Anxiolytic Medication Abuse & Addiction Risks

Anxiolytic medications, also called anti-anxiety drugs, are specifically designed to reduce anxiety and related symptoms. While these medications can be highly effective when used as prescribed, their calming effects and potential for creating physical dependence often lead to them being abused.

If you or someone you know is struggling with anxiolytic abuse or addiction, recovery is possible with the right treatment and support. You don’t have to face this challenge alone. Learn how you can get your medication abuse and mental health care back on track.

Anti-anxiety medications can include several types of anxiolytic drugs that produce calming effects, but the most common types are benzodiazepines like Xanax, Valium and Klonopin. Non-benzodiazepine medications like buspirone may also be given, because it’s generally considered non-habit forming, but takes several weeks to achieve symptom relief.

Anxiolytic drugs enhance the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that naturally calms brain activity. They’re typically prescribed to treat generalized anxiety disorder, panic disorder, social anxiety disorder and various phobias.

When used correctly, anxiolytics can significantly improve your quality of life by reducing debilitating anxiety symptoms. However, the intended effects of these drugs can also lead some people to abuse them. Several factors contribute to why a person taking anxiolytics may fall victim to abuse, including:

• Physical dependence: Your body can become physically dependent on these medications even when taking them as prescribed, leading to withdrawal symptoms if you stop taking them suddenly.
• Psychological dependence: The relief you get may cause you to believe you can’t cope without taking them, even if there are negative consequences.
• Tolerance buildup: Over time, you may need higher doses to achieve the same anxiety-relieving effects, which can lead to taking more than prescribed.
• Self-medicating behavior: You might increase your dose during particularly stressful periods or use the medication to cope with problems beyond anxiety.
• Pleasant side effects: The euphoric feelings these medications can produce may encourage non-medical use.
• Rapid symptom relief: The quick-acting nature of many anxiolytics can create a pattern of reaching for medication as soon as even mild anxiety occurs.
• Mixing substances: A person may combine them with alcohol or opioids for a more potent effect.

Even when you start under a doctor’s care, these factors can push you toward patterns of misuse that spiral into addiction.

Anxiolytic dependence can occur within weeks, especially on benzodiazepines like alprazolam (Xanax), due to its fast-acting effect that only lasts a short duration. Abuse can lead to dependence, leading to further abuse. When you abuse anxiolytics by taking them in ways other than prescribed, your risk of developing an addiction increases significantly.

Anxiolytic abuse can lead to addiction through several interconnected ways, including:

• Brain chemistry changes. Repeated abuse alters your brain’s reward system and natural GABA production, making it difficult to feel calm or normal without the medication.
• Tolerance escalation. As your tolerance increases, you need progressively higher doses to achieve the desired effects, accelerating the addiction process.
  Withdrawal avoidance. Fear of uncomfortable withdrawal symptoms can drive continued use even when you want to stop.
• Psychological dependence. You may become mentally and emotionally reliant on the medication to handle any stressful situation or negative emotion.
  Conditioned response. Your brain begins to associate anxiety relief exclusively with medication rather than developing healthy coping mechanisms.

Even if you’re prescribed anti-anxiety medications legitimately, you can still develop an addiction, especially if you have certain risk factors. Your likelihood of developing anxiolytic addiction increases if you have an addictive personality, previous substance abuse history, family history of addiction, mental health disorders beyond anxiety or environmental factors like high stress or easy access to medications.

Anxiolytics are some of the commonly prescribed medications nationwide, per the Cleveland Clinic, so they’re often readily available. Access could include a legitimate prescription, through a friend’s or family member’s prescription or even purchasing them illegally.

While anyone with access to these drugs could be at risk of abusing them, those who are at the highest risk are often the ones with a valid prescription to treat anxiety or related mental health conditions. Your anxiety disorder may already put you at a higher risk of abusing your prescription medication, as the Substance Abuse and Mental Health Services Administration (SAMHSA) states that substance use problems occur more frequently with certain mental health problems, including anxiety disorders.

Commonly prescribed anxiolytic medications that carry abuse potential include:

• Klonopin (clonazepam)
• Valium (diazepam)
• Xanax (alprazolam)

Even if you began taking anxiolytics for legitimate reasons, you can’t assume you’re immune to abuse. Benzodiazepines, in particular, have well-documented misuse potential. Nearly 10% of U.S. adults reported benzodiazepine misuse by age 35, according to a study published in the “Psychiatric Services” journal in May 2023.

Recognizing the signs and symptoms of anxiolytic abuse is crucial for getting help before the situation becomes more serious. These warning signs can help you identify if you or a loved one may be developing a problem with these medications.

Physical and behavioral signs of anxiolytic abuse include:

• Taking higher doses or more often than prescribed
• Seeking refills sooner because your prescription ran out earlier than it should have
• Attempting to get extra prescriptions by doctor shopping
• Mixing your anxiety medications with alcohol or other drugs for stronger effects
• Having withdrawal symptoms when not taking your medication
• Letting responsibility at home, school or work slide because of your medication’s impact
• Pulling away from friends or skipping activities you once enjoyed due to medication use
• Lying about how much you’re using or hiding pills from family
• Continuing to use anxiolytics even when it has negative consequences
• Struggling to handle anxiety or stress without medication
• Being confused or having problems concentrating or with your memory
• Dealing with mood swings, irritability or depression when not on medication
• Experiencing excessive sleepiness or an inability to sleep that’s unusual
• Having trouble with coordination, feeling dizzy or slurring your speech

Catching problematic use early can prevent a dangerous slide into full dependence. You may notice subtle shifts in behavior and routines that can signal a potential problem. Knowing these early indicators can help you realize you or a loved one may need help before the problem becomes even more severe.

Anxiolytics include several different medications used to treat anxiety and panic disorders. All anxiolytics carry risk when misused, but some have higher abuse potential. Taking any of these medications beyond their prescribed use can potentially lead to abuse and addiction.

Benzodiazepines are the most commonly abused anxiolytics because they act fast and have potent effects. These medications work quickly to reduce anxiety but also carry the highest risk for dependence and abuse. Common benzodiazepines include:

• Klonopin (clonazepam): Takes longer to kick in but lasts a long time, often prescribed for both anxiety and seizure disorders
• Valium (diazepam): Lasts longer than some options but builds up in your system, with misuse potentially leading to oversedation and memory problems
• Xanax (alprazolam): Fast-acting but doesn’t last long, often prescribed for panic attacks and most frequently abused, potentially due to large number of prescriptions issued for many years

Non-benzodiazepine anxiolytics include azapirones like buspirone, which are used as an alternative to benzodiazepines for anxiety because they generally have lower abuse potential. Buspirone is less sedating and doesn’t produce the same euphoric effects, making it less likely to be abused, but some people may still misuse it and take more than prescribed.

Anxiolytics have general side effects even when taken as directed, but more severe and dangerous side effects can occur when these medications are abused. While specific effects can vary based on the exact type of anxiolytic being abused, the dose taken, how long it’s taken and personal factors, severe side effects of abuse can include:

• Extreme drowsiness that interferes with daily activities
• Memory gaps and blackouts, particularly while under the influence
• Difficulty thinking clearly, making decisions or processing information
• Slowed breathing, especially when combined with alcohol, opioids or other depressants
• Increased risk of falls and accidents due to poor coordination and balance
• Increased agitation, aggression or disinhibition/impulsiveness
• Depression and suicidal thoughts, particularly during withdrawal
• Digestive problems, including nausea, vomiting and constipation
• Cardiovascular issues such as irregular heartbeat and low blood pressure
• Skin problems and increased sensitivity to the sun with long-term abuse

According to the National Institute on Drug Abuse, nearly 14% of overdose deaths involving opioids also involved benzodiazepines in 2021. Almost 11,000 overdose deaths involved benzodiazepines in 2023, according to the Centers for Disease Control and Prevention, but nearly 70% of these deaths also involved illicitly manufactured fentanyl.

Abusing anxiolytics significantly increases your risk of overdose, which can be life-threatening. The risk becomes even more dangerous when you combine anxiolytics with alcohol, opioids or other central nervous system depressants. Signs and symptoms of a possible overdose may include:

• Severe confusion or disorientation
• Extreme drowsiness or inability to stay awake
• Slurred speech or difficulty speaking
• Loss of coordination or ability to walk
• Slow, shallow or irregular breathing
• Blue lips, fingernails or skin
• Weak or rapid pulse
• Cold, clammy skin
• Loss of consciousness or unresponsiveness
• Muscle weakness or limpness
• Seizures in some cases
• Coma and possibly death

If you suspect someone is having an anxiolytic overdose, call emergency services immediately. Overdoses require immediate medical attention and can be fatal without proper treatment.

SAMHSA indicates that over 25% of adults with serious mental health conditions also have a substance use problem. Furthermore, substance abuse occurs more frequently among those with certain types of mental health issues, such as anxiety disorders. When a person has a mental health disorder and a substance use disorder (SUD), it’s called a co-occurring disorder or dual diagnosis, which requires specialized treatment to address both issues at the same time.

Taking a dual approach is essential because stopping anti-anxiety medications like benzodiazepines abruptly can cause serious withdrawal symptoms, which can be life-threatening if you were abusing your medication. Plus, stopping without addressing your anxiety or other mental health condition can lead to a return of debilitating symptoms, which may trigger a relapse.

SAMHSA data shows that people receiving integrated care for co-occurring disorders have better long-term outcomes than those treated for only one condition. Specialized dual diagnosis treatment programs provide integrated care that addresses your substance abuse and mental health disorders at the same time, rather than addressing each condition separately. Effective treatment may include:

• Medical stabilization to manage withdrawal safely in a supervised setting
• Psychiatric evaluation to adjust your anxiety treatment plan without medication
• Various individual and group therapy approaches for anxiety and addictive behaviors
• Lifestyle support, such as stress management, sleep hygiene and exercise
• Aftercare planning to ensure continuity of care following treatment

Recovery from anxiolytic abuse typically involves working with medical professionals to taper off the medication you’ve been abusing safely. Abruptly stopping anxiolytics can cause dangerous withdrawal symptoms, including seizures, so medical supervision is essential for your safety.

Depending on your specific situation, your healthcare provider may recommend replacing your current medication with a less addictive alternative. For example, if you’ve been abusing a fast-acting benzodiazepine like Xanax, your doctor might switch you to a longer-acting benzodiazepine like Valium during the tapering process, then eventually transition to a non-benzodiazepine anxiolytic like buspirone, with a much lower abuse potential.

Other medication alternatives your doctor might consider include certain antidepressants that also treat anxiety, such as selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) like venlafaxine (Effexor).

In some cases, your healthcare provider might recommend non-medication approaches as your primary treatment, such as therapy and lifestyle changes, while using medication only as needed for severe symptoms. This approach can help reduce your reliance on anxiolytics and other prescription medications. A tailored plan lets you manage anxiety safely while breaking the cycle of misuse.

Dual diagnosis programs, specifically designed to help you recover from both substance abuse and mental health issues, offer the most comprehensive approach to treating anxiolytic abuse. These programs recognize that your anxiety disorder and substance abuse are interconnected and require specialized treatment strategies.

Treatment typically includes several levels of care, each designed to meet your specific needs. Your exact treatment plan is individualized and will include the ideal combination of the following:

• Detoxification: Medical supervision, with 24/7 monitoring and medication management to minimize withdrawal and ensure your safety as the medication leaves your system.
• Inpatient Treatment: Inpatient care in a hospital or treatment facility, providing the highest level of medical supervision and intensive therapy.
• Partial Hospitalization Programs: Intensive daily treatment lasting 6 to 8 hours that allows you to return home at night, offering structured therapy and medical monitoring without requiring overnight stays.
• Residential treatment: Living in a treatment facility for several weeks to months while participating in comprehensive therapy and educational programs, while developing recovery skills in a supportive environment.
• Intensive outpatient programs: Attending treatment sessions several times per week while maintaining your daily responsibilities, allowing you to practice recovery skills in real-world situations.
• Outpatient treatment: Regular therapy sessions and medical appointments while living at home, providing ongoing support and monitoring as you continue your recovery.

Various types of therapy are available to help you overcome anxiolytic abuse while managing your underlying anxiety disorder. These therapeutic approaches work together to help you develop healthy coping strategies and address the root causes of both your addiction and mental health condition.

Effective therapy options include:

• Cognitive Behavioral Therapy (CBT): – Helps you identify and change negative thought patterns and behaviors that contribute to your anxiety and substance abuse, teaching practical skills for managing triggers and cravings.
• Dialectical Behavior Therapy (DBT): Focuses on teaching mindfulness, tolerance of distress, regulation of emotions and interpersonal skills to help you manage intense emotions without turning to substances.
• Group Therapy: Provides peer support and allows you to share experiences with others facing similar issues, helping you feel less alone in your situation.
• Family Therapy: Involves your loved ones in the recovery process to help you repair relationships damaged by substance abuse and create a supportive environment at home.
• Cognitive Enhancement Therapy (CET): Helps improve cognitive functions that may have been impaired by substance abuse, such as attention, memory and problem-solving skills.
• Motivational Interviewing: A collaborative approach that helps you find your own motivation for change and overcome mixed feelings about engaging in treatment.
• Contingency Management: Encourages abstinence from substance use and recovery through positive reinforcement.
• Individual Counseling: Provides one-on-one support to address personal issues, trauma and specific challenges unique to your situation.

Even after formal treatment ends, recovery is an ongoing journey. Continuing care after completing your initial treatment is crucial for maintaining your recovery and preventing a relapse. Long-term support helps you handle ongoing challenges and reinforces the skills you learn in treatment.

Important continuing care options include:

• Ongoing Outpatient Care: Regular therapy sessions to monitor your mental health and adjust treatment as needed for consistent professional support.
• Telehealth Therapy: Virtual counseling sessions that make it easier to maintain consistent care regardless of location or schedule, ensuring you can access support when needed.
• Medication Management: Regular medical appointments to monitor any medications prescribed for your anxiety disorder or other mental health condition to ensure they’re working effectively without causing problems.
• Support Groups: Peer support through in-person groups like Narcotics Anonymous or online anxiety-specific groups through organizations like the Anxiety and Depression Association of America to provide ongoing connection and accountability.
• Sober Living Environments: Structured living situations that provide additional support and accountability during early recovery while you transition back to independent living.

Recovery from anxiolytic addiction and your underlying mental health condition is possible with the correct support and treatment approach. You’re not alone in your struggle to manage your medication abuse and learn to manage your anxiety in healthy ways. Don’t be afraid to take the first step in reclaiming your life and developing the skills you need for long-term recovery and mental wellness.

PsyWeb can connect you with professional help to guide you through every stage of the recovery process. Our listings include high-quality treatment programs specifically designed to address both substance abuse and mental health conditions, ensuring you receive comprehensive care tailored to your unique needs.

Contact us today to explore top treatment options for anxiolytic addiction and mental health support in your area.