Is Xanax an Opioid?: Differences Between Opioids and Benzodiazepines
Medically Reviewed by Dr. Francine Mends, MD on May 29, 2020
Thousands of Americans take Xanax every year to treat anxiety and panic disorders, but do you know whether Xanax is an opioid or a benzo?
Out of the top 50 drugs prescribed in the United States, 8% of them are opioids or benzodiazepines.
Opioids and benzos have many traits in common. For instance, they’re both:
- Euphoric, or they make you feel high
- Highly habit-forming even when used as directed
- Associated with respiratory side effects like slowed breathing or death
Despite that, they’re used for different purposes. Opioids are used for chronic pain, while benzos treat panic and anxiety disorders.
What Is Xanax?
Xanax is a benzodiazepine drug. It’s known by the generic name alprazolam. Xanax and other benzos work by increasing a chemical in the brain and nervous system called GABA (or gamma-aminobutyric acid-A).
When there’s more GABA in your system, your brain and nervous system are less sensitive to stimulation. The result is less anxiety and better control over mood.
All benzos work the same way that Xanax does. Xanax is considered a high-potency benzo, so it’s stronger than other drugs in its class.
Uses of Xanax
Xanax is approved by the Food and Drug Administration (FDA) to treat panic disorder, anxiety associated with depression, and anxiety disorder. It’s used off-label to treat:
- Premenstrual syndrome
You should not use Xanax to self-treat any condition without the help of a doctor. Xanax is highly addictive and should only be used under supervision.
Side Effects of Xanax
The most common side effects of Xanax include:
- Increased saliva production
- Loss of sex drive and sexual ability
These side effects are not typically serious. They may get better as you continue to take the medication.
Xanax causes physical dependence, which is a common and serious side effect. The effects of dependence include withdrawal and cravings when you go too long between doses. During withdrawal, you may experience:
- Anxiety and other mood changes
- Diarrhea and stomach pain
- Excessive sweating
- Muscle pain
- Nausea and vomiting
Serious and uncommon side effects from Xanax include:
- Mood changes
- Memory loss
- Slurred speech
- Suicidal thoughts
- Trouble walking
Talk to your doctor right away if you experience any of these serious side effects. These symptoms can be a sign of an overdose or a drug interaction.
In rare cases, Xanax can cause liver problems. Call your doctor if you notice signs of liver disease, such as yellow eyes or skin.
Finally, Xanax can cause life-threatening reactions. Call 911 if you notice the following symptoms:
- Severe dizziness
- Swelling of the face, tongue, or throat
- Trouble breathing
What Are Opioids?
Opioids are narcotic drugs that are often used as pain relievers. They work by activating opioid receptors in the brain, which reduces the perception of pain.
Like benzos, opioids are highly habit-forming. Opioid receptors control your reward system and are linked to addictive behaviors.
Uses of Opioids
Opioids are FDA-approved to treat moderate to severe pain. That includes pain from end-stage cancer, acute pain, and chronic pain. They’re also used in surgical anesthesia and to treat postsurgical pain.
The FDA recommends that doctors should use the lowest dosage that’s effective. Opioids aren’t used as a first-line defense against pain. Instead, they’re used when the doctor deems the risks lower than the benefits for that patient.
Examples of Opioids
Some commonly-prescribed opioids include:
- Fentanyl, which is FDA-approved to treat advanced cancer pain and other forms of severe pain
- Hydromorphone, which treats severe, long-term pain in people who are tolerant to other opioids
- Hydrocodone, which treats 24/7 severe pain in patients who don’t respond to other opioids
- Methadone, which treats moderate and severe pain, as well as opioid use disorder (OUD)
- Morphine, which treats moderate and severe pain that’s resistant to other opioids
- Oxycodone, which treats moderate and severe pain after procedures in the short-acting form, or for chronic severe pain in the long-acting form
This isn’t an exhaustive list of every opioid, but it includes the most commonly prescribed ones.
Side Effects of Opioids
All opioids have similar side effects because they act on the same receptors in the brain and nervous system. Many of those side effects are mild, but a few of them are serious or even life-threatening.
The most common side effects of opioids include:
- Euphoria, or feeling high
These side effects are common and not life-threatening. Most people who use opioids long-term experience at least one of these effects.
Respiratory depression is a common side effect that can be life-threatening. Tell your doctor if you experience:
- Slowed breathing
- Trouble breathing
- Trouble waking
- Uncontrollable sleepiness
Physical dependence is another common side effect that can be life-threatening by leading to an overdose. The signs of dependence include:
- Cravings when you aren’t using opioids
- Tolerance, or needing to take larger doses for the same effect
- Withdrawal when you stop using opioids
Some people experience uncommon side effects. Tell your doctor if you experience:
- Hyperalgesia, or increased pain
- Muscle spasms
- Severe dizziness, a sign of low blood pressure
What’s the Difference Between Opioids and Benzodiazepines?
At first glance, opioids and benzos look similar enough. They both cause a sedating, euphoric high. And both of them are known for being highly addictive, even when you use them the way your doctor directs.
Both types of drugs even cause respiratory depression, which is slowed breathing that can lead to death. And interestingly, both drug classes are used to treat opioid use disorder (OUD).
However, opioids and benzos are very different in several ways.
- Opioids are used to treat pain, while benzos treat anxiety and panic disorders.
- Opioids act on opioid receptors in the brain, while benzos affect chemical production.
- Benzos have side effects that are generally considered more tolerable than those from opioids.
- Benzos are more commonly prescribed for long-term use now that opioid prescribing is finally declining.
Treatment for Addiction to Opioids and Benzodiazepines
If your opioid or benzo use is getting out of hand, don’t despair. You’re not alone in this: thousands of Americans develop an addiction after receiving a prescription for a narcotic drug.
That addiction doesn’t have to be the rest of your life. You have more control of the situation than you think.
Many treatment centers specialize in opioid or benzo treatment, with options that include:
- Inpatient treatment, which offers structure and supervision for clients who need the most support.
- Residential treatment, which offers a homelike environment and more freedom with 24/7 support.
- Partial hospitalization programs, which keep you in treatment for several hours daily to accommodate your real-life schedule.
- Outpatient programs, which give you the freedom to attend appointments part-time while you live your life and tend to responsibilities.
These programs use evidence-based treatment to treat opioid or benzo dependency. There are resources to keep you on the right track, from therapy and counseling to group meetings and medication.
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