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How Does Xanax Help With Heroin Withdrawal? How Effective Is It?

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In the U.S. in 2017, about 494,000 people age 12 and older said they had used heroin at least one time in the past year, according to the U.S. Centers for Disease Control and Prevention.

Recovering from heroin addiction usually requires help. This help can be imperative during the withdrawal process since many people do not complete detox because of the discomfort involved. 

Some medical professionals prescribe Xanax during detox, but it is not commonly used. Usually, other medications are preferred to treat specific symptoms of withdrawal. Learn more about how it works and when it is appropriate.

Xanax and Heroin Withdrawal

Xanax is a benzodiazepine. Traditionally, doctors prescribe this drug to treat panic disorder and anxiety. It works by increasing the effects of GABA (gamma-Aminobutyric acid) to create a sense of calm and relaxation.

If Xanax is prescribed during heroin withdrawal, it is usually to reduce specific symptoms, such as insomnia or anxiety. If this drug is used to help with opiate withdrawal, it is typically used for the shortest time possible, as it can quickly result in physical dependence. 

How Effective Is It?

There are no viable studies that address how helpful Xanax can be during the heroin withdrawal process. In many cases, a person benefits the most from a comprehensive treatment program. This would include a combination of therapies and medications.

Xanax may be a medication that is used depending on the needs of the client. It may be used alone or with other drugs to aid withdrawal or to provide supportive care for specific symptoms. Other medicines for particular symptoms might also be indicated if someone has withdrawal symptoms that are especially bothersome. 

In many cases, Xanax is not prescribed when opiates are involved. This is due to the high risk for benzodiazepine abuse, according to research published in the European Journal of Pharmacology. Other drugs that are not benzodiazepines can help with the withdrawal symptoms that Xanax might be prescribed for, such as insomnia and anxiety, and these medications are generally preferred. 

When a benzodiazepine is prescribed, it is usually diazepam for insomnia, according to research published in the British Journal of Clinical Pharmacology. However, this is usually only considered when the person had a dependence on benzodiazepine drugs in addition to heroin addiction. 

Can Other Medications Be Used to Aid Withdrawal?

Medication-assisted treatment (MAT) can help people to overcome challenges that occur during the withdrawal process. For heroin withdrawal, buprenorphine, methadone, and naltrexone are the primary forms of MAT.

When a person stops using heroin, they can become sick and experience intense cravings. The medication-assisted treatment essentially replaces heroin with an opioid-based medication. This reduces withdrawal symptoms and cravings so that the person can focus on recovery instead of on heroin, according to Partnership for Drug-Free Kids.

MAT is not just medication use. It also focuses on therapy to reduce the risk of relapse, enable recovery, and address behavioral issues. 

Methadone, buprenorphine, and naltrexone have all been approved by the FDA for heroin withdrawal, according to the U.S. Food and Drug Administration

Naltrexone works as an opioid antagonist, blocking narcotic effects. This medication can be given via a monthly injection or a daily pill. Before someone can start using the shot, they must have at least a week of abstinence from opioids, according to Partnership for Drug-Free Kids

Methadone is an opioid agonist. It helps to prevent withdrawal symptoms but does not block other narcotics. It is available as a liquid and a pill. Both are usually dispensed daily at a clinic.

Buprenorphine is an opioid agonist/antagonist. It works to reduce withdrawal symptoms while blocking other narcotics when it is combined with naloxone in Suboxone. There are different forms of this drug, including a cheek film, a daily tablet that dissolves, and an implant that goes below the skin and lasts for six months.

Choosing Which Medication Will Work Best

According to the Society of General Internal Medicine 36th Annual Meeting, the following should be considered when determining with medicine will work best for the individual dealing with heroin withdrawal:

  • Buprenorphine has a reduced risk for adverse outcomes. It also tends to allow for a faster resolution of symptoms.
  • Methadone may be ideal for those who need narcotic pain relief while simultaneously overcoming heroin addiction. 

The choice of which medication to use will be made by the supervising physician in conjunction with the client. Other members of the treatment team, such as therapists, may weigh in on this decision.

Factors to consider include the treatment setting, the client’s support system, past attempts at recovery, and medical issues.

Medical Detox vs. MAT

Medical detox focuses only on the withdrawal stage of addiction treatment, according to the National Institute on Drug Abuse. It does not work to address long-term treatment. MAT is a comprehensive treatment program that does not abruptly end after the person completes the withdrawal stage. 

When used for heroin, medical detox typically provides comfort and medical support. The process focuses on reducing withdrawal symptoms so that the person is less likely to use heroin to alleviate these symptoms.

During medical detox, trained professionals will monitor the client during the entire detox process. Once the process ends, they can aid the client with getting into a long-term treatment program. This may be at the same facility or a different facility, depending on availability.

Medical detox is not designed to resolve the client’s long-standing social, behavioral, and psychological problems related to their substance abuse, according to information published in Detoxification and Substance Abuse. When it is part of a comprehensive addiction treatment program, it will involve a transition into addiction therapy.

Medication Use 

The medical detox process may involve different medications to keep the person more comfortable. For example, if a person experiences nausea and vomiting that makes it hard to relax, they might receive an antiemetic drug. An antihistamine might be considered for someone who is experiencing intense itching.

The medications used during this type of treatment are typically targeted at the withdrawal effects a person experiences. When a person enters treatment, they receive an initial evaluation to see which medicines can be beneficial. They will be reviewed throughout the process so that proper changes can be made as necessary.

While Xanax isn’t a primary medication used during heroin withdrawal, some physicians may deem it appropriate for a given situation, such as a patient who is experiencing intense anxiety or panic attacks.
No one should attempt to use Xanax during heroin withdrawal without a doctor’s direct oversight. Doing so could be incredibly dangerous. 

Sources

Heroin Overdose Data. Centers for Disease Control and Prevention. from https://www.cdc.gov/drugoverdose/data/heroin.html

Ativan vs. Xanax. RxList. from https://www.rxlist.com/ativan_vs_xanax/drugs-condition.htm

(1996) Effect of Alprazolam on Opiate Withdrawal: A Combined Behavioral and Microdialysis Study. European Journal of Pharmacology. from https://www.ncbi.nlm.nih.gov/pubmed/8905331

(January 2014) Pharmacological Strategies for Detoxification. British Journal of Clinical Pharmacology. from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4014033/

Medication-Assisted Treatment for Opioid Addiction. Partnership for Drug-Free Kids. from https://drugfree.org/article/medication-assisted-treatment/#help

Information About Medication-Assisted Treatment (MAT). Food and Drug Administration. from https://www.fda.gov/Drugs/DrugSafety/InformationbyDrugClass/ucm600092.htm

Considering Medication-Assisted Treatment? Make Sure You Know the Fine Print. Partnership for Drug-Free Kids. from https://drugfree.org/parent-blog/considering-medication-assisted-treatment-make-sure-you-know-the-fine-print/

(April 2013) Management of Substance Withdrawal in Acutely Ill Medical Patients: Opioids, Alcohol, and Benzodiazepines. Society of General Internal Medicine 36th Annual Meeting. from https://www.sgim.org/File%20Library/SGIM/Meetings/Annual%20Meeting/Meetign%20Content/AM13%20handouts/WF11–Anika-Alvanzo.pdf

Medical Detoxification. National Institute on Drug Abuse. from https://www.drugabuse.gov/publications/teaching-packets/understanding-drug-abuse-addiction/section-iii/7-medical-detoxification

Overview, Essential Concepts, and Definitions in Detoxification. Detoxification and Substance Abuse Treatment. from https://www.ncbi.nlm.nih.gov/books/NBK64119/

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