Long-Term Benzodiazepine Therapy, or: Why I’ve Chosen To Take Xanax For 5 Years

pexels-photo-576831Xanax, also known as alprazolam, is a Schedule IV (4) drug. According to the DEA, A Schedule IV drug is classified as having “a low potential for abuse and low risk of dependence.”  So what does that mean for someone who has been taking a Benzodiazepine Class Drug for 5 years?

It means I am physically dependent and adapted to Xanax, my use of Xanax is not rooted in a psychological desire for it. I do refer to myself as a controlled drug addict, not because I mentally crave the drug but I am under the influence of it. It’s how I choose to classify myself, and myself only. I have never referred to other benzo users in any such way. 

My starting dose in 2012: One 0.5-milligram tablet twice daily, afternoon dose as needed.

Current Prescription: 2-milligram tablets, one tablet by mouth 3 times daily.

If I forget one dose I start getting ill almost immediately. I become nauseous, sweaty, dizzy and nervous. A very strong headache will begin and my hand tremors will be more pronounced. I start displaying the serious symptoms of benzo withdrawal in a very short amount of time because well…that’s what’s happening. I do everything I can to make sure I never miss a dose. I also only take the three pills allotted to me each day. Every month I get a script filled for 90 pills, and I take 90 pills in a month.

Have I ever screwed up? So bad. Once there was a mix-up with the prescription. I was sure I could make it through the weekend without my pills. I lasted one day before I was crawling in circles on my bed. I was sweating, keening, twisting and yanking the sheets in my hands while I writhed in pain and begged for help. I remember apologizing to the nurses at the hospital for my hairy legs (no one cared) while I did laps around the bed on my hands and knees. The awesome women got my blood pressure, temperature, and the reason I was there out of me while I flopped around, croaking and mewling inhuman noises. I was in severe alprazolam withdrawal, and I needed benzos inside of me pronto. Not my finest moment, but one of the more interesting ones. *Important note: my husband drove me. No one was in danger except me. Never attempt to drive while in full withdrawal. Call for a ride or use 911.*

I am med compliant, meaning I take all my prescribed medications as directed. I never change doses or stop a drug without consulting my psychiatrist first. Countless medicines have come and gone, but along with Oxcarbazepine, alprazolam has been part of my daily drug regimen for 5 years.

So why choose to take a Benzo for so long? Why become physically dependent on such a controversial medication when there are so many adverse side effects and possible consequences? 

  1. I have a great relationship with my psychiatrist – I have been seeing Dr. B since 2012, he was the doctor who finally properly diagnosed me. He helped me claw my way out of the living hell I was stuck in. If I have concerns about a medicine we discuss it, and he respects my bodily autonomy. Open communication and trust, without them it would be pointless to continue seeing him all these years.
  2. Risk vs. Reward – With any medicine I choose to take I have to weigh all the options of the long-term consequences. With Xanax, it may be permanent short-term memory loss and an increased risk of Alzheimer’s (to name a few). An “everyday” medicine like Ibuprofen may lead to liver disease. The therapeutic benefits I get from taking my meds (and sometimes Ibuprofen) outweigh these risks. Leading me to…
  3. My anxiety is debilitating – I not only have Bipolar Disorder but Major Depressive Disorder, severe anxiety, including social anxiety, OCD, and chronic PTSD. My mood stabilizers and antidepressants can only do so much. I know I am the most important cog in the machine, I have to put in the most work. I cannot rely on medications to “fix me.” They are a bridge helping close the gap between me and total madness. 
  4. I can only tolerate stress until my levels become unhealthy – I suffer from intrusive thoughts and compulsions. My intrusive thoughts are, at times, never-ending. My mind never stops churning, and the combo of medicines (whatever incarnation) can’t seem to slow it down. Compulsions get in the way and make living a normal life more difficult. Xanax helps slow my reactiveness to unhealthy thought patterns, which can lead me down very dark paths.
  5. Xanax helps me stop and breathe, calm down, and order my thoughts. It has greatly reduced the amount and length of panic attacks. It helps, along with combination medication therapy, to keep my mood stable for long periods of time.

Over the last 5 years, I have learned amazing life changing coping skills for my anxiety. I don’t rely on my “tabs” to get me from A to B.  I have had multiple episodes of mania and depression without having to up my dosage of alprazolam. Sometimes we go a year or more before a dose change is needed. I am very aware I am continuously building up a tolerance to the medication. This issue lands on my Risk vs. Reward list. It is worth it to me, for now, to continue using Xanax long term.

Things that people should know but for some reason oftentimes don’t or choose to ignore: What is right for me may be very wrong for other people. It is extremely important to never take a benzodiazepine without a prescription. Never give someone a pill, you don’t know what kind of reaction they will have. Never take more than you are prescribed, the risk of overdose is real and it can happen quickly. Never drink or do other non-prescription drugs with your med. Impairment happens quickly on Benzo’s when a person first begins taking them. Always use caution when making decisions that could affect you or the people around you. Keep your Benzo’s locked away from kids, teenagers, and company. If you lose your prescription or if it’s stolen it cannot be refilled until your next refill date. Always use caution when telling people you are on this kind of medicine, it is hard to spot someone addicted. 

One more thing: Here is an interesting explanation on how Benzodiazepines work in our brains. 


If you or someone you know is addicted to Benzos or Opiates call 1-800-662-HELP (4357)
If you or someone you know is feeling suicidal call 1-800-273-TALK (8255), call your doctor, a loved one or friend, or go to your nearest emergency room. You Matter.