Xanax is not a standard medication used for opiate withdrawal, but it may be administered in some cases under strict medical supervision. Xanax is the brand name for alprazolam, a prescription drug for generalized anxiety disorder and panic disorder.
Opiate withdrawal can be distressing and the toll it takes both physically and mentally can increase the risk of relapse. Xanax can reduce anxiety, insomnia, and depression during withdrawal, however, it should not be taken unless specifically recommended by a physician.
Addiction to Xanax and caution has to be applied to prevent it from replacing one substance use with another.
What Is Xanax?
Xanax belongs to a group of prescription drugs called benzodiazepines, which calms the central nervous system and brain activity. It’s available as a tablet or in liquid form. In the U.S., Xanax is one of the most commonly prescribed medicines, with around 3.4 million patients filling prescriptions for it annually [1].
Xanax works by enhancing the gamma-aminobutyric acid (GABA) neurotransmitter in the brain, which slows down nerve activity and calms the central nervous system. It also interrupts electrical signals, making it harder for nerve cells to fire and transmit stress, fear, and panic.
It is a fact-acting benzodiazepine — effects can be felt as soon as one hour after taking it in pill form. It has a half-life of around 11 hours, meaning it takes 11 hours for half of the original dose taken to be removed from the body [2]. The fast-acting and long-lasting effects of Xanax explain why it’s highly addictive. Even when prescribed for a short period of time, physical dependence can form and withdrawal can occur when it’s stopped suddenly or when the dosage is dramatically reduced [3].
Among people with opioid use disorder (OUD), up to 70% report misusing benzodiazepines. Xanax is the most misused benzodiazepine due to its rapid onset [4].
Is Xanax Used in Opiate Withdrawal?
Typically, no. Xanax is not a first-line medicine for opiate withdrawal. It doesn’t treat opiate withdrawal symptoms such as cravings, nausea, or muscle aches.
Still, there are some scenarios when a doctor may prescribe Xanax as part of opiate withdrawal. These include [5]:
- When the person already has a co-occurring opiate and benzodiazepine addiction
- To lower extreme anxiety — in severe withdrawal cases or when the person has a pre-existing anxiety disorder
- To improve sleep when insomnia is persistent during withdrawal
In these circumstances, Xanax is generally prescribed for only a few days to address severe and acute symptoms or to help people gradually taper-off their addiction to opiates, benzodiazepines, or both.
Risks of Xanax in Opiate Withdrawal
There are a number of risks that arise from using Xanax during opioid withdrawal.
The highly-addictive nature of Xanax makes using it in the earliest (and most vulnerable) stage of opiate recovery dangerous. People have greater access to misuse it and to develop a dependence on it.
In the event that a person does become addicted to Xanax while withdrawing from opiates, trying to stop both substances will mean the process is likely prolonged and much more distressing. It can create further health complications and increase the risk of overdose.
Combining Xanax with opiates raises the odds of respiratory depression — slow or stopped breathing — a life-threatening withdrawal symptom that can lead to coma [6].
Rebound anxiety is a possibility, too. When Xanax clears the body, anxiety and insomnia can seemingly return more intensely, especially among people with mental health disorders and sleep disorders. The intensity of the rebound may drive people to abandon withdrawal attempts and to use substances again.
Safe Withdrawal from Opiates
Opiate withdrawal is more often carried out using medication-assisted treatment (MAT), involving FDA-approved medicines to safely taper off opioids, alleviate withdrawal symptoms, and lower the risk of relapse.
Medicines such as buprenorphine or methadone are commonly administered for opioid withdrawal. Research shows more than 80% of adults with OUD quit using opioids one year after finishing MAT treatment [7]. Meanwhile buprenorphine is considered to be one of the most impactful MAT approaches to opioid addiction for relapse prevention and harm reduction [8].
All MAT is carefully monitored and given by licensed clinicians as part of a broader, comprehensive treatment program. The care team checks for adverse reactions and can adjust dosage accordingly. The risk of double addiction or worse withdrawal symptoms is significantly lowered.
Evidence-based therapies such as cognitive behavioral therapy (CBT) and dialectical behavioral therapy (DBT) are used alongside MAT to support reframing negative thinking that fuels addictive behaviors. It also looks at trauma that often sits underneath substance use.
Safe Withdrawal from Opioid Addiction at Red Rock Recovery, Colorado
At Red Rock Recovery, we’re a team of licensed medical professionals who offer empathetic care to overcome opioid addiction and to understand its roots and triggers.
From our centers in Colorado, we offer recovery programs spanning medical detox, residential care, and outpatient treatment. We use evidence-based therapies, including CBT and DBT to support you as you develop healthy coping skills and emotional regulation. We also have MAT to alleviate withdrawal symptoms and cravings when clinically needed.
Our clinicians treat co-occurring mental health disorders, including anxiety and depression. We host wellness activities such as hiking and yoga and make the most of the beautiful nature surrounding our centers to ensure you heal both inside and out.
Where you’ve been doesn’t have to be where you’re going. Start a new path. Contact our admissions team.
Sources
[1] ClinCalc. 2024. Alprazolam. clincalc.com.
[2] Drugs.com. 2025. How long does Xanax (alprazolam) last and stay in your system?. drugs.com.
[3] Ait-Daoud, N. et al. 2018. A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine.
[4] Stein, M. et al. 2018. Beliefs about the Consequences of Using Benzodiazepines among Persons with Opioid Use Disorder. Journal of Substance Abuse Treatment.
[5] Stein, M. et al. 2016. Reasons for Benzodiazepine Use Among Persons Seeking Opioid Detoxification. Journal of Substance Abuse Treatment.
[6] National Institute on Drug Abuse. 2022. Benzodiazepines and Opioids. nida.nih.gov.
[7] Brunisholz, K. et al. 2021. Trends in abstinence and retention associated with implementing a Medication Assisted Treatment program for people with opioid use disorders using a Collective Impact approach. Progress in Community Health Partnerships.
[8] Spayde-Baker, A. Patek, J. 2023. A Comparison of Medication-Assisted Treatment Options for Opioid Addiction: A Review of the Literature. International Journal of Addiction Nursing.