonly prescribed psychotropic medication in the United States in the treatment of panic and anxiety disorders. Xanax has been subject to misuse for recreational purposes because of its disinhibition, euphoria, and anxiolytic effects. Most of the near-fatal cases with alprazolam are due to polydrug use. Common benzodiazepines include diazepam (Valium) and clonazepam (Klonapin), among others.

Xanax is considered a short-acting benzodiazepine, which means that it doesn’t last as long as other benzodiazepine medications. Benzodiazepines like Xanax reduce anxiety by attaching to a receptor in your brain called the GABA-A (gamma-aminobutyric acid-A.) When Xanax binds to this receptor, it has a calming effect in the brain. 

Non-addictive alternatives to benzos for anxiety as well as various therapies are better long-term choices for treating anxiety because Xanax has side effects, a risk of overdose, and the potential for dependence.

More facts:

• Benzos work by slowing down the central nervous system and decreasing brain activity. The effects typically last between 6 hours to over 24 hours.

• Xanax is the most common benzodiazepine that leads to emergency room visits due to drug misuse, according to a study in the Journal of Addiction Medicine. 

• Benzodiazepines were involved in nearly 7,000 overdose deaths in 23 states from January 2019–June2020 – 17% of all drug overdose deaths.

• Illicit benzodiazepine deaths increased 520% (from 51 to 317) from Q2 2019 to Q2 2020.

• Prescription benzodiazepine deaths increased 22% (from 921 to 1,122) from Q2 2019 to Q2 2020.

• Illicit benzodiazepines include etizolam, flualprazolam, and flubromazolam. These drugs are not produced in the US and aren’t approved by the US FDA.

• The most dangerous types of benzos are knock-off versions, counterfeit pills that look exactly like legal benzos, but instead contain analogues with no history of human trials. They’re also referred to as “Xannies.” Benzodiazepine Test Strips have proven to be useful as a screening tool in certain contexts, but they’re not a comprehensive screen and are best used in conjunction with additional technologies like mass spectrometry.

• Opioids and benzos, both downers, are often lethal in combination, slowing breath to a stop. Unfortunately, many people are prescribed both drugs simultaneously. In a study of over 300,000 continuously insured patients receiving opioid prescriptions between 2001 and 2013, the percentage of persons also prescribed benzodiazepines rose to 17 percent in 2013 from nine percent in 2014. The study showed that people concurrently using both drugs are at higher risk of visiting the emergency department or being admitted to a hospital for a drug-related emergency.

• Between 1996 and 2013, the number of adults who filled a benzodiazepine prescription increased by 67%, from 8.1 million to 13.5 million. The quantity obtained also increased from 1.1 kg to 3.6 kg lorazepam-equivalents per 100,000 adults.

• From 2002 to 2015, fatal outcomes from overdosing on Benzodiazepines quadrupled, according to the National Institute on Drug Abuse (NIDA)

• NIDA warns that individuals are 10x more likely to die from an overdose when taking Benzodiazepines with painkillers. In addition, Benzo users may suffer strong withdrawal symptoms for months and even years after discontinuation. Sudden discontinuation of Benzodiazepine drugs could cause seizures even death.

• It is important to use Benzodiazepines only in the amount, frequency, and manner prescribed by a doctor.

Indications of a substance use disorder from Xanax: 

• Combining Xanax with other drugs, like opiates or alcohol

• Depression

• Impulsivity

• Aggressiveness

• Cognitive impairment 

• Strong cravings for Xanax

• Isolation from friends and family  

The Benzo trap: Xanax is supposed to be taken no longer than for up to 6 weeks. Despite that, prescriptions are often refilled in alarming rates. As a result, the number of people seeking treatment for primary benzo addictions continues to rise — from 6,929 in 2002 to 17,019 a decade later in 2012, according to the Substance Abuse and Mental Health Services Administration.

Other resources for Xanax:

• National Institute on Drug Abuse, Benzodiazepines and Opioids

• Benzodiazepine Information Coalition: Nonprofit educating people about the potential adverse effects of benzodiazepines taken as prescribed. This site includes a comprehensive list of resources, including support, medical professionals, podcasts, movies and more.

• Anatomy of an Epidemic, by Robert Whitaker. This book illustrates the astonishing rise of mental illness in US while shredding the myth around psychiatric drugs

Marijuana Fact Sheet

Marijuana is a product of the cannabis plant and its main active chemical is THC. It poses substantial health and safety risks to young people, yet it is the most widely used drug among this population. The teen and early adult years are when our children are most vulnerable to marijuana’s harmful effects. It can affect brain development, grades, relationships and physical health. Risk for addiction increases too. A recent spike in adolescent and young adult use, coupled with a decade-long decline in thinking about marijuana as risky or harmful, is concerning. Source linked.

Studies have shown that the use of marijuana is associated with reduced cognitive function in teens. One study found that teens who regularly use marijuana lose an average of 5.8 IQ points by the time they reach adulthood. A recent study found that marijuana has a more negative impact on a teenager’s cognitive development than alcohol. Source linked.

Vaping marijuana as well as other substances has become a public health crisis. Source linked.

A JAMA study found that teens in their senior year of high school were most likely to be vaping marijuana compared to younger adolescents. In 2018, for example, one in three grade-12 students reported vaping weed.

"Without a doubt, cigarettes and e-cigarettes are unhealthy and not good for lungs. However, vaping marijuana appears even worse," study author Carol Boyd, professor emerita and codirector of the Center for the Study of Drugs, Alcohol, Smoking & Health at the University of Michigan in Ann Arbor told CNN in a prior interview.

Marijuana vaping by school-aged youth doubled between 2013 and 2020, a new study found, with reported use within the last 30 days rising seven-fold during the same time period.

Risks about e-cigarettes.

Cannabis Use Disorder:

At least two of the following symptoms within a 12-month period indicates cannabis use disorder:

• Taking more cannabis than was intended

• Difficulty controlling or cutting down cannabis use

• Spending a lot of time on cannabis use

• Craving cannabis

• Problems at work, school, and home as a result of cannabis use

• Continuing to use cannabis despite social or relationship problems

• Giving up or reducing other activities in favor of cannabis

• Taking cannabis in high-risk situations

• Continuing to use cannabis despite physical or psychological problems

• Tolerance to cannabis

• Withdrawal when discontinuing cannabis.

Remember, the new way of describing cannabis use disorder means that the severity of the person's physical addiction is unrelated to the severity of their disorder. With a list of 11 symptoms to choose from, someone can have cannabis use disorder, severe, without having any tolerance or withdrawal, the hallmarks of addiction. By the same token, they can meet the criteria for mild cannabis use disorder, despite experiencing severe physical tolerance and withdrawal. (VeryWell Mind)

More information about cannabis:

• The word “marijuana” refers to parts of or products from the plant Cannabis sativa that contain substantial amounts of tetrahydrocannabinol (THC.) THC is the substance that’s primarily responsible for the effects of marijuana on a person’s mental state. Some cannabis plants contain very little THC. Under U.S. law, these plants are considered “industrial hemp” rather than marijuana.

• The FDA has not approved the cannabis plant for any medical use. However, the FDA has approved several drugs that contain individual cannabinoids.

• The use of cannabis has been linked to an increased risk of motor vehicle crashes.

• Smoking cannabis during pregnancy has been linked to lower birth weight.

• Adolescents using cannabis are four to seven times more likely than adults to develop cannabis use disorder.

• The use of cannabis, especially frequent use, has been linked to a higher risk of developing schizophrenia or other psychoses (severe mental illnesses) in people who are predisposed to these illnesses.

• The FDA has warned the public not to use vaping products that contain THC. Products of this type have been implicated in many of the reported cases of serious lung injuries linked to vaping.

For more information about cannabis, click here.

Other Resources:

Johnny’s Ambassadors is an excellent resource for everything one needs to know about the dangerous impact of marijuana on young brains

Blue Rising Together is about changing the policies about dangerous THC potencies on the cannabis market

Moms Strong shares stories about the harmful effects of marijuana on youth

Partnership to End Addiction Marijuana: What you need to know to help protect children, teens, and young adults

SAMHSA, Preventing Marijuana Use Among Youth

Adverse Health Effects of Marijuana Use N Engl J. Med. 2014 June 5, Nora D. Volkow, MD

Every Brain Matters is a community of support, advocacy, and science

IASIC - Doctors Educating on Marijuana.

Cocaine Fact Sheet

Methamphetamine Fact Sheet