[content-overview]

<strong>The term “alcoholism” is commonly used in American society, but it is a nonclinical descriptor.</strong> Unlike laypersons, researchers, doctors, therapists, and a host of other professionals require a consensus on what constitutes the different levels of alcohol use. The <a href="http://www.psychiatry.org/psychiatrists/practice/dsm/dsm-5" target="_blank" rel="noopener"><em>Diagnostic and Statistical Manual of Mental Disorder-5</em></a><em> (DSM-5)</em>, a publication of the American Psychiatric Association, provides professionals in the mental health field with an indispensable diagnostic tool that helps them to identify the various mental health disorders, including alcohol use disorder. [/content-overview]
<h2>What Is Alcohol Use Disorder?</h2>
According to the <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-use-disorders" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a>, in 2012, an estimated 7.2 percent of American adults aged 18 and older, approximately 17 million people, had a diagnosable alcohol use disorder. Men have alcohol use disorder almost twice as often as women; of the estimated 17 million affected adults, 11.2 million were men and 5.7 million were women. Adolescents are not immune. In 2012, an estimated 855,000 young people between 12-17 years of age had this disorder.

No two individuals who experience alcohol abuse are the same; however, DSM-5 provides clinicians with a set of <a href="http://pubs.niaaa.nih.gov/publications/dsmfactsheet/dsmfact.pdf" target="_blank" rel="noopener">11 factors</a> that can guide them in the diagnosis of an alcohol use disorder and its severity grade. In short, if a person has experienced at least two of the 11 factors (or symptoms) in the past year then the person is considered to have an alcohol use disorder. The existence of two or three symptoms equals a diagnosis of mild alcohol use disorder, while four to five symptoms is considered moderate, and six or more is considered severe.

[callout]
<strong>Ready to get help?</strong>Take a short quiz of DSM-5 criteria to assess the severity of your alcohol use.
<h4><strong><a href="https://americanaddictioncenters.org/self-assessment" target="_blank" rel="noopener">Take Self-Assessment</a></strong></h4>
[/callout]

To provide insight into the alcohol use diagnostics process, consider the following sample of four possible symptoms:
<ul>
 	<li><a href="/alcoholism-treatment/family-marital-problems/">An interference with work, school, family, and/or other responsibilities as a result of alcohol consumption</a></li>
 	<li>Continuing to consume alcohol despite the negative impact it is having on one's relationships</li>
 	<li>Engaging in risky behavior after drinking, such as fighting, driving, swimming, having unprotected sex, or operating machinery</li>
 	<li>Over time, requiring more alcohol to achieve the desired intoxicating effects</li>
</ul>
<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/StagesOfAlcoholism.png"><img class="aligncenter size-full wp-image-56648" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/StagesOfAlcoholism.png" alt="what are the stages of alcoholism" width="700" height="3098" /></a>

Overall, the 11 factors address both the physical and psychological components of alcohol use disorder. The distinction between physical dependence and psychological addiction is an important one to understand. As the <a href="http://www.drugabuse.gov/publications/principles-drug-addiction-treatment-research-based-guide-third-edition/frequently-asked-questions/there-difference-between-physical-dependence" target="_blank" rel="noopener">National Institute on Drug Abuse</a> explains, physical dependence is a component of addiction, but it is not synonymous with addiction. In other words, a person can be physically dependent on alcohol or another drug of abuse without being psychologically dependent on it.

There are two main hallmarks of physical dependence. First, the body will build a tolerance, which is a natural process. As tolerance builds, a person who consumes alcohol will require a higher volume in order to experience the familiar effects. Second, the body will go through withdrawal if intake of the familiar drug ceases or if there is a significant reduction in the usual amount. When a chronic alcohol abuser stops drinking the signs of withdrawal will set in. They may continue to drink in order to avoid feeling such symptoms.

Individuals with an alcohol use disorder (alcoholism) will likely experience the symptoms of physical dependence as well as psychological effects.

Withdrawal symptoms include: anxiety, confusion, tremors, racing heart, nausea, vomiting, and/or sleeplessness.
The psychological component of addiction does not refer to the effects alcohol has on one's mental state, such as disordered thinking. Rather, it refers to how the person's thoughts and actions become geared toward obtaining alcohol and consuming it, even to the exclusion of important responsibilities.
<h2>Early Alcohol Abuse</h2>
In terms of the DSM-5, new alcohol users could display 0-2 of the 11 symptoms discussed. The difficulty is that one never knows if social or occasional drinking will lead to the development of alcohol use disorder. In the <a href="http://www.healthline.com/health/stages-alcoholism#Alcoholism1" target="_blank" rel="noopener">early phases of alcohol abuse</a>, a person will usually get an introduction to different types of alcohol and experiment with alcohol in various forms.

Most often, these experimenting individuals are either high school students or young adults, such as college students. Drinking is usually a social event among this younger set, and they collectively binge drink as a way of partying. They may not be regular drinkers, but binge drinking alone still puts them at risk of developing alcohol use disorder. According to the National Institute on Alcohol Abuse and Alcoholism, <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking" target="_blank" rel="noopener">binge drinking</a> occurs when, within two hours, a person reaches a blood alcohol content of 0.08 or greater. For women, depending on body weight, this usually requires four drinks, and in men, it requires five drinks in 2 hours. However, many binge drinkers will exceed the four or five drink mark and experience higher levels of BAC as well as a host of debilitating physical and mental side effects.

Some binge drinkers or party drinkers will not progress beyond the experimental phase to drink regularly. Those who do continue to drink heavily or regularly may do so because they are environmentally or genetically predisposed to do so. For instance, <a href="http://pubs.niaaa.nih.gov/publications/FamilyHistory/famhist.htm" target="_blank" rel="noopener">children of people with an alcohol use disorder</a> are four times more likely to also experience this disorder. Further, research suggests that certain elements of a child's home life can dispose them to alcohol abuse, such as seeing a parent abuse alcohol or other drugs, or being exposed to a parent's depression or conflict/violence in the family. Additionally, some people have an existing mental health disorder, and they may graduate from social drinking to more frequent drinking because they perceive it relieves some of their psychiatric symptoms.
Environmental and genetic factors aside, the sheer number of drinks people consume in a given period of time can put them at risk for developing an alcohol use disorder. Women who have a daily intake of more than three drinks, or more than seven per week, are considered at risk. Men, due to their physiological differences from women, are considered to be at risk if they partake in more than four drinks a day or more than 14 per week.
<h2>Problematic Alcohol Abuse</h2>
Moderate use of alcohol is associated both with the frequency of consumption as well as the intention around drinking. A person who has an emotional or psychological attachment to drinking may be at a higher risk for developing an alcohol use disorder compared to a person who regularly has a glass of wine with a meal.

Generally, problem drinking is associated with the loss of control over one's alcohol intake and/or displaying signs that alcohol consumption is interfering with one's normal life activities. In such a case, in terms of the DSM-5 factors discussed, the person would begin to show more symptoms, possibly 3-5. At this stage, a person may or may not be physically dependent on alcohol. In other words, the cessation of drinking will lead to withdrawal symptoms.

<img class="aligncenter wp-image-32869 size-large" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/dramatic-image-of-a-sad-woman-59686475-1024x684.jpg" alt="sad girl high on suboxone pills" width="1024" height="684" />

However, if a person has an attachment to drinking, such as relying on it to “have a good time,” they may develop problematic drinking habits and eventually develop an AUD. <a href="/alcoholism-treatment/physical-health/">If alcohol dependence sets in, it will likely be more difficult to stop drinking because of the presence of withdrawal symptoms </a>and possibly cravings for alcohol.

Most addiction professionals agree that an at-home detox or “going cold turkey” is never advisable. The best practice would be to talk with an addiction counselor or mental health professional about safe options to detox from alcohol.

The need for a medically supervised detox depends, in part, on the length of time of alcohol abuse and usual volume of consumption. In some cases, alcohol withdrawal can present heightened risks and even lead to fatality. Individuals who are at risk for withdrawal effects require supervised medical detox. As a result, it is recommended that anyone seeking to detox from alcohol consult a medical professional first.
<h2>Severe Alcohol Abuse</h2>
A review of the 11 factors set forth in the DSM-5 regarding severe alcohol use disorder (i.e., the presence of six or more factors) provides additional insight into this condition. Having six or more of the alcohol use disorder symptoms would indicate the need for a treatment intervention to address the addiction.

Before discussing the negative outcomes associated with alcohol (i.e., its possibly devastating effects on one's life, including poor health, conflict in relationships, troubled finances, and precarious employment status) consider the class of heavy drinkers known as "highly functioning." A <a href="http://www.webmd.com/mental-health/addiction/features/high-functioning-alcoholic" target="_blank" rel="noopener">highly functioning person who abuses alcohol</a> will be able to work every day, exceed expectations, and meet all required financial obligations.

An estimated 20 percent of individuals who abuse alcohol may be classified as highly functioning. Continued drinking, however, is essentially a ticking time bomb. In terms of the negative fallout associated with heavy chronic drinking, despite appearances to the contrary, a highly functioning individual is not immune.

The development of negative health conditions and diseases is a major concern surrounding alcohol abuse. Health troubles can range in severity, but the following health conditions and diseases may manifest due to chronic, heavy alcohol abuse:
<ul>
 	<li>Cardiovascular disease</li>
 	<li>Anemia</li>
 	<li>Dementia</li>
 	<li>Cirrhosis</li>
 	<li>Cancer</li>
 	<li>Seizures</li>
 	<li>Depression</li>
 	<li>High blood pressure</li>
 	<li>Nerve damage</li>
 	<li>Pancreatitis</li>
 	<li>Gout</li>
 	<li>Infectious diseases</li>
</ul>
In some cases, alcohol abuse may exacerbate conditions but not cause them. In other cases, alcohol may be a component cause of a condition, and ongoing alcohol use will cause flare-ups. For instance, alcohol abuse can be a component cause of gout and worsen the condition.

Alcohol has been found to be directly causally related to some diseases and conditions, such as mouth cancer in a person with a history of heavy chronic drinking. In the unfortunate event that a chronic drinker develops a serious health condition or disease, the treating physician can explain whether alcohol was a direct cause or a component cause. The attending physician can also explain how continued drinking will impact the specific condition(s) present.
<h2>End-Stage Alcohol Abuse</h2>
In <em>One Flew Over the Cuckoo's Nest</em>, celebrated author Ken Kesey insightfully communicated the extreme cost that drinking can have on a chronic user's life when Chief Bromden described the last time he saw his father, “He was blind and diseased from drinking. And every time he put the bottle to his mouth, he didn't suck out of it, it sucked out of him.” This quote artistically communicates a truth about alcohol abuse; in end-stage alcohol abuse, a person loses control over alcohol use and actually becomes controlled by it.
The end stage may be thought of as the most severe articulation of all the possible problems associated with alcohol use disorder. It is a circumstance of reversals; rather than living to drink, a person in the end stage likely drinks to live. At this point, individuals have lost the ability to stop themselves from drinking. After a long enough period of heavy chronic alcohol use, withdrawal symptoms may be so painful that the person is motivated to continually drink just to prevent them.

At this point, an individual may develop a serious disease, such as cirrhosis of the liver. Cirrhosis of the liver emerges from years of liver damage. As individuals continually consume alcohol, their liver produces scar tissue instead of new healthy tissue. Over time, the scar tissue in the liver prevents the necessary flow of blood. The presence of scar tissue also impairs the body's ability to clean toxins from the blood, control infections, process nutrients, and absorb cholesterol and certain vitamins.In addition to chronic health diseases and conditions, persons in the end stage of alcohol abuse may be at a heightened risk of falls and other accidents due to balance and coordination problems. Most often, when death occurs after a fall, it is due to bleeding in the brain and not the fall itself.
A person in the end stage of alcohol abuse is also at risk for intentional self-harm. The loss of control over alcohol consumption can leave a person feeling powerless. Withdrawal, as stated, can be painful. The end stage alcohol abuse is in a true quagmire. Help is always available, as the depression associated with alcohol abuse can lead individuals to end their lives.

[callout-complex title="Getting Help" image="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/detox-help-1024x547.jpg" alt="Doctor hands writing on a clipboard."]

Alcohol abuse can have harrowing and hazardous side effects at every phase; however, <a href="/alcoholism-treatment/">each stage of alcohol abuse is treatable.</a> Even if certain chronic conditions cannot be reversed, abstinence can help to better manage them. Achieving sobriety is always a win for a person's health and wellbeing whether treatment occurs in the early, middle, or end stage. It's never too late to get help and achieve recovery.

Alcohol abuse is never exclusively about alcohol. For this reason, a full spectrum of rehab services that starts with medical detox and continues to treat the psychological aspects of abuse is needed.
[/callout-complex]

Stages of Alcoholism: Early, Chronic and End Stage

[callout]
<h4 class="text-elegant text-center no-margin-v">How Does Alcohol Impact Cognitive Ability?</h4>
[link-bank position="left" title="Occasional and moderate drinkers:"]
<ul>
 	<li>Memory impairment</li>
 	<li>Blackout</li>
 	<li>Recklessness</li>
 	<li>Impaired decision-making</li>
</ul>
[/link-bank]

[link-bank position="right" title="Heavy and/or chronic drinkers:"]
<ul>
 	<li>Diminished gray matter in the brain</li>
 	<li>Inability to think abstractly</li>
 	<li>Loss of visuospatial abilities</li>
 	<li>Wernicke-Korsakoff syndrome</li>
 	<li>Memory loss</li>
 	<li>Loss of attention span</li>
</ul>
[/link-bank]

[/callout]

<strong>Alcohol is an integral part of the American social scene. The failed experiment of Prohibition demonstrated the formidable demand Americans have for alcohol.</strong>
As advertisements caution, alcohol is meant to be enjoyed responsibly; however, alcohol consumption can cause individuals to lose their ability to think responsibly.

Alcohol is associated with a host of familiar <a href="https://dontbottleitup.org.uk/facts-about-alcohol/short-term-effects-of-alcohol/" target="_blank" rel="noopener">cognitive changes</a>, such as a loss of inhibitions, confused or abnormal thinking, and poor decision-making. Recreational alcohol users generally recover from its effects without any long-term problems. However, even short-term loss of control over normal mental functioning can result in legal and personal troubles that would likely not have occurred if alcohol were not involved. Alcohol consumption continues to maintain a foothold so strong in American culture that it is nearly impossible to imagine life without it.

[callout]
<h2>What Is Alcohol?</h2>
As the <a href="http://www.drugabuse.gov/drugs-abuse/alcohol" target="_blank" rel="noopener">National Institute on Drug Abuse</a> explains, the active ingredient in beer, wine, and liquor is ethyl alcohol, or ethanol, which is known colloquially as alcohol.
The process known as <a href="http://www.alcoholandyou.org.uk/facts/howisitmade.html" target="_blank" rel="noopener">fermentation</a> produces alcohol. When yeast is fermented, sugar breaks down into carbon dioxide and alcohol. Carbon dioxide exits the process through gas bubbles and leaves behind a combination of water and ethanol. The process is so precise that if any air is present in the yeast, the result will be ethanoic acid, a chemical found in common vinegar.

Alcohol is basically made from sugar and yeast, but different sources of sugar can produce different types of alcohol. For instance, the sugar from grape pulp is combined with yeast to create either red or white <a href="http://winefolly.com/review/how-wine-is-made-in-pictures/" target="_blank" rel="noopener">wine</a>. In the case of <a href="http://blog.beeriety.com/2009/07/06/how-beer-is-made/" target="_blank" rel="noopener">beer</a>, the source of the sugar is usually barley, but it can also be other grains, such as wheat or rye. To release the sugars, the grains must be malted, mashed, and boiled. Once the sugars are ready for use, yeast is added and the fermentation process begins. Different liquors are made different ways. When it comes to <a href="http://www.livescience.com/41298-what-is-vodka.html" target="_blank" rel="noopener">vodka</a>, for example, there is a popular belief that potato is usually the source of the sugar; however, the majority of vodka is made from fruit, barley, wheat, sorghum, or corn.

Alcohol products, such as wine, beer, and liquor, are made in commercial distilleries, but the process of making DIY alcohol (<a href="http://science.howstuffworks.com/innovation/edible-innovations/moonshine3.htm" target="_blank" rel="noopener">moonshine</a>) still relies on the basics discussed above. In some parts of the world, such as Scandinavian Europe and Russia, moonshine is a popular and low-cost alternative to commercial alcohol in some locales. Moonshine is known for its potency, which can be dangerous. Moonshine can be 150-proof, which translates into it being 75 percent alcohol. An added hazard is that it is not created in a regulated setting; therefore, there are fewer, if any, quality and safety guarantees. Although there is not a pressing public concern about rampant sales of moonshine, there are <a href="http://www.daytondailynews.com/news/news/local-education/13-year-old-builds-moonshine-still-for-class-teach/nkM5k/" target="_blank" rel="noopener">reports of Americans making DIY alcohol</a> and finding themselves in legal hot water as a result. For instance, a 51-year-old man was arrested in Ohio after selling moonshine out of his camper at a fair. The man's ostensible motive was to make a profit. The Ohio court ordered the moonshine maker to pay an $800 penalty and required him to complete 50 hours of community service.

Making moonshine may sound antiquated to modern ears, but it demonstrates the relative ease with which alcohol can be illegally made. Although some Americans still have Prohibition sympathies, the ability to home-produce alcohol serves as a reminder that it would likely be impossible to entirely remove alcohol from the American landscape.

[/callout]
<h2>Alcohol Consumption in the US</h2>
The <a href="http://www.samhsa.gov/data/sites/default/files/NSDUHresultsPDFWHTML2013/Web/NSDUHresults2013.pdf" target="_blank" rel="noopener">National Survey on Drug Use and Health</a> is a key source of information about the patterns of alcohol and other drug use in America. The 2013 survey made the following estimated findings with respect to alcohol consumption:
<ul>
 	<li>About 52.2 percent of Americans aged 12 or older were current alcohol users.</li>
 	<li>Approximately 6.3 percent of the population aged 12 or older (16.5 million) were heavy alcohol users.</li>
 	<li>In the past 30 days, 22.9 percent of the population aged 12 or older (60.1 million) reported binge drinking behavior.</li>
 	<li>About 10.9 percent of Americans aged 12 or older reported that they had driven a car under the influence at least once in the past year.</li>
 	<li>Approximately 8.7 million Americans under the legal drinking age (12-20 years of age) were current alcohol users. This statistic includes 5.4 million binge drinkers and 1.4 million heavy drinkers.</li>
</ul>
Alcohol is the most commonly abused drug in the US, with marijuana occupying second place. Despite the known dangers of excessive alcohol consumption, these statistics clearly reflect that many alcohol users engage in heavy use and binge drinking. Further, despite the well-known fact that alcohol impairs brain functioning, an estimated one in 10 Americans aged 12 or older operated a vehicle under the influence. This statistic demonstrates that only a fraction of those who drive under the influence are actually detected.

[quote]It is well established in the mental health field that alcohol consumption can exacerbate an underlying mental health disorder.[/quote]

In the field of substance abuse treatment, an individual who simultaneously has a substance use disorder and at least one other mental health disorder is considered to have a dual diagnosis. Whether alcohol causes or simply accompanies the underlying mental health disorder is not clearly understood. However, there is general consensus that <a href="/alcoholism-treatment/">individuals who abuse alcohol and have a mental health disorder diagnosis require treatment for both conditions.</a>

[callout]
<h2>Alcohol in the Brain</h2>
<img class="alignleft size-medium wp-image-22025" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/CNS-depressants-300x202.jpg" alt="Brain Model" width="300" height="202" />

While it is true that alcohol can initially perk people up and even help them to socialize at a party, alcohol is a central nervous system depressant. The depressant effects of alcohol are witnessed when people who have been drinking have slurred speech and poor limb coordination that prevents them from being able to walk properly. Although these outward signs of intoxication can be easily observed, it isn't as clear how alcohol acts on a deeper level inside the body. So, <a href="http://science.howstuffworks.com/life/inside-the-mind/human-brain/alcoholism4.htm" target="_blank" rel="noopener">how does alcohol act at the neurological level</a>?
Alcohol acts on the receptor sites for the neurotransmitters (chemical messengers) known as GABA, glutamate, and dopamine. Alcohol's activity on the GABA and glutamate sites results in the <a href="/alcoholism-treatment/physical-health/">physiological effects associated with drinking</a>, such as a slowing down of movement and speech. Alcohol's activity on the dopamine site in the brain's reward center produces the pleasurable feelings that motivate many people to drink in the first place.

As a <a href="https://www.psychologytoday.com/blog/you-illuminated/201006/your-brain-alcohol" target="_blank" rel="noopener">Psychology Today</a> article on this topic discusses, the degree to which alcohol impacts a person's mood, behavior, and neurological functioning depends in part on whether the blood alcohol content (BAC) is elevating or decreasing. With 1-2 drinks, the person may feel excited or more talkative, but with more and more alcohol in their system, they become more sedated and being to lose control of their movement and may experience impaired thinking and memory. The fluctuation in BAC helps to account for why the same person can go from being the life of the party to needing help with basics, like walking.
In addition, the following factors have been shown to influence how alcohol impacts a person's brain functioning over time:
<ul>
 	<li>The volume a person drinks</li>
 	<li>How often a person drinks</li>
 	<li>The age at which drinking began</li>
 	<li>The number of years a person has been drinking</li>
 	<li>The person's sex, age, and genetic factors</li>
 	<li>Whether the person's family has a history of alcoholism</li>
 	<li>Whether the person was exposed to alcohol as a fetus</li>
 	<li>The person's general health condition</li>
</ul>
When considering the negative consequences of alcohol, people often think of what can happen in public, such as getting into a car accident or an alcohol-induced altercation. However, people play a game of roulette with themselves when they drink, especially when they drink heavily, because the effects of alcohol on the brain are uncertain both in the short-term and long-term. If other drugs are added to the alcohol consumption, the risks become more serious.

[/callout]

[callout]
<h4>More about the Effects on the Brain or Body</h4>
<ul>
 	<li><a href="/alcoholism-treatment/body-effects">Alcohol on the Body</a></li>
 	<li><a href="/benzodiazepine/mental-physical-effects">Benzodiazepines</a></li>
 	<li><a href="/blog/crystal-meth-effect-body">Crystal Meth</a></li>
 	<li><a href="/ecstasy-abuse/mental-and-physical-effects/">Ecstasy</a></li>
 	<li><a href="/heroin-treatment/effects/">Heroin</a></li>
 	<li><a href="/cocaine-treatment/effects-on-the-brain/">Cocaine</a></li>
 	<li><a href="/meth-treatment/effects-on-the-brain-and-cns/">Meth</a></li>
 	<li><a href="/methadone-addiction/effects-on-the-brain-and-body/">Methadone</a></li>
 	<li><a href="/morphine-treatment/mental-and-physical-effects/">Morphine</a></li>
</ul>
[/callout]

<a name="Occasional Drinkers"></a>
<a name="Moderate Drinkers"></a>
<h2>Occasional Drinkers</h2>
In occasional drinkers, alcohol can produce one or more short-term effects after one or more drinks. Memory impairment can begin after a few drinks, and it can become increasingly worse as the consumption increases. A high volume of alcohol consumption, especially on an empty stomach, can result in a blackout. Occasional drinkers will usually recover from a blackout without any lasting mental problems. However, there are numerous dangers associated with acute alcohol intoxication, such as engaging in reckless activities like unprotected sex, vandalism, and driving. Further, an alcohol-involved incident, such as a car accident, can cause ongoing problems as court dates will need to be attended, fines must be paid, and educational or treatment requirements will have to be met.
<h2>Moderate Drinkers</h2>
As the <a href="http://www.cdc.gov/alcohol/faqs.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a> discusses, the <em>Dietary Guidelines for Americans</em> considers a moderate drinker to be a person who consumes one drink (applies to women) or two drinks (applies to men) per day. Despite extensive news coverage of medical reports that moderate drinking has positive health benefits, the guidelines advise that this is not a reason to start drinking. Moderate alcohol consumption has negative associations, such as increasing the risk of breast cancer and causing violence, falls, drownings, and car accidents. Moderate drinking does not insulate a person from the cognitive impairment associated with drinking and the dangerous consequences that can result.

<a name="Heavy and Chronic Drinking"></a>
<h2>Heavy and Chronic Drinking</h2>
<img class="alignright size-medium wp-image-32835" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/Black-and-white-image-of-a-you-60258002-300x200.jpg" alt="blind girl on drugs" width="300" height="200" />

Unlike an occasional or moderate drinker, <a href="http://pubs.niaaa.nih.gov/publications/aa63/aa63.htm" target="_blank" rel="noopener">a person who drinks heavily</a> over an extended period of time may develop deficits in brain functioning that continue even if sobriety is attained. In other words, cognitive problems no longer arise from drinking alcohol but from brain damage that prior drinking caused. In short, long-term alcohol abuse can negatively impact the brain's “hard wiring” such that even when drinking ends, the cognitive problems persist.

According to the <a href="http://pubs.niaaa.nih.gov/publications/aa53.htm" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a>, most heavy long-term alcohol users will experience a mild to moderate impairment of intellectual functioning as well as diminished brain size. The most common impairments relate to the ability to think abstractly as well as the ability to perceive and remember the location of objects in two- and three-dimensional space (visuospatial abilities).

In addition, there are numerous brain disorders associated with chronic alcohol abuse. For example, research supports that up to 80 percent of chronic alcohol users have a thiamine deficiency, and some in this group will progress to a serious brain disorder known as Wernicke-Korsakoff syndrome (WKS). Symptoms of WKS include confusion, paralysis of eye nerves, impaired muscle coordination, and <a href="/learning-disorders/">persistent problems with memory and learning ability</a>.

Fortunately, certain types of cognitive impairment can be reversed through abstinence from alcohol. Studies show that those who have recently undergone medical detox exhibit mild but significant improvement in certain cognitive abilities, especially those related to visuospatial tasks, problem-solving abilities, and short-term memory. Through ongoing abstinence, over a period of several months to one year, a recovering individual will continue to improve cognitive skills, such as visuospatial abilities, working memory, and attention span. In addition, research shows that brain volume can increase with abstinence.

Short and Long Term Mental Effects of Alcohol

[callout title="What Are Some Side Effects of Ambien?"]
Ambien (generic name: zolpidem tartrate) was designed to provide insomnia relief, without the side effects of barbiturate drugs. Ambien side effects include:
[columns count="3"]
<ul class="text-sm">
 	<li>Rapid heartbeat</li>
 	<li>Nausea</li>
 	<li>Vomiting</li>
 	<li>Diarrhea</li>
 	<li>Loss of appetite</li>
 	<li>Impaired vision</li>
 	<li>Slow breathing rates</li>
 	<li>Muscle cramps</li>
 	<li>Allergic reactions</li>
 	<li>Memory loss</li>
 	<li>Inability to concentrate</li>
 	<li>Disorientation</li>
 	<li>Emotional blunting</li>
 	<li>Depression and/or suicidal thoughts</li>
 	<li>Anxiety</li>
 	<li>Insomnia</li>
 	<li>Nightmares</li>
 	<li>Sedation</li>
 	<li>Confusion</li>
 	<li>Dizziness</li>
 	<li>Aggression</li>
 	<li>Addiction</li>
</ul>
[/columns]

[/callout]

<b>Finding a medication that provides satisfying sleep without serious side effects can be challenging.</b>

<img class="alignright size-full wp-image-33459" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/what-are-ambien-side-effects.jpg" alt="what-are-ambien-side-effects" width="350" height="300" />

Many widely used sleep medications, including benzodiazepines like Valium and barbiturates like Nembutal, can cause daytime drowsiness, over-sedation, and chemical dependency. In the 1990s, Ambien, or zolpidem tartrate, was designed to offer the benefits of other hypnotic drugs without some of the more severe side effects. Ambien has since become one of the most popular sleep medications, ranking at number 15 on the list of the most frequently prescribed drugs in the country, according to <a href="https://www.imshealth.com/deployedfiles/imshealth/Global/Content/StaticFile/Top_Line_Data/2010_Top_Products_by_RX.pdf" target="_blank" rel="noopener">IMS Health</a>.

At its introduction, Ambien was touted as a safe short-term sleep aid, lacking the risks of narcotic sedatives. But now that Ambien has been available to the public for over 20 years, the more serious side effects of this medication have come to light. Understanding these side effects can help consumers make informed decisions about using hypnotic drugs and may discourage nonmedical users from taking this drug recreationally.

[callout title="Physical Side Effects"]
When taken as directed, Ambien calms the activity of the brain and nerves, making it easier for the user to fall asleep. At the same time, Ambien can have serious side effects on the cardiovascular, respiratory, digestive, and sensory systems. Some of the potential reactions to Ambien include:

[columns count="2"]
<ul>
 	<li>Rapid or irregular heartbeat</li>
 	<li>Nausea and vomiting</li>
 	<li>Abdominal pain</li>
 	<li>Diarrhea</li>
 	<li>Appetite loss</li>
 	<li>Double vision</li>
 	<li>Pinpoint pupils</li>
 	<li>Respiratory depression</li>
 	<li>Muscle cramps</li>
 	<li>Skin rashes</li>
 	<li>Abnormal body movements</li>
</ul>
[/columns]

Some users have had a life-threatening allergic reaction to zolpidem.

[quote]Symptoms of an allergic response include hives, shortness of breath, and swelling of the face, lips, mouth, or tongue. An allergic reaction requires emergency medical treatment.[/quote]

[/callout]
<h2>Cognitive Impairment</h2>
<img class="alignright size-full wp-image-32477" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/boosting_brain.jpg" alt="cognitive impairment " width="220" height="150" />

Ambien is categorized as a non-benzodiazepine hypnotic medication. The chemical structure of this drug was designed to reproduce the effects of benzodiazepines on the central nervous system without the potential for abuse or addiction. Like benzodiazepines, Ambien acts on receptor cells in the brain that bind with GABA (gamma-aminobutyric acid), a brain chemical that influences sleep and other neurological activities. Some users have experienced negative cognitive or psychological side effects to Ambien, such as:
[columns count="2"]
<ul>
 	<li>Memory loss</li>
 	<li>Difficulty concentrating</li>
 	<li>Disorientation to place or time</li>
 	<li>Loss of emotional affect</li>
 	<li>Loss of pleasure in daily life</li>
 	<li>Depression</li>
 	<li>Suicidal thoughts or suicide attempts</li>
 	<li>Anxiety</li>
 	<li>Sleep disturbances</li>
 	<li>Nightmares</li>
</ul>
[/columns]

Although Ambien was originally intended to produce less drowsiness than other sleep medications, recent research has shown that at higher doses, the drug can remain active in the individual the morning after it is taken. The U.S. Food and Drug Administration (FDA) recently issued a warning about the possibility of “next-morning” impairment after taking Ambien. The FDA found that in some users, blood tests revealed that there was enough Ambien in the system to cause impairment at tasks that require mental alertness and coordination, such as driving. To reduce the risk of this side effect, the FDA recommends that prescribers limit the dose of the drug, especially for women.
Individuals who take Ambien for nonmedical reasons are at risk of experiencing an intensification of adverse side effects, including the following:

[columns count="2"]
<ul>
 	<li>Excessive sedation</li>
 	<li>Confusion and disorientation</li>
 	<li>Lack of motor coordination</li>
 	<li>Slow response times</li>
 	<li>Delayed reflex reactions</li>
 	<li>Dizziness</li>
 	<li>Hallucinations</li>
 	<li>Impaired judgment</li>
 	<li>Aggression</li>
</ul>
[/columns]

Although Ambien is classified as a sedative, this drug can give the user a rush of energy and euphoria when it is abused at high doses. However, misusing this drug can result in extreme drowsiness, confusion, and clumsiness, all of which increase the risk of falls, fractures, and other accidental injuries. The National Highway Traffic Safety Administration reports that users who take Ambien to the point of intoxication may experience sedation for up to 16 hours after taking the drug. Taking Ambien with other drugs that depress the central nervous system, such as alcohol, opioid pain medications, or tranquilizers, intensifies the sedative effects of Ambien and heightens the risk of overdose or injury.

Depression and suicidal thoughts have been observed in some individuals who have taken Ambien. The <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3878174/" target="_blank" rel="noopener">DARU Journal of Pharmaceutical Sciences</a></em> presents a case report of a young man who became depressed and attempted suicide after taking Ambien. He had no known history of mood disorders or past suicide attempts. The FDA cautions that individuals with a history of depression may experience a worsening of their depressive symptoms and an increase in suicidal thoughts after taking Ambien.
<h2>Sleepwalking and Other Activities</h2>
After taking Ambien before going to sleep, some individuals have experienced episodes of sleep walking and other unconscious behaviors. These activities include eating, driving, having sex, and holding conversations with other people. In these reported cases, the individuals were unaware of these activities while they were occurring.
Case studies published in the <em><a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/" target="_blank" rel="noopener">Journal of Clinical Sleep Medicine</a> </em>indicate that some patients have experienced a behavior called sleep eating disorder, or night eating disorder, after taking Ambien. These individuals woke to find evidence that they had consumed food during the night, but they had no memory of doing so. Other patients reported having complete conversations, leaving their homes to walk through the neighborhood, or even waking up behind the wheel with no memory of driving. One woman had alarms installed on the doors of her home to alert her family if she tried to leave the house while sleeping.

[quote]For some users, sleep behaviors can be corrected by reducing the dose of Ambien, but in extreme cases, the drug may have to be discontinued in order to prevent the behavior.[/quote]

[callout]
Although Ambien and other sedative-hypnotics are still widely prescribed as short-term treatments for insomnia, the <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2008/019908s027lbl.pdf" target="_blank" rel="noopener">Food and Drug Administration (FDA)</a> changed prescribing guidelines in 2012 to cut the recommended lowest dose in half.
[/callout]

<img class="alignright size-full wp-image-44388" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/ambien-blackout.jpg" alt="Ambien: Dangers of Blackouts" width="375" height="248" />

This is after numerous reports of users participating in dangerous activities, including driving, having sex, and eating, while they were reportedly asleep. These instances are sometimes called <a href="http://www.webmd.com/sleep-disorders/news/20060315/ambien-linked-to-sleep-eating#1" target="_blank" rel="noopener">Ambien blackouts</a>: The person performs activities after they have taken Ambien, although they do not remember them. The clinical term, however, is <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762721/" target="_blank" rel="noopener"><em>parasomnia</em></a> – an activity like walking, eating, talking on the phone, and others, which occurs after a person has gone to sleep.

There are certainly reports of sleepwalking, sleep-eating, and sleep-driving that do not involve Ambien and other prescription sleep aids, but the addition of Ambien appears to induce these behaviors in people who do not normally have them and may potentially make them worse in people who do have parasomnias.
<h2 style="text-align: center;">Sleep-Driving</h2>
Ambien can induce <a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3227709/" target="_blank" rel="noopener">complex behaviors</a> while asleep. The most famous of these is sleep-driving, which has led to legal problems for people who take Ambien, whether as prescribed or for recreational reasons. The FDA notes that use of alcohol and other drugs <a href="/health-complications-addiction/nervous-system/">that depress the central nervous system</a> (including prescribed opioid painkillers) increases the risk of parasomnias, especially more complex and dangerous ones like sleep-driving. The person will get out of bed, get into their car, and begin driving as normal, without being awake or fully awake; the person will not remember the incident and may only be aware of the incident if they are pulled over and arrested for intoxicated driving.

The National Highway Traffic Safety Administra<a href="https://one.nhtsa.gov/people/INJURY/research/job185drugs/zolpidem.htm" target="_blank" rel="noopener">tion (NHTSA)</a> reports that the first four or five hours after consuming Ambien involves cognitive and motor coordination impairment, whether the person is asleep or not.
<h2 style="text-align: center;">Sleep-Eating</h2>
[callout]

Sleep-eating is another dangerous activity that people may perform while experiencing an Ambien blackout. Without remembering, a person may get out of bed and eat; while this could be harmful for people who are trying to lose weight or who have a regulated diet for other health reasons, sleep-eating is also dangerous because the person may attempt to prepare food on the stove or in the oven, and hurt themselves or cause damage to their house.

[/callout]

A report in the <a href="http://wislawjournal.com/2006/04/26/ambien-users-wake-up-smell-the-lawsuits/" target="_blank" rel="noopener"><em>Wisconsin Law Journal</em> from 2006</a> notes that one woman sued the pharmaceutical company that manufactures Ambien because she ate dangerous items, including raw eggs and uncooked rice, on top of whole loaves of bread, numerous canned goods, and entire bags of chips and candy. She reportedly woke up vomiting from noxious combinations of food, developed an ulcer, and gained an unhealthy amount of weight very quickly.

[callout title="More on Drug Side Effects"]
<ul>
 	<li><a href="/adderall/side-effects">Adderall</a></li>
 	<li><a href="/ativan-treatment/side-effects">Ativan</a></li>
 	<li><a href="/barbiturate/side-effects">Barbiturates</a></li>
 	<li><a href="/benzodiazepine/mental-physical-effects">Benzodiazepines</a></li>
 	<li><a href="/fentanyl-treatment/side-effects/">Fentanyl</a></li>
 	<li><a href="/hydrocodone-treatment/side-effects/">Hydrocodone</a></li>
 	<li><a href="/klonopin-treatment/side-effects/">Klonopin</a></li>
 	<li><a href="/oxycodone/side-effects/">Oxycodone</a></li>
</ul>
[/callout]
<h2>Having Sex while Asleep</h2>
Having sex during an Ambien blackout may lead to contracting sexually transmitted infections (STI), including HIV and herpes. While people with partners or spouses are more likely to experience this parasomnia, it is possible that a person may take Ambien, sleepwalk, and initiate sexual contact with a stranger or acquaintance. If prophylactics are not used, then either person could contract an STI.

People who struggle with Ambien abuse and addiction may intentionally mix the drug with other intoxicating substances, such as alcohol, to enhance the euphoric effects. This means that they may experience more blackouts than other people, especially since alcohol can also cause blackouts or large patches of amnesia. During a blackout, people may accidentally harm themselves or others.
<h2 style="text-align: center;">Abuse, Addiction, and Withdrawal</h2>
Ambien was first developed to provide an effective alternative to other sleep medications, without the potential for abuse or addiction.

However, research has shown that Ambien can produce tolerance, dependency, and withdrawal — all signs of a potentially addictive drug. One of the most serious side effects of using Ambien is the possibility of becoming chemically dependent on the medication, or needing Ambien in order to feel comfortable and function normally.

If Ambien is taken according to a doctor's orders and used on a short-term basis, chemical dependency and addiction are unlikely to develop. <a href="/ambien-treatment/long-term/">Individuals at risk of addiction include those who take Ambien for longer than a few weeks</a>, those who take more than the recommended dose, and recreational users who abuse the drug for nonmedical reasons. Recreational users often take Ambien in unsafe ways, such as crushing the drug into a powder and mixing it with alcoholic beverages or snorting it. Taking Ambien this way significantly increases the risk of over-sedation, overdose, and addiction.

A case study published in the <em><a href="http://www.ncbi.nlm.nih.gov/pubmed/11154097" target="_blank" rel="noopener">Journal of Clinical Neuropharmacology</a></em> describes the experiences of a 43-year-old woman who experienced severe withdrawal symptoms after she stopped taking Ambien. The patient had misused the drug by taking it at excessively high doses. When the drug was discontinued too quickly, she experienced reactions similar to those associated with withdrawal from benzodiazepines, including seizures. This experience, and other studies that followed, indicate that the brain and body can become dependent on Ambien, and that a gradual dose reduction is required to prevent serious reactions after stopping the medication.

Additional withdrawal symptoms may include:

[columns count="2"]
<ul>
 	<li>Anxiety</li>
 	<li>Sleeplessness</li>
 	<li>Agitation</li>
 	<li>Dizziness</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Nausea</li>
 	<li>Muscle cramps</li>
</ul>
[/columns]

With prescription drug abuse and addiction becoming more common, drug rehab programs have been developed to treat these conditions safely. A detox program for Ambien includes a medically monitored drug taper, in which the dose of the drug is lowered in small increments to prevent extreme physical or neurological reactions. After the detox phase, the therapeutic services of rehab can address the thought patterns and behaviors that underlie addiction.

No matter what an individual's level of Ambien abuse may be, rehab offers a way to recover physical and psychological health.

[callout title="What Are the Side Effects of Other Drugs"]
[columns count="2"]
<ul>
 	<li><a href="/adderall/side-effects/">Adderall</a></li>
 	<li><a href="/ativan-treatment/side-effects/">Ativan</a></li>
 	<li><a href="/barbiturate/side-effects/">Barbiturates</a></li>
 	<li><a href="/cocaine-treatment/long-term-side-effects-of-abuse/">Cocaine</a></li>
 	<li><a href="/fentanyl-treatment/side-effects/">Fentanyl</a></li>
 	<li><a href="/hydrocodone-treatment/side-effects/">Hydrocodone</a></li>
 	<li><a href="/inhalant-abuse/side-effects/">Inhalant</a></li>
 	<li><a href="/ketamine-abuse/long-term-side-effects/">Ketamine</a></li>
 	<li><a href="/klonopin-treatment/side-effects/">Klonopin</a></li>
 	<li><a href="/kratom/side-effects/">Kratom</a></li>
 	<li><a href="/lunesta-treatment/side-effects/">Lunesta</a></li>
 	<li><a href="/meth-treatment/side-effects/">Meth</a></li>
 	<li><a href="/methadone-addiction/side-effects/">Methadone</a></li>
 	<li><a href="/oxycodone/side-effects/">Oxycodone</a></li>
 	<li><a href="/phenobarbital-abuse/long-term-side-effects/">Phenobarbital</a></li>
 	<li><a href="/psychedelics/side-effects-of-dmt/">DMT</a></li>
 	<li><a href="/suboxone/side-effects/">Suboxone</a></li>
 	<li><a href="/tramadol-abuse/side-effects/">Tramadol</a></li>
</ul>
[/columns]

[/callout]

Serious Ambien Side Effects: Memory, Depression, and More

[content-overview]
Physical signs of marijuana use include red eyes, poor muscle coordination, delayed reaction times, and increased appetite. A sudden shift in mood from tense to relaxed could indicate marijuana use, as could abrupt symptoms of anxiety, panic, and/or hallucinations. Marijuana also has a distinctive smell, sometimes described as skunk-like. Catching a whiff of this scent on a person's clothing or hair could also be a sign that the person has used the drug recently.[/content-overview]

At home, at work, or in other places where sobriety is the norm, individuals who are high on marijuana may sometimes go unnoticed.

Oftentimes, people who notice a change in someone may second-guess their initial perception. As part of this process of doubting, people may attribute the concerning behavior to fatigue, illness, or even just an off mood.

<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/HowToTellWhenSomeoneIsHigh.png"><img class="aligncenter size-full wp-image-56635" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/HowToTellWhenSomeoneIsHigh.png" alt="How to tell when someone is high on marijuana" width="700" height="2957" /></a>

As the concerning behavior persists, it becomes more difficult for concerned individuals to deny that there may be a problem. <a href="/marijuana-rehab/child-using/">In order to informally investigate if drug abuse is occurring</a>, it's important to have an understanding of both physical and psychological signs of abuse.
<h2>The Effects of Marijuana on the Brain</h2>
Most Americans have a general idea about the side effects associated with marijuana use, and these effects are the result of <a href="http://headsup.scholastic.com/students/the-science-of-marijuana" target="_blank" rel="noopener">how marijuana acts on the brain</a>. THC is the short-form term for delta-9-tetrahydrocannabinol, which is the psychoactive chemical in marijuana. Blood carries THC to the brain where it acts on cannabinoid receptors (the complexes that interact with the cannabinoid neurotransmitter). Cannabinoids naturally occur in the body.

The general effect of cannabinoids on cannabinoid receptor sites is to slow down communications between the cells in the body and the brain. The presence of THC has a similar effect, which is why marijuana is often associated with a relaxing and calming effect. THC also triggers the brain's reward system, which results in the pleasurable effects associated with marijuana.
<h2>Signs of Use</h2>
The <a href="http://www.drugfreeworld.org/drugfacts/marijuana/short-and-long-term-effects.html" target="_blank" rel="noopener">short-term effects of marijuana use</a> are also signs of recent use. As the Foundation for a Drug-Free World notes, the following are some common physical side effects associated with marijuana use:
<ul>
 	<li>Panic</li>
 	<li>Anxiety</li>
 	<li>Poor muscle and limb coordination</li>
 	<li>Delayed reaction times and abilities</li>
 	<li>An initial liveliness</li>
 	<li>Increased heart rate</li>
 	<li>Distorted senses</li>
 	<li>Red eyes</li>
</ul>
<h2>Methods to Use Marijuana</h2>
A marijuana high can generally last up to a few hours. In general, the duration of the high will depend on the user's level of tolerance, the particular potency of the marijuana, and the way the drug was consumed. The following are some of the most popular ways marijuana is used:
<ul>
 	<li>Smoking it (in a bong or rolling papers)</li>
 	<li>In food as "edibles"</li>
 	<li>In teas</li>
 	<li>In hash or wax form</li>
 	<li>In a vaporizer</li>
 	<li>In tonics and tinctures</li>
</ul>
The consumption of marijuana-based edibles can increase the likelihood of adverse reactions. The THC in edibles takes longer to be absorbed into the blood than when marijuana is smoked. As a result, the individual who consumes edible forms of marijuana may overeat to compensate for the lag time in the high, which can be dangerous
<h2>Hazards of Use</h2>
The hazards are not limited to edibles. A high level of THC in the body can lead to <a href="https://www.nlm.nih.gov/medlineplus/ency/article/000952.htm" target="_blank" rel="noopener">acute marijuana toxicity</a>.

[quote]In some cases, the toxicity may owe to the marijuana alone, but some drug dealers mix other drugs into marijuana (such as hallucinogens).[/quote]

The substances added to marijuana may result in serious effects, such as:
<ul>
 	<li>Chest pain and heart rhythm irregularity</li>
 	<li>Hyperactivity and/or aggressiveness</li>
 	<li>Cardiac arrest</li>
 	<li>Heart attack</li>
 	<li>Headache and high blood pressure</li>
 	<li>Stroke</li>
 	<li>Seizures</li>
</ul>
<h2>Increased Potency</h2>
Marijuana is not only a popular drug; it is an evolving one. The <a href="http://www.drugabuse.gov/publications/drugfacts/marijuana" target="_blank" rel="noopener">National Institute on Drug Abuse</a> warns that the potency of marijuana has been on the rise for the last few decades. The increased potency mainly stems from the ability of marijuana cultivators to continually create new, more powerful strains.

The increased THC may result in uncommon and easily observable side effects. As <a href="http://www.cnn.com/2013/08/09/health/weed-potency-levels/" target="_blank" rel="noopener"><em>CNN</em></a> reports, Dr. Stuart Gitlow of the American Society for Addiction Medicine has found that approximately one in every 100 people who uses highly potent marijuana will manifest psychotic symptoms. Further, as <a href="http://www.foxnews.com/health/2015/02/17/smoking-high-potency-marijuana-may-cause-psychiatric-disorders/" target="_blank" rel="noopener"><em>Fox News</em></a> reports, one study found that smoking marijuana with high THC content can lead to the onset of psychiatric disorders.

[media image="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/07/Marijuana-1.jpg" alt="Marijuana on table"][/media]

These observations about super potent marijuana translate into guidance for concerned individuals. Sudden or uncharacteristic psychotic symptoms (e.g., a disconnection from reality) can be evidence of marijuana use (although it may separately be a sign of a mental health disorder). Psychiatric side effects may be more acute in a person who has an existing mental health disorder, but individuals without a diagnosis are not immune from severe reactions. It is important to note that super potent marijuana is not the same as “synthetic marijuana” (chemicals sprayed onto leaves and sold under various  names, such as Spice). According to <a href="http://www.livescience.com/19140-synthetic-marijuana-unusual-side-effects.html" target="_blank" rel="noopener">reports on synthetic marijuana</a> side effects, some users have experienced extreme aggression, the inability to speak, hallucinations, and/or general unresponsiveness.

Marijuana use may lead to addiction and/or physical dependence, despite popular belief that it won't. Regular users may begin to build a tolerance and require more of it to achieve the effects. With increasing and continued use, they may become dependent and experience withdrawal if they stop. They may also eventually become addicted.

Although marijuana withdrawal is generally considered to be mild, effects can include irritability or anxiety. In heavy users, <a href="http://www.webmd.com/mental-health/addiction/news/20080507/withdrawal-symptoms-from-smoking-pot" target="_blank" rel="noopener">marijuana withdrawal symptoms</a> can include cravings for marijuana, trouble sleeping, irritability, anxiety, and boredom.

[quote]To avoid these symptoms, or to get a reprieve from them, some people who thought they were done with marijuana decide to resume use.[/quote]
<h2>Finding Marijuana and Related Paraphernalia</h2>
Whether a concerned person finds paraphernalia accidentally or after a search, the discovery can confirm suspicions or alert individuals that drug use is occurring. It is critical to note that searching for drug paraphernalia can be construed as an invasion of privacy, but on balance with the hazards associated with marijuana abuse, it may be considered justified. The question then arises as to where to look. Individuals who are hiding marijuana use from the people with whom they reside can be very inventive.

The following is a partial list of some marijuana-specific types of paraphernalia:
<ul>
 	<li>Rolling papers (usually white or brown)</li>
 	<li>Pipes (various materials, such as glass)</li>
 	<li>Cigar papers (contents emptied)</li>
 	<li>Bongs</li>
 	<li>E-cigarettes (to smoke concentrates)</li>
 	<li>Roach clips</li>
</ul>
The following are some places where persons who use marijuana or other drugs may <a href="http://www.paysonroundup.com/news/2011/apr/22/addicts-get-creative-when-hiding-their-stash/" target="_blank" rel="noopener">hide drugs or paraphernalia</a>:
<ul>
 	<li>In a carved-out space at the top of a door</li>
 	<li>In over-the-counter drug packages</li>
 	<li>In an unopened soda can</li>
 	<li>In hollowed-out cans</li>
 	<li>Under a fish tank</li>
 	<li>In the lining of a speaker</li>
 	<li>In a drop ceiling</li>
 	<li>In the false roof of a bird house</li>
 	<li>In a wall outlet</li>
 	<li>Between slats of assembled furniture</li>
</ul>
Once marijuana or paraphernalia is discovered, the next issue will be determining its age or when it was last used. Old marijuana may have mold on it, be brittle, break into a near powder-like consistency, and/or not have a fresh plant-like smell. In some cases, a person may fold marijuana into an envelope or piece of paper that may have a date.

A judgment of the age of paraphernalia can be difficult. A bong or pipe that is well used will be darkened from the burn residue of the marijuana. In cases where the marijuana use just occurred, the bong or pipe may be hot or warm. When marijuana smokers make a “blunt,”they will discard the tobacco contents, which may then be found in the garbage or bits may be discovered on the floor. Regarding marijuana edibles, light-colored baked goods like chocolate chip cookies may have a green hue. Edibles may have a noticeable odor, especially if they have high marijuana content.
<h2>Additional Signs</h2>
[media image="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/07/Driving-under-the-influence-of-marijuana.jpg" alt="Driving under the influence of marijuana"][/media]

Individuals who are concerned that someone they care about is abusing marijuana should be advised that this drug invites <a href="http://www.ccsa.ca/Resource%20Library/CCSA-Cannabis-use-Risky-behaviours-and-Harms-2014-en.pdf" target="_blank" rel="noopener">risky behavior</a>.

Uncharacteristically risky or reckless behavior may be a sign that marijuana use or other drug use is occurring. Some of the risky behaviors associated with marijuana include:
<ul>
 	<li>Driving under the influence of marijuana</li>
 	<li>Being a passenger while knowing the driver is "high"</li>
 	<li>Having unprotected sex</li>
 	<li>Conflicts, public fights, or relationship problems</li>
 	<li>Legal troubles such as a DUI arrest</li>
</ul>
[quote]When marijuana users continue to use this drug despite negative outcomes or acute problems, they may be in the grip of addiction.[/quote]

As marijuana is addictive, it has the potential to become a priority in a person's life. As marijuana use becomes a pressing priority, important obligations will likely begin to suffer. Often, concerned individuals will become especially motivated to help the marijuana abuser to get help after an incident, such as a DUI, or other clear indication of a problem. <a href="/marijuana-rehab/">It is never too soon to seek treatment.</a>

What Are the Signs That Someone Is High?

[callout title="What Are The Long-Term Effects of Heavy Adderall Use?"]

People who abuse a great deal of Adderall over a long period of time may experience:

[columns count="2"]
<ul>
 	<li>Sleep difficulties</li>
 	<li>Inability to concentrate</li>
 	<li>Lack of motivation</li>
 	<li>Depression</li>
 	<li>Irritability</li>
 	<li>Lethargy</li>
 	<li>Fatigue</li>
 	<li>Aggression</li>
 	<li>Thoughts of suicide</li>
 	<li>Mood swings</li>
 	<li>Paranoia</li>
 	<li>Hallucinations</li>
 	<li>Anxiety</li>
 	<li>Panic attacks</li>
 	<li>Heart disease</li>
 	<li>Weight loss</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Constipation</li>
</ul>
[/columns]

[/callout]

[quote]Close to 50 million prescription stimulant drugs like Adderall were dispensed in 2011 to treat symptoms of attention deficit hyperactivity disorder, or ADHD.[/quote]

<img class="alignright wp-image-28243" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/adderall-abuse.jpg" alt="adderall abuse" width="246" height="211" />

This represents an almost 40 percent rise in these prescriptions since 2007, the <a href="http://www.deadiversion.usdoj.gov/nflis/spec_rpt_adhd_2012.pdf" target="_blank" rel="noopener">Drug Enforcement Agency</a> (DEA) states.ADHD is one of the most common childhood neurobiological disorders. The <a href="http://www.cdc.gov/nchs/fastats/adhd.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a> (CDC) reported that as of July 2015, almost 10 percent, or close to 6 million, American children between the ages of 4 and 17 had been diagnosed with ADHD at some point in their lifetimes.

Adderall (amphetamine-dextroamphetamine) is intended to increase focus and attention spans in those suffering from ADHD. It is also prescribed to treat narcolepsy at times.

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<img class="alignleft wp-image-28255" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/adderall-abuse-rates-college.jpg" alt="adderall abuse rates college" width="335" height="287" />

As prescriptions for Adderall rise, so may its potential for diversion and nonmedical use, which increases its health risks too. Adderall is abused as a "smart drug" across college campuses. It may be abused by students to combat pressures of higher education, as students perceive it will help them get better grades because they can stay up and study for longer.

A study at the University of Kentucky found that 30 percent of its students had abused an ADHD stimulant drug like Adderall at some point as a possible "study enhancer," <a href="http://www.cnn.com/2011/09/01/health/drugs-adderall-concentration/" target="_blank" rel="noopener"><em>CNN</em></a> reports.

Adderall also suppresses the appetite and may also be abused as a weight loss drug. Other times it may be used in conjunction with other drugs or alcohol recreationally, or to get "high." Mixing Adderall with other substances can be very dangerous and may more easily result in a life-threatening overdose or negative interaction between the substances.

[quote]Stimulant drugs like Adderall are addictive and using them recreationally may increase the chances of developing a psychological and physical dependence on them.[/quote]

Adderall's side effects include: physical damage to the brain, internal systems, and organs.
<h2>How Extended Adderall Use Affects the Brain</h2>
Stimulants increase concentration and energy levels while decreasing the need for sleep and suppressing the appetite. Adderall increases the activity of several neurotransmitters, such as serotonin, norepinephrine, and especially dopamine. Over time, the changes in dopamine activity can impact our brain’s reward center, and alter our ability to experience pleasure without the chemical support of continued amphetamine use.. The more often Adderall is taken, the more ingrained these changes become. A tolerance to the drug may form, and more Adderall may be needed at each dose in order to feel the same desired effects.

As Adderall leaves the bloodstream, withdrawal symptoms and drug cravings may occur, indicating a physical and emotional dependence on the drug. The way in which Adderall is abused, along with the amount and duration of abuse can affect the dependence level to the drug. Crushing the pills and then injecting or snorting them, for example, sends the drug into the brain more rapidly than ingesting them whole and having them enter the bloodstream via the digestive tract. As a result, injecting or snorting the crushed pills increases the chances for a life-threatening overdose and the potential for addiction. Addiction is a disease that affects each person individually, and environmental and biological factors may also play a role in its onset.

Someone who is dependent on Adderall may have trouble sleeping and concentrating, notice a lack of motivation, and feel depressed, irritable, lethargic, or fatigued when it is removed from the body. Abusing amphetamines like Adderall may raise the risk of aggression and suicidal thoughts, according to <em><a href="https://abcnews.go.com/Health/MindMoodNews/adderall-psychosis-suicide-college-students-abuse-study-drug/story?id=12066619&amp;page=2" target="_blank" rel="noopener">ABC News</a></em>.For someone who has been abusing Adderall for an extended period of time, the emotional aspect of withdrawal may be the most noticeable side effect. Natural production of dopamine is reduced, causing low moods and trouble feeling pleasure without the drug.

[quote] The more and longer Adderall is abused, the more pronounced the mood swings may be when it is no longer available in the body. Most of these changes in the brain will likely be repaired over time with sustained abstinence and proper care and support, fortunately.[/quote]

In some cases, Adderall and other prescription stimulants have been reported to cause psychosis and schizophrenia-like symptoms, such as paranoid delusions, hallucinations, and other behavioral or mood disturbances, according to the journal <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2670101/" target="_blank" rel="noopener"><em>Molecular Psychiatry</em></a>. Anxiety and panic attacks may also be triggered by long-term use of an amphetamine stimulant or during Adderall withdrawal. The <a href="http://www.accessdata.fda.gov/drugsatfda_docs/label/2007/011522s040lbl.pdf" target="_blank" rel="noopener">U.S. Food and Drug Administration</a>, or FDA, even prints warnings on Adderall labels about potential negative psychiatric side effects. Symptoms may be heightened in someone with a history of mental illness or an underlying mental health disorder, such as bipolar disorder or schizophrenia.

[link-bank title="More on Long-Term Effects"]
<ul>
 	<li><a href="/health-complications-addiction/permanent-effects/">Permanent Effects of Drug Abuse</a></li>
 	<li><a href="/marijuana-rehab/long-term-effects/">Marijuana</a></li>
 	<li><a href="/methadone-addiction/side-effects/">Methadone </a></li>
 	<li><a href="/pcp-abuse/long-term-effects/">PCP</a></li>
 	<li><a href="/phenobarbital-abuse/long-term-side-effects/">Phenobarbital</a></li>
 	<li><a href="/valium-treatment/long-term/">Valium</a></li>
 	<li><a href="/vyvanse-abuse/risks-long-term-damage/">Vyvanse</a></li>
 	<li><a href="/xanax-treatment/long-term-severe/">Xanax</a></li>
</ul>
[/link-bank]
<h2>Physical Side Effects</h2>
<img class="alignright size-full wp-image-38976" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/side-effects-of-adderall-use.jpg" alt="Adderall side effects" width="375" height="300" />

Stimulants like Adderall raise body temperature, heart rate, and blood pressure, and repeated use or abuse, particularly in high doses, can create a range of medical issues from a stroke to a seizure to a heart attack.

Adderall can cause damage to the heart and cardiovascular system when used for a prolonged period of time, especially when used in excess. The most common ADHD medication cardiovascular problems reported are hypertension (high blood pressure) and tachycardia (irregular heart rate), as published by <a href="http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3489818/" target="_blank" rel="noopener"><em>Brain and Body</em></a>. Sudden cardiac death may also be a potential side effect of Adderall.

[callout title="Other side effects of abusing Adderall long-term include:"]
<ul>
 	<li>Heart disease</li>
 	<li>Dizziness</li>
 	<li>Abdominal pain</li>
 	<li>Weight loss</li>
 	<li>Insomnia</li>
 	<li>Dry mouth</li>
 	<li>Heart palpitations</li>
 	<li>Headaches</li>
 	<li>Tremors</li>
 	<li>Trouble breathing</li>
 	<li>Constipation</li>
 	<li>Hyperactivity</li>
 	<li>Feeling jittery or "on edge"</li>
</ul>
[/callout]

[quote]Using Adderall heavily for a long period of time increases all the risk factors and potential long-term side effects, which may get progressively worse.[/quote]

The heart muscle may be weakened with prolonged stimulant abuse, leading to more complications. Changes in the brain, as well as mood and behavior issues related to prolonged Adderall abuse, may also continue unless the drug is safely removed from the body.

Detox from Adderall is not sufficient treatment, however. It must be followed with a substance abuse treatment program to help prevent relapse and support long-term recovery.
<h3 class="text-center">Featured Content</h3>
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Long-Term Effects of Adderall Use

Drug and Alcohol Withdrawal Symptoms, Timelines, and Treatment

[content-overview]
Almost all American adults over the age of 18 have consumed alcohol at some point. The <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics" target="_blank" rel="noopener">National Institute on Alcohol Abuse and Alcoholism</a> (NIAAA) estimates close to 87 percent of the adult population has had at least one drink in their lifetime.
[/content-overview]

[callout position="right"]
<h2>Alcohol Withdrawal</h2>
Alcohol withdrawal can be broken down into three stages:
<ul>
 	<li>Stage 1: Anxiety, <a href="https://americanaddictioncenters.org/alcoholism-treatment/insomnia/" target="_blank" rel="noopener">insomnia</a>, nausea, and abdominal pain characterize this stage, which begins 8 hours after the last drink.</li>
 	<li>Stage 2: High blood pressure, increased body temperature, unusual heart rate, and confusion come with this stage, which begins 24-72 hours after the last drink.</li>
 	<li>Stage 3: Hallucinations, fever, seizures, and agitation come with this stage, which tends to begin 2-4 days after the last drink.</li>
</ul>
All symptoms tend to decrease within 5-7 days.
[/callout]

Unlike many other addictive substances, alcohol is legal to those over age 21 and readily available. Many people drink alcohol on a regular basis without any issues. In fact, <a href="http://www.mayoclinic.org/healthy-lifestyle/nutrition-and-healthy-eating/in-depth/alcohol/art-20044551" target="_blank" rel="noopener">Mayo Clinic</a> publishes that drinking in moderation (no more than one drink a day for a woman and two for a man) may even have some health benefits. Patterns of binge or heavy drinking, (drinking more than four drinks for a woman or five for a man in a span of two hours, or more than seven drinks a week for a woman and 14 per week for a man) can contribute to a problem with alcohol, according to <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/moderate-binge-drinking" target="_blank" rel="noopener">NIAAA</a>.

Stats on alcohol abuse and its effects include:
<ul>
 	<li>An estimated 16.6 million American adults in 2013 had an alcohol use disorder (AUD), according to the <a href="http://www.niaaa.nih.gov/alcohol-health/overview-alcohol-consumption/alcohol-facts-and-statistics" target="_blank" rel="noopener">NIAAA</a>.</li>
 	<li>One out of every three visits to the emergency room is related to the consumption of alcohol, per the <a href="http://www.ibtimes.com/1-out-3-er-visits-are-alcohol-related-heres-what-patients-drank-charts-1395699" target="_blank" rel="noopener"><em>International Business Times</em></a>.</li>
 	<li>Alcohol consumed in excess was responsible for one out of every 10 deaths in working age adults (ages 20-64) from 2006-2010, the <a href="http://www.cdc.gov/alcohol/fact-sheets/alcohol-use.htm" target="_blank" rel="noopener">Centers for Disease Control and Prevention</a>(CDC) publishes.</li>
 	<li>Alcohol is the third-leading preventable cause of death in America according to NIAAA, as 88,000 people each year die from an alcohol-related cause.</li>
</ul>
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&nbsp;

<img class="aligncenter size-full wp-image-30897" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/alcohol-withdrawal.png" alt="alcohol abuse withdrawal" width="700" height="400" />

As someone drinks, levels of dopamine are elevated in the brain, resulting in a flood of pleasant feelings. Alcohol can elevate mood, increase self-confidence, and lower inhibitions. As alcohol leaves the bloodstream, these feelings and dissipate.

[quote]Repetitive alteration of the dopamine levels in the brain can cause it to expect the presence of alcohol and therefore discontinue its production at previous levels without the substance.[/quote]

<img class="aligncenter size-full wp-image-27120" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/er_alcohol.jpg" alt="er and alcohol" width="400" height="365" />

The more a person drinks, the more tolerant to alcohol the body becomes and the more dependent the brain may be on its interference. When alcohol's effects wear off, someone who is dependent on it may suffer from withdrawal symptoms that can range from mild to life-threatening.

<iframe src="https://www.youtube.com/embed/mguKKuOfvhM" width="100%" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

[callout title="Alcohol Withdrawal Side Effects"]
Alcohol withdrawal is likely to start between six hours and a day after the last drink, as reported in <a href="http://www.aafp.org/afp/2013/1101/p589.html" target="_blank" rel="noopener"><em>American Family Physician</em></a>. Withdrawal can be broken down into three stages of severity:
<ul>
 	<li><em>Stage 1 (mild): </em>anxiety, insomnia, nausea, abdominal pain and/or vomiting, loss of appetite, fatigue, tremors, depression, foggy thinking, mood swings, and heart palpitations</li>
 	<li><em>Stage 2 (moderate): </em>increased blood pressure, body temperature and respiration, irregular heart rate, mental confusion, sweating, irritability, and heightened mood disturbances</li>
 	<li><em>Stage 3 (severe/delirium tremens): </em>hallucinations, fever, seizures, severe confusion, and agitation</li>
</ul>
[/callout]

Alcohol withdrawal is highly variable, and it is influenced by several factors, such as length of time drinking, the amount consumed each time, medical history, presence of a co-occurring mental health disorder, family history of addiction, childhood trauma, and stress levels. The use of other drugs in conjunction with alcohol can also influence withdrawal and increase the potential dangers and side effects. The more dependent on alcohol a person is, the more likely the person is to experience more severe withdrawal symptoms. Each person may not go through every stage of withdrawal, therefore.

[quote]The most serious form of alcohol withdrawal is delirium tremens (DTs), which occurs in 3-5 percent of individuals in alcohol withdrawal, according to the <a href="http://www.nejm.org/doi/full/10.1056/NEJMra1407298" target="_blank" rel="noopener"><em>New England Journal of Medicine</em></a> (NEJM), and it can be fatal without treatment.[/quote]

DTs may not start for a day or two after alcohol leaves the bloodstream, and it can occur without warning. It is primarily for this reason that alcohol withdrawal should be closely supervised by a medical professional who can continually monitor vital symptoms and ensure the individual's safety during detox. Stopping drinking “cold turkey”is never recommended without medical supervision. Alcohol withdrawal can be fatal, as the brain and central nervous system experience a rebound after being suppressed by alcohol repetitively for an extended period of time. Sudden removal of the central nervous system depressant can be life-threatening.

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<h2>Detox Timeline</h2>
There is no specific and concrete timeline for alcohol withdrawal; however, it is typically held that withdrawal will follow the following general timeline, as detailed by the <a href="https://www.nlm.nih.gov/medlineplus/ency/article/000764.htm" target="_blank" rel="noopener">National Library of Medicine</a> (NLM):
<ul>
 	<li><em>Roughly 8 hours after first drink:</em> The first stage withdrawal symptoms may begin.</li>
 	<li><em>After 24-72 hours</em>: Symptoms generally peak in this time period, and stage 2 and 3 symptoms can rapidly manifest.</li>
 	<li><em>5-7 days later</em>: Symptoms may start to taper off and decrease in intensity.</li>
 	<li><em>Beyond the first week:</em> Some side effects, particularly the psychological ones, may continue forseveral weekswithout treatment.</li>
</ul>
<img class="aligncenter size-full wp-image-27185" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/alcohol_detox_timeline.jpg" alt="alcohol detox timeline" width="730" height="193" />

During detox, the first step is usually to monitor and control the physical symptoms and reach a stable point. This is often accomplished via medical detox, which may use medications to treat symptoms like nausea, dehydration, seizures, and insomnia. Benzodiazepines are commonly used during alcohol detox to reduce some of the potential over-activity the central nervous system may undergo as it attempts to restore its natural order. Blood pressure, heart rate, respiration, and body temperature should all be closely monitored in a medical detox center, and steps can be taken to ensure that they remain at safe levels.

<img class="alignleft size-full wp-image-27180" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2015/10/healthy_diet.jpg" alt="healthy diet" width="301" height="333" />

At times, alcohol usage may be slowly reduced over a period of time through a detailed tapering schedule that should be set up and supervised by a medical professional. In this way, alcohol can be weaned out of the system in a controlled manner in order to avoid more dangerous withdrawal side effects. Someone dependent on alcohol may also suffer from malnutrition. Supplements and the implementation of a healthy diet and regular sleep schedule may improve withdrawal side effects and help the body heal faster.
<h2>Managing Symptoms in a Detox Center</h2>
After the physical symptoms have been controlled, mental health professionals can help reduce some of the more powerful emotional side effects of withdrawal.

Anxiety, depression, and potential suicidal ideation can be managed by medications coupled with therapy and counseling sessions. Preventing relapse is an important part of any alcohol detox center, and 12-step groups and individual therapy can offer continued support through detox and beyond. Alcohol detox centers use three medications, which are approved by the <a href="http://www.drugabuse.gov/publications/drugfacts/treatment-approaches-drug-addiction" target="_blank" rel="noopener"> U.S. Food and Drug Administration</a> (FDA), to help with alcohol-related cravings in the treatment of alcohol withdrawal and dependency: disulfiram, naltrexone, and acamprosate. These medications work to manage withdrawal symptoms and discourage individuals from drinking again. Naltrexone blocks opioid receptors in the brain, thereby reducing cravings and the potential rewards that may come from drinking, while acamprosate is believed to work on long-term withdrawal symptoms. Disulfiram can make people sick if they drink, thereby making drinking undesirable. A fourth medication, topiramate, also shows promise for the treatment of alcohol use disorders by also potentially interfering with the way alcohol "rewards" drinkers, as reported in the journal <a href="http://www.ascpjournal.org/content/8/1/12" target="_blank" rel="noopener"><em>Addiction Science and Clinical Practice</em></a>. Alcohol withdrawal should not be attempted without theprofessional help of a detox center, as symptoms can pop up and magnify very quickly. Even after the physical effects of alcohol withdrawal are under control, protracted withdrawal, or the continuation of emotional symptoms and cravings, can continue and may lead to relapse without the right level of support and treatment.

[quote]A medical detox program can provide the most comprehensive and supportive environment during all stages of alcohol withdrawal and detox.[/quote]
<p data-pm-slice="1 1 []">[/button-styled]</p>
<p data-pm-slice="1 1 []">[button-styled link="/insurance-coverage" width='auto']Outcomes Study[/button-styled]</p>

Alcohol Withdrawal Symptoms, Treatment, and Timeline

Clonazepam Withdrawal Symptoms, Length, and Treatment

[content-overview]
Opiate drugs, including prescription opioid painkillers and heroin, can produce withdrawal symptoms just hours after the last dose, and the symptoms can last for a week or more. Unassisted withdrawal may not be life-threatening, but it can lead to relapse. Medications and therapy, accessed in medical detox, may make relapse less likely.

Withdrawal symptoms include:
<ul>
 	<li>Nausea</li>
 	<li>Muscle cramping</li>
 	<li>Depression</li>
 	<li>Agitation</li>
 	<li>Anxiety</li>
 	<li>Opiate cravings</li>
</ul>
[/content-overview]

[quote]The <a href="http://www.drugabuse.gov/about-nida/legislative-activities/testimony-to-congress/2015/americas-addiction-to-opioids-heroin-prescription-drug-abuse" target="_blank" rel="noopener">National Institute on Drug Abuse</a> (NIDA) publishes that between 26.4 million and 36 million people around the globe abuse opiate drugs, which includes prescription pain relievers and the illegal drug heroin.[/quote]

<a href="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/OpiateWithdrawalTimeline.jpg"><img class="aligncenter size-full wp-image-56645" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/03/OpiateWithdrawalTimeline.jpg" alt="timeline, symptoms and treatment for opioid withdrawal" width="700" height="3159" /></a>

Opiates change the way the brain responds to pain stimuli and can also produce a "high" feeling by disrupting the reward and pleasure centers in the brain.

The central nervous system, which includes the brain, cardiovascular and respiratory systems,
has opioid receptors that receive opiate drugs, and these drugs bring a variety of physical and emotional effects. Heart
rate, respiration, blood pressure, and body temperature are lowered while pleasant feelings are increased.

[callout]
Repeated use or abuse of an opioid drug can actually change the way an individual's brain chemistry works and lead to physical and psychological dependence. The body may not feel "normal" anymore without the drug's interaction, and <a href="/withdrawal-timelines-treatments/oxycodone/">withdrawal symptoms may start in between doses or when an individual stops taking the opiate.</a>Each opiate drug has a unique half-life, which is the length of time it takes for half the amount of a drug to be eliminated from the body. As a result, withdrawal symptoms may start at different times, depending on the drug and method in which it is taken.Heroin is the fastest acting opioid; therefore, it also has the shortest half-life, according to the Drug Enforcement Administration (DEA). Its half-life may only be a matter of minutes to a few hours. Short-acting prescription opioid drugs, such as immediate-release oxycodone (OxyContin) and hydrocodone (Vicodin), have half-lives around 4-6 hours, the <a href="http://americanpainsociety.org/uploads/education/section_3.pdf" target="_blank" rel="noopener">American Pain Society</a> publishes. The <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/017116s029lbl.pdf" target="_blank" rel="noopener">U.S. Food and Drug Administration</a> (FDA) reports that the <a href="/methadone-addiction/how-long-in-system/">half-life of methadone may be much longer</a>, closer to an average of 30 hours.
[/callout]

Injecting, snorting, and smoking drugs may have a more immediate effect; however, they may also stop working sooner than drugs that are swallowed and digested through the stomach and digestive system. The start of withdrawal is highly dependent on the type and method of opioid drug abused.

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<h2>Signs of Opiate Withdrawal</h2>
Opiate withdrawal symptoms may range from mild to severe, depending on how dependent the individual is on an opioid drug. Dependency can be tied to the length of time taking a particular drug, dosage amount, which drug was taken, how the drug was taken, underlying medical conditions, the co-occurring presence of a mental health issue, and certain biological and environmental factors, such as family history of addiction, previous trauma, or highly stressful and unsupportive surroundings. Withdrawal from an opioid drug may roughly adhere to the following timeline, although it can vary from person to person.
<h3>Early Withdrawal Symptoms</h3>
These usually start within 6-12 hours for short-acting opiates, and they start within 30 hours for longer-acting ones:
<ul>
 	<li>Tearing up</li>
 	<li>Muscle aches</li>
 	<li>Agitation</li>
 	<li>Trouble falling and staying asleep</li>
 	<li>Excessive yawning</li>
 	<li>Anxiety</li>
 	<li>Nose running</li>
 	<li>Sweats</li>
 	<li>Racing heart</li>
 	<li>Hypertension</li>
 	<li>Fever</li>
</ul>
<h3>Late Withdrawal Symptoms</h3>
These peak within 72 hours and usually last a week or so:
<ul>
 	<li>Nausea and vomiting</li>
 	<li>Diarrhea</li>
 	<li>Goosebumps</li>
 	<li>Stomach cramps</li>
 	<li>Depression</li>
 	<li>Drug cravings</li>
</ul>
Some of the psychological withdrawal symptoms and cravings for opioid drugs may continue longer than a week in some cases. Therapy and psychological support provided by a mental health professional as a part of a complete substance abuse treatment program can decrease the symptoms and side effects of withdrawal.

[callout title="More on Withdrawal &amp; Timelines"]
<ul>
 	<li><a href="/dilaudid-abuse/how-long-is-withdrawal">Hydromorphone (Dilaudid)</a></li>
 	<li><a href="/heroin-treatment/withdrawal-symptoms">Heroin</a></li>
 	<li><a href="/methadone-addiction/as-short-term-detox">Methadone</a></li>
 	<li><a href="/morphine-treatment/timelines-symptoms">Morphine</a></li>
 	<li><a href="/opana-treatment/detox-timeline">Opana</a></li>
 	<li><a href="/suboxone/withdrawal">Suboxone</a></li>
 	<li>Codeine</li>
 	<li><a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/vicodin">Hydrocodone (Vicodin)</a></li>
 	<li><a href="https://americanaddictioncenters.org/demerol-abuse">Meperidine (Demerol)</a></li>
 	<li><a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/oxycodone">Oxycodone (Percocet or Oxycontin)</a></li>
</ul>
[/callout]
<h2>Detox Options</h2>
There are several treatment and detox options for the removal of opioids from the body, and some may provide a more comprehensive model than others. Medical detox, for instance, encompasses both pharmacological and psychological treatment methodologies while under close supervision of both medical and mental health specialists in a safe and comforting residential setting, while standard detox may be performed in an outpatient basis. Opiate withdrawal symptoms can be very uncomfortable, and medical detox may provide the safest and smoothest way to detox. Vital signs, such as blood pressure, respiration levels, body temperature, and heart rate, can all be closely monitored in a medical detox center that may utilize medications to regulate brain and body functions.Mental health professionals can also evaluate and stabilize individuals during medical detox. While there is no specific timeline for detox, as each individual will likely experience withdrawal from opiates differently, medical detox usually lasts 5-7 days.

[quote]Opioid drugs should not be stopped suddenly, without physical and emotional support and supervision, as the side effects of withdrawal may be powerful and even have dangerous complications.[/quote]

Medications, such as anticonvulsants, antidepressants, and other symptom-specific pharmaceuticals, may be useful during medical detox to control the more difficult withdrawal symptoms.

Medical professionals may help an individual wean off opioid drugs by slowly lowering, or tapering, the dosage during medical detox. This keeps the opioid receptors filled and prevents the onset of severe withdrawal symptoms. Drug cravings and withdrawal as a whole may be managed by replacing a short-acting opioid like heroin with a longer-acting one such as methadone. Buprenorphine is a partial opioid agonist often used during opioid detox and dependency treatment as well, as it remains active in the body for longer than most opioids and requires a lower dosage. Partial agonists also do not usually create the same "high" as full agonists do, therefore making them less likely to be abused. Buprenorphine even stops being effective after a certain point, further acting as an abuse deterrent.
<div style="text-align: center;"><iframe src="https://www.youtube.com/embed/kwUAAK-jPK0" width="560" height="315" frameborder="0" allowfullscreen="allowfullscreen"></iframe></div>
Naloxone and naltrexone are opioid antagonists that bind to opioid receptor sites along the central nervous system and "block" other opioids from filling them. This means that even if someone tries to take a drug like heroin while on an antagonist, the drug will not produce the desired effects and instead may cause a precipitated withdrawal syndrome to start. Precipitated withdrawal is the sudden and rapid onset of withdrawal symptoms, which can be intense and can serve to keep someone on an antagonist from attempting to abuse an opioid agonist at the same time.

Naloxone is added to buprenorphine as an inactive relapse-prevention agent in drugs like Suboxone and Zubsolv unless the drugs are altered and then abused via injection. Naltrexone products like Vivitrol are used more commonly to help prevent relapse after detox is completed and opioid drugs are fully removed from the brain and body. The intention of detox is to stabilize an individual dependent on opioids both emotionally and physically, and detox may use both pharmacological and psychological therapy methods to accomplish this.
<h2>Medical Detox as Part of a Whole Treatment Plan</h2>
Since addiction is a chronic and relapsing disease, with both physical and emotional side effects and symptoms, treatment needs to be comprehensive. Medical detox is relatively short and can provide the stepping stones for a more stable recovery. Relapse is common for individuals struggling with addiction as it may seem like a return to drug abuse may offer relief. After a period of not using drugs, tolerance to certain levels of drugs may be reduced, however, and relapse after detox can be especially dangerous as it may increase the risk for a fatal overdose.

Drug overdose is the leading cause of injury death in America. The <a href="http://www.asam.org/docs/default-source/advocacy/opioid-addiction-disease-facts-figures.pdf" target="_blank" rel="noopener">American Society of Addiction Medicine</a> (ASAM) estimates that 100 Americans die of a drug overdose every day, and 46 people in the United States die daily due to prescription opioid overdose. <a href="http://www.nytimes.com/2014/12/23/upshot/painkiller-abuse-a-cyclical-challenge.html?_r=0" target="_blank" rel="noopener"><em>The New York Times</em></a> reports that opioids are responsible for more deaths than any other medication or drug. Medical detox may help smooth out withdrawal, reducing side effects, preventing serious complications, and reducing drug cravings. This can provide a good start toward recovery and help to maintain sobriety long-term.

[quote]Detox followed with counseling, education, family and individual therapy, and support groups can help an individual stop using drugs and maintain sobriety.[/quote]
<h4>About Drug and Alcohol Detox</h4>
<ul>
 	<li><a href="/drug-detox/same-day-admittance">Same Day Admittance</a></li>
 	<li><a href="/drug-detox/cost">What Is the Cost?</a></li>
</ul>

Opiate Withdrawal Timelines, Symptoms and Treatment

[content-overview]
A tapering Xanax dose, supervised by a medical detox team, is a safer alternative to cold-turkey withdrawal.
[/content-overview]

Xanax withdrawal symptoms can take hold within hours of the last dose, and they can peak in severity within 1-4 days. During withdrawal, people can experience:
[columns count="2"]
<ul>
 	<li>Headaches</li>
 	<li>Blurred vision</li>
 	<li>Muscle pain</li>
 	<li>Tremors</li>
 	<li>Diarrhea</li>
 	<li>Numb fingers</li>
 	<li>Sensitivity to light and sound</li>
 	<li>Loss of appetite</li>
 	<li>Insomnia</li>
 	<li>Heart palpitations</li>
 	<li>Sweating</li>
 	<li>Anxiety</li>
 	<li>Panic</li>
 	<li>Paranoia</li>
 	<li>Seizures</li>
</ul>
[/columns]

<img class="aligncenter" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/05/what-is-xanax.jpg" />
Benzodiazepines are a class of prescription drugs with sedating properties that stem from their ability to increase the activity of the inhibitory neurotransmitter known as GABA.

One of the most popular of these medications is Xanax, or alprazolam in its generic form, as <a href="http://www.cbsnews.com/news/how-the-fda-is-sleeping-through-the-xanax-epidemic/" target="_blank" rel="noopener"><em>CBS News</em></a> reports that in 2011, it was the 11th most prescribed drug in the United States.Xanax is used in the management of panic and anxiety disorders. Xanax is commonly abused because, in addition to its sedative effects, its use is associated with increased dopamine release in the reward pathways of our brains. In 2011, the <a href="http://www.samhsa.gov/data/sites/default/files/DAWN2k11ED/DAWN2k11ED/DAWN2k11ED.pdf" target="_blank" rel="noopener">Drug Abuse Warning Network</a> (DAWN) reported that close to 10 percent of all emergency department visits related to the abuse of pharmaceuticals involved the benzodiazepine, or benzo, alprazolam.

Xanax is also considered to be very addictive. Even the <a href="http://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018276s044,021434s006lbl.pdf" target="_blank" rel="noopener">U.S. Food and Drug Administration</a> (FDA) prescribing information for Xanax indicates that taking the drug can lead to dependence, especially when taking high doses for longer than a month. GABA acts as a kind of natural sedative in the brain, slowing down certain functions and muting reactions to stress. Over time, Xanax may actually influence the production of GABA, and the brain may stop making it without the presence of the drug. The brain may then become dependent on Xanax, and when it leaves the bloodstream, withdrawal can start as the brain struggles to regain its natural sense of order and balance. Xanax withdrawal should not be attempted without medical assistance, as it can be dangerous and even potentially life-threatening.
<h2>Xanax Addiction</h2>
<iframe src="https://www.youtube.com/embed/x-7sNPF0pKo?rel=0&amp;controls=0&amp;showinfo=0" width="853" height="480" frameborder="0" allowfullscreen="allowfullscreen"></iframe>

&nbsp;

[button-color link='insurance-coverage']Learn more about insurance coverage and verify your insurance with AAC[/button-color]
<h2>Physical Withdrawal Symptoms</h2>
As a central nervous system depressant, Xanax serves to slow down heart rate, blood pressure, and temperature in the body in addition to minimizing anxiety, stress, and panic. Xanax may also help to reduce the risk of epileptic seizures. When the brain gets used to this drug, slowing all of these things down on a regular basis, if it is suddenly removed, these functions may rebound.
<img class="aligncenter" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/05/physical-withdrawal-symptoms-of-xanax.jpg" />

[callout title="Physical Withdrawal Symptoms of Xanax"]
Blood pressure, body temperature, respiration, and heart rate may go up rapidly, and seizures that can lead to coma and even death may occur. Some of the physical warning signs of Xanax withdrawal to watch for include:
[columns count="3"]
<ul>
 	<li>Headache</li>
 	<li>Blurred vision</li>
 	<li>Muscle aches</li>
 	<li>Tension in the jaw and/or teeth pain</li>
 	<li>Tremors</li>
 	<li>Nausea</li>
 	<li>Vomiting</li>
 	<li>Diarrhea</li>
 	<li>Numbness of fingers</li>
 	<li>Tingling in arms and legs</li>
 	<li>Sensitivity to light and sound</li>
 	<li>Alteration in sense of smell</li>
 	<li>Loss of appetite</li>
 	<li>Insomnia</li>
 	<li>Cramps</li>
 	<li>Heart palpitations</li>
 	<li>Hypertension</li>
 	<li>Sweating and/or fever</li>
 	<li>Delirium</li>
</ul>
[/columns]
[/callout]

Xanax should not be stopped suddenly, or "cold turkey," and vital signs like blood pressure, heart rate, and temperature need to be closely monitored during withdrawal. Grand mal seizures have been well documented, the <a href="http://www.ncbi.nlm.nih.gov/pubmed/21815323" target="_blank" rel="noopener"><em>Journal of the Oklahoma State Medical Association</em></a> publishes, as dangerous side effects of benzodiazepine withdrawal may be fatal without professional assistance during Xanax detox.

[link-bank title="More on Withdrawal &amp; Timelines"]
<ul>
 	<li><a href="/ativan-treatment/withdrawal-timeline">Ativan</a></li>
 	<li><a href="/benzodiazepine/length-of-withdrawal">Benzodiazepine</a></li>
 	<li><a href="/halcion-addiction/withdrawal">Halcion</a></li>
 	<li><a href="/valium-treatment/withdrawal-duration">Valium</a></li>
</ul>
[/link-bank]
<h2>Psychological Withdrawal Symptoms</h2>
Benzodiazepines such as Xanax act on the reward, mood regulation, and motivation regions of the brain, and when a dependency is formed, these parts of the brain will be affected as well. When an individual dependent on Xanax then attempts to stop taking the drug, the brain needs some time to return to previous levels of functioning. The emotional symptoms of benzodiazepine withdrawal can be powerful, as anxiety, panic, and paranoia may increase with the drug's removal from the body. Depression and thoughts of suicide should also be closely watched for during benzodiazepine withdrawal.Xanax withdrawal can leave people feeling generally "out of sorts," unable to control their emotions, irritable, and jumpy. Mood swings, nightmares, trouble concentrating, short-term memory loss, and hallucinations are also potential side effects of Xanax withdrawal. Support from mental health professionals can be very beneficial, and therapy and counseling may help an individual control and manage the emotional symptoms of benzo withdrawal.

<img class="aligncenter size-full wp-image-57249" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/05/psychological-withdrawal-symptoms.jpg" alt="Psychological Withdrawal Symptoms of Xanax" width="698" height="251" />
<h2>Xanax Withdrawal Timeline</h2>
Xanax is considered a short-acting benzodiazepine, with an average half-life of 11 hours, the <a href="https://www.accessdata.fda.gov/drugsatfda_docs/label/2011/018276s044,021434s006lbl.pdf" target="_blank" rel="noopener">FDA</a> states. As soon as the drug stops being active in the plasma of the blood, usually 6-12 hours after the last dose, withdrawal symptoms can start.

<img class="aligncenter" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/05/xanax-withdrawal-timeline-and-detox.jpg" />

For shorter-acting benzos like Xanax, acute withdrawal symptoms usually begin with 6-8 hours, peak around the second day, and resolve within 4-5 days. Protracted, or post-acute symptoms, may last for weeks or months. These lasting symptoms may lead to relapse if not addressed with continued treatment, such as regular therapy.

Some people may experience protracted withdrawal, however, which can include psychiatric symptoms and drug cravings.

Protracted withdrawal can last for several weeks, months, or even years without being addressed by a mental health professional.
<h2>Factors Affecting Withdrawal</h2>
Withdrawal is unique to each individual  and the withdrawal timeline may be affected by several different factors. The more dependent the body and brain are to Xanax, the longer and more intense withdrawal is likely to be. Regular dose, method of ingestion, mixture with other drugs or alcohol, age at first use, genetics, and length of time using or abusing Xanax can all contribute to how quickly a dependence is formed and how strong it may be.

High stress levels, family or prior history of addiction, mental health issues, underlying medical complications, and environmental factors can also make a difference in how long withdrawal may last for a particular individual and how many side effects are present. Xanax withdrawal can be made more comfortable and less dangerous with the help of medical and mental health professionals trained in treating substance abuse and dependency.
<h2>Safety of Xanax Detox Centers</h2>
[media image="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/07/doctor.jpg" alt="Doctor consulting people getting help"][/media]

Benzodiazepine withdrawal is best handled in a professional environment at a Xanax detox center. A detox center offers supervision, monitoring, and support in a safe and controlled environment. Medical and mental health professionals are available to offer the necessary treatment and support.

Withdrawal can be safely controlled and side effects reduced with a slow and controlled tapering schedule set up by a professional. By slowly lowering the amount of Xanax taken over a safe period of time, the more intense withdrawal symptoms may be largely avoided. At times, a longer-acting benzodiazepine, like Valium (diazepam), may be substituted for Xanax during detox. By keeping a small amount of a benzo in the bloodstream, drug cravings and withdrawal may be controlled for a period of time until the drug is weaned out of the system completely. Adjunct medications like antidepressants, beta-blockers, or other pharmaceuticals may be effective in treating specific symptoms of Xanax withdrawal.

Professionals tend to agree that the best and safest way to conduct benzodiazepine detoxification is through a combination of psychological support and gradual dose tapering, the journal <a href="http://www.benzo.org.uk/amisc/ashdiag.pdf" target="_blank" rel="noopener"><em>Current Opinions in Psychiatry</em></a> cites. Therapy sessions that include stress management techniques and relapse prevention tools may be important following the initial physical detox from Xanax. For example, Cognitive Behavioral Therapy, or CBT, helps individuals to find the connection between their thoughts and actions and work to make them more positive in nature.

An individual may notice a change in appetite and weight loss during Xanax withdrawal as well, making eating healthy and balanced meals during detox especially important.

<img class="aligncenter size-full wp-image-57252" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2019/05/Saftey-of-detox-centers-for-xanax-withdrawal.png" alt="Safety of Xanax Detox Centers" width="698" height="336" />

[quote]Xanax detox centers and substance abuse treatment programs may also include holistic methods, such as yoga, meditation, acupuncture, and massage therapy, to relieve stress and encourage healing.[/quote]

[callout title="About Drug and Alcohol Detox"]
<ul>
 	<li><a href="/drug-detox/same-day-admittance">Get into Detox Today</a></li>
 	<li><a href="/drug-detox/insurance">Help with Insurance</a></li>
 	<li><a href="/drug-detox/pregnant">Issues While Pregnant</a></li>
</ul>
[/callout]

Xanax Withdrawals Duration, Dangers, and Treatment

<strong>Kratom is a botanical substance coming from the plant <i>Mitragyna speciosa</i> native to places like Thailand and other regions of Southeast Asia.</strong>

Kratom abuse has been around for thousands of years, as indigenous people like laborers and farmers in Thailand and Malaysia reportedly chewed the leaves of the plant or brewed them in tea in order to combat fatigue, increase energy levels and productivity, and relieve pain or strained muscles, the <a href="http://www.deadiversion.usdoj.gov/drug_chem_info/kratom.pdf" target="_blank" rel="noopener">DEA</a> publishes.

Kratom can, in effect, make someone "high" when abused. In Thailand, it is considered a controlled substance and the third most commonly abused illegal drug, <a href="http://usnews.nbcnews.com/_news/2012/03/19/10760892-asian-leaf-kratom-making-presence-felt-in-us-emergency-rooms" target="_blank" rel="noopener">NBC News</a> reports. In the United States, kratom is listed as a "drug of concern" by the <a href="http://www.dea.gov/pr/multimedia-library/publications/drug_of_abuse.pdf" target="_blank" rel="noopener">Drug Enforcement Administration</a> (DEA), although the drug is not controlled or considered illegal in most states.

Kratom may be mixed with a caffeinated beverage, or codeine-containing cough syrup to create the drink called <em>4×100</em>. Often consumed by young Muslims in southern Thailand, this drink is said to have effects similar to alcohol intoxication, the <a href="http://www.emcdda.europa.eu/publications/drug-profiles/kratom" target="_blank" rel="noopener">European Monitoring Centre for Drugs and Drug Addiction</a> (EMCDDA) reports. In the United States, kratom may be marketed as a dietary or nutritional supplement, or sold under the radar in tobacco or head shops, most commonly in a powder or tablet form. Kratom is known to have a variety of reported uses and desired effects, from sexual enhancement to pain relief to a "safe" and legal "high." In North Carolina, New York, Colorado, and possibly more states, kratom may be sold as a drink called <i>ketum</i> in bars, <a href="http://www.nytimes.com/2016/01/03/us/kratom-an-addicts-alternative-is-found-to-be-addictive-itself.html?_r=0" target="_blank" rel="noopener"><i>The New York Times</i></a> states.

[quote]Kratom may also be abused by those battling heroin or opioid addiction as a method of combating opioid withdrawal even though kratom carries a potential risk for dependence and addiction in and of itself.[/quote]

<a href="https://americanaddictioncenters.org/neurontin-abuse/">Individuals seem to be regularly seeking a new method to get high.</a> The uptick in kratom abuse and adverse reactions to the substance may have caused the <a href="http://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm480344.htm" target="_blank" rel="noopener">U.S. Food and Drug Administration</a> (FDA) to ban its import in 2014.

<a name="Kratom"></a>
<div class="panel-block bg-dkblue pad-all text-white">
<h2>Kratom High by Dosage Amount</h2>
The <a href="http://www.nursingshow.com/2015/10/20/kratom-update-from-lisa-booze-and-maryland-poison-center/" target="_blank" rel="noopener">Nursing Show</a> publishes that kratom likely takes effect within 5-15 minutes and <a href="/kratom/how-long-last/">remains effective for 2-5 hours after taking it</a>. In low doses, kratom is considered to be a stimulant drug that increases sociability and alertness. In higher doses, kratom may have effects similar to those of opioid drugs. These effects include:
<ul class="bullet">
 	<li>Reduced anxiety</li>
 	<li>Sedation</li>
 	<li>Lowered pain sensations</li>
 	<li>Relaxation</li>
 	<li>Pinpoint pupils</li>
</ul>
Additionally, kratom may produce a "high," or rush of euphoria that is akin to the effects of opioid abuse. The <a href="http://www.oasas.ny.gov/AdMed/FYI/kratomfyi.cfm" target="_blank" rel="noopener">New York State Office of Alcoholism and Substance Abuse Services</a> (NY OASIS) compares the interaction of kratom with opiate receptors in the brain to how morphine interacts with the brain. Opioid drugs bind to opioid receptors, which then creates a flood of some of the brain's neurotransmitters, or chemical messengers, that help to regulate mood and influence the decision-making process. When the level of these neurotransmitters is increased in the brain, it makes a person feel good, thereby elevating mood. <a href="https://americanaddictioncenters.org/codeine-addiction/">Opioid abuse causes a high that leaves a person feeling euphoric, mellow, and less sensitive to pain.</a>

Kratom abuse may have similar effects. In some cases, kratom exposure has resulted in psychosis. Symptoms of kratom-induced psychosis may include hallucinations, confusion, and delusion, the DEA reports.

</div>

Does Kratom Get You High?

<h2>What is Alcohol Poisoning?</h2>
Many people consume alcohol every day, although a surprising number of individuals in the US consume too much. According to the Centers for Disease Control, there are approximately 2,200 alcohol poisoning deaths per year, which is around six per day. Because not many people understand the limits of alcohol tolerance in the body, alcohol poisoning can occur rapidly, without much warning.

Alcohol poisoning occurs when a person consumes too much alcohol, which floods the bloodstream and begins to affect areas of the brain that control vital physical functions like breathing, heart rate, and temperature. Depressed or uneven breathing, cool body temperature, and seizures are all potential symptoms of alcohol poisoning.

While alcohol poisoning can occur if a person accidentally consumes ethanol through a household product or other form, for the most part, alcohol poisoning happens when a person drinks too many alcoholic beverages in too short a time. The liver can process one serving of alcohol per hour, with one serving being:
<ul>
 	<li>12 ounces of beer</li>
 	<li>5 ounces of wine</li>
 	<li>8 ounces of malt liquor</li>
 	<li>1.5 ounces of distilled spirits, like whiskey, tequila, gin, rum, or vodka</li>
</ul>
<img class="alignright size-medium wp-image-32728" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/04/Yound-beautiful-woman-in-depre-82877243-300x200.jpg" alt="Yound-beautiful-woman-in-depre-82877243" width="300" height="200" />

<a href="/alcoholism-treatment/binge-drinking">Binge drinking is a major cause of alcohol poisoning</a> and related death in the US. The definition of binge drinking is four or more drinks in a two-hour period for women, and five or more drinks in the same time period for men. Although binge drinking is primarily associated with college students, the CDC found that the demographic group who suffered from alcohol poisoning most often was middle-aged adults. People between the ages of 35 and 64 suffered from alcohol poisoning more often than young adults. This could be in part due to changes in body chemistry as people age, the number of prescription medications that could interact with alcohol, and also changes in drug preferences in the two demographics. White, middle-aged men were the most likely to die from alcohol poisoning, compared to other groups.

Statistically, 90 percent of binge drinkers who experienced alcohol poisoning were not dependent on alcohol.
<h2>The Effects of Alcohol Poisoning on the Body</h2>
Because the liver can only process one serving of alcohol per hour, if a person drinks two servings, there will be an extra unit in the person’s system, which takes extra time to process. Alcohol is typically consumed in liquid form as a drink, so it enters the bloodstream and goes to the brain via digestion in the stomach and intestines. This is one of the slower processes for consuming an intoxicating substance, which means that the number of drinks a person has consumed may not be completely in the bloodstream when the person begins to show symptoms of extreme alcohol intoxication or poisoning. <a href="/alcoholism-treatment/physical-health">The person could still be affected by continued digestion of alcohol</a>, even if they are already suffering from alcohol poisoning.

Alcohol poisoning affects the body by:
<ul>
 	<li>Slowing brain functions, starting with balance and coordination, but eventually affecting other body systems</li>
 	<li>Irritating the stomach and causing vomiting</li>
 	<li>Stopping gag reflex as muscles lose sensitivity and coordination, which can lead the individual to choke on their own vomit</li>
 	<li>Affecting the nerves that control heartbeat and breathing, which can cause these functions to slow down, become irregular, or stop altogether</li>
 	<li>Drastically lowering blood sugar, leading to seizures</li>
 	<li>Lowering body temperature, which can cause hypothermia</li>
 	<li>Dehydrating the body, which can lead to brain damage</li>
</ul>
[callout]
<h2>Alcohol Poisoning Symptoms</h2>
Symptoms of alcohol poisoning include:
[columns count="2"]
<ul>
 	<li>Confusion or disorientation</li>
 	<li>Vomiting</li>
 	<li>Hypothermia</li>
 	<li>Inability to stay conscious</li>
 	<li>Cold or clammy skin</li>
 	<li>Lack of physical coordination, including an inability to walk</li>
 	<li>Irregular pulse</li>
 	<li>Depressed breathing</li>
 	<li>Seizure</li>
 	<li>Choking</li>
 	<li>Loss of bowel or bladder control</li>
 	<li>Blue-tinged skin, especially around the lips or under the fingernails</li>
</ul>
[/columns]
[/callout]
<h2>How to Help Someone Suffering from Alcohol Poisoning</h2>
In the event a person suffers from alcohol poisoning, immediately call 911. Stay with the individual to prevent accidental self-harm or to prevent the person from choking on their own vomit if unconscious. It is vitally important to get emergency medical help as soon as possible, even if the person is conscious and speaking, because there is likely more alcohol in the person’s stomach that will be processed, and this could increase the degree of alcohol poisoning.

After calling 911 for emergency medical help, there are other steps to take to help a person who is experiencing alcohol poisoning. These include:
<ul>
 	<li>Keep the person awake if possible.</li>
 	<li>Keep the person informed. Let the person know if you are going to touch them or perform any action on them, as some individuals may become aggressive.</li>
 	<li>Keep the person sitting.</li>
 	<li>If the person is conscious and able to swallow, try to get them to slowly drink water.</li>
 	<li>If the person is unconscious and lying down, carefully roll them onto their side with their arms over their head so they will not choke on their own vomit.</li>
 	<li>Get a warm blanket for the person, as alcohol poisoning will likely make them feel cold.</li>
</ul>
<h2>Things NOT To Do for Someone Experiencing Alcohol Poisoning</h2>
Urban myths suggest that food, coffee, sudden shocks, or medication can help a person sober up faster. However, when a person is suffering from alcohol poisoning, the only way to help is to get emergency medical attention as quickly as possible.
[callout-complex]

<strong>If you suspect alcohol poisoning, call 911 and take some of the above steps. Do not perform any of the following: </strong>
<ul>
 	<li>Do not give the person coffee, because caffeine can cause further dehydration.</li>
 	<li>Do not attempt to feed the person, because they may choke on the food due to a lack of gag reflex or ability to swallow.</li>
 	<li>Do not give the person any other medications, because mixing drugs and alcohol will likely make the alcohol poisoning worse.</li>
 	<li>Do not make the person throw up to get alcohol out of the stomach, because their gag reflex will likely not work and they could choke.</li>
 	<li>Do not walk the person around, in an attempt to “walk it off,” because their reduced physical coordination could lead to falls or other accidental harm.</li>
 	<li>Do not put the person in a cold shower, because that could increase hypothermia.</li>
 	<li>Do not let the person “sleep it off,” because alcohol is likely still digesting into their bloodstream and their symptoms could get much worse.</li>
 	<li>Do not leave the person alone.</li>
 	<li>Do not allow the person to drink more alcohol.</li>
</ul>
[/callout-complex]
Once the individual is at the hospital, they will receive medical treatment and remain monitored until doctors know the alcohol has been processed out of their system and there is no remaining damage that should be treated.

[callout-complex]

<strong>Professional medical treatment for alcohol poisoning may include: </strong>
<ul>
 	<li>Monitoring by doctors and nurses</li>
 	<li>Intubating or other methods to prevent choking and allow breathing</li>
 	<li>Oxygen therapy</li>
 	<li>Intravenous fluids to rehydrate the person</li>
 	<li>Vitamins and glucose to raise blood sugar and prevent seizures</li>
 	<li>Stomach pumping to remove alcohol remaining in the stomach</li>
 	<li>Hemodialysis, especially for people who accidentally consume ethanol from household products or other means, to filter toxins and waste from the blood directly</li>
</ul>
[/callout-complex]
<h2>Avoid Alcohol Poisoning</h2>
There are steps everyone can take to prevent alcohol poisoning. These steps include:
<ul>
 	<li>Drink in moderation, or stick to one drink per hour.</li>
 	<li>Drink water after every one or two drinks.</li>
 	<li>Do not drink on an empty stomach.</li>
 	<li><a href="/most-harmful-drinking-games/"> Avoid drinking games or situations where there is pressure to drink too much.</a></li>
 	<li>Do not mix alcohol with other substances, including prescription medications.</li>
</ul>
[callout]
<h2>Get Help after Alcohol Poisoning</h2>
If a person experiences alcohol poisoning, it does not necessarily mean an alcohol use disorder, or alcoholism, is present, though <a href="/alcoholism-treatment/stages">people struggling with alcohol use disorder do have an increased risk of experiencing alcohol poisoning</a>. Rehabilitation programs can help those in need to fully recover from alcohol abuse. Medical detox is always needed in cases of alcohol withdrawal since withdrawal symptoms can be life-threatening in some instances. Comprehensive therapy should follow medical detox, ensuring the issues behind the substance abuse are fully addressed.
[/callout]

Alcohol Poisoning Symptoms - How Do You Know

Medical professionals often research and warn against the dangers of polydrug use, or the ingestion of more than one type of drug. While polydrug use often centers on substances like alcohol, heroin, cocaine, or marijuana, there is a growing trend of mixing prescription medications for recreational purposes. Some users may attempt to mix opioid painkillers (e.g., Vicodin or oxycodone) and benzodiazepines (e.g., Xanax or Valium) in an effort to enhance the painkilling or euphoric effects of opiates. This combination has drawn a great deal of attention due to its potential consequences.
<h2>Opiates</h2>
Opioid prescription painkillers are a class of medications that bind with opioid receptors in the brain to stop a person from feeling serious pain. These drugs are typically derived from the opium poppy and reduce pain messages from parts of the body to the brain. These are typically prescribed after surgery, such as wisdom tooth removal, or to treat chronic pain from arthritis or cancer.

Two of the most common opioid painkillers are Vicodin, which is a combination of hydrocodone and acetaminophen, and oxycodone, which is found in prescription medications like <a href="https://americanaddictioncenters.org/percocet-treatment/how-long-in-system/">Percocet</a> and OxyContin. Both drugs are prescribed to treat moderate to severe pain, which over-the-counter painkillers like ibuprofen cannot help.
<h2>Benzos</h2>
<a href="https://americanaddictioncenters.org/benzodiazepine/">Benzodiazepines are a family of medications that are prescribed to treat anxiety</a>, alcohol withdrawal, muscle spasms, and seizures. They induce relaxation in the central nervous system and allow muscles to relax. Two of the most commonly prescribed benzodiazepines are Xanax (alprazolam) and Valium (diazepam). Both are prescribed to treat anxiety and panic disorders, and <a href="https://americanaddictioncenters.org/valium-treatment/">Valium is sometimes prescribed to treat seizures and alcohol withdrawal symptoms</a>.
<h2>Abuse of Opiates and Benzos</h2>
<img class="alignright size-medium wp-image-30651" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2016/03/white-pills-43854715-300x200.jpg" alt="white pills" width="300" height="200" />Opioid painkillers and benzodiazepines are two of the most frequently abused prescription drugs in the world, although they are frequently prescribed together. Medical researchers have been concerned about this combination since the 1970s, when the trend began to surface. A report from the Drug Abuse Warning Network shows that combining opioid medications and benzodiazepines increases the risk of overdose leading to emergency medical care. Another report published in the British Medical Journal suggests that, while some of these emergency room visits involve prescribing practices that accidentally mix benzodiazepines and opioids in dangerous quantities, some patients take more of these drugs than prescribed, or they get a “high” off taking higher doses than prescribed of both medications. They noted that benzodiazepines enhanced the effects of opioid painkillers, which means this drug combination has a high potential for abuse.

The BMJ study found that, of 2,400 veterans in the study’s population who died because of a drug overdose while taking opioid painkiller prescriptions, 49 percent had been concurrently prescribed benzodiazepines. While some of these individuals may have been abusing opioid painkillers and benzodiazepines to create a high, an article published in the Washington Post suggests that people who abuse these two medications together must be exposed to this combination in the first place, and that is typically through their doctors’ prescribing practices. People who suffer acute or chronic pain, for example, may receive opioids like Vicodin to treat the pain on a long-term basis, while also receiving a prescription for Valium to treat muscle spasms. Or, if individuals suffer from anxiety, they may receive a Xanax prescription from their therapist, while also receiving oxycodone to treat chronic pain.

In February 2016, lawmakers and regulators began pushing the Food and Drug Administration to issue a black box warning on both prescription opioid painkillers and benzodiazepines about mixing these two medication types.
<h2>Why Is It Dangerous to Combine Valium or Xanax and Oxycodone or Vicodin?</h2>
Both opioid medications, such as <a href="https://americanaddictioncenters.org/withdrawal-timelines-treatments/oxycodone/">oxycodone</a> and Vicodin, and benzodiazepines, like Xanax and Valium, have a high potential for addiction and abuse when they are taken alone. Both of these types of medications are high on the list of drugs that lead to overdose and prescription drug deaths.

According to the American Society of Addiction Medicine, in 2014, there were 18,893 prescription painkiller-related overdose deaths in the US. Between 1999 and 2006, there was a 250 percent increase in fatal overdoses in the United States due to opioid painkillers; more than half of those overdoses were due to a combination of opioid painkillers and another medication, most typically benzodiazepines. For people hospitalized due to a benzodiazepine overdose between 1998 and 2008, 95 percent of the time, benzodiazepines were combined with another drug; in 54.2 percent of those cases, opiate drugs (heroin or prescription painkillers) were the other drug in the combination.

This combination appears to be especially dangerous because benzodiazepines enhance the “high” from opioid painkillers. When people become addicted to opioid painkillers like Vicodin or oxycodone, they can develop a tolerance over time so they do not experience the same effect; however, when these individuals add benzodiazepines to the mix, they can return to the same euphoric feeling they had the first time they abused opioids.

[callout]
The Centers for Disease Control noted that, in about half of overdose deaths caused by opioid drugs, including Vicodin and oxycodone, another type of drug acted as a contributing factor. Benzodiazepines like Valium and Xanax were found most frequently, in about 17 percent of the cases, to contribute. This deadly combination leads to two primary problems:
[columns count="2"]
<ul>
 	<li>Depressed breathing</li>
 	<li>Enhanced sedation</li>
</ul>
[/columns]
Death may result if emergency medical assistance does not come in time.
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[callout title="Dangers of Mixing Drugs"]
<ul>
 	<li><a href="/benzodiazepine/mixing">Suboxone and Benzodiazepines</a></li>
 	<li><a href="/methadone-addiction/and-mixing-heroin">Methadone and Heroin</a></li>
 	<li><a href="/suboxone/combined-with-adderall">Suboxone and Adderall</a></li>
 	<li><a href="/valium-treatment/dangers">Valium and Drugs or Alcohol</a></li>
 	<li><a href="/steroid-abuse/mixing-with-cocaine">Steroids and Cocaine</a></li>
 	<li><a href="/xanax-treatment/dangers-of-mixing-with-klonopin">Klonopin and Xanax</a></li>
 	<li><a href="/polysubstance-abuse">Polysubstance Abuse</a></li>
</ul>
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<h2>What Happens When Opioid Painkillers and Benzodiazepines Are Mixed</h2>
It is possible to overdose on either opioid painkillers, like Vicodin or oxycodone, or benzodiazepines, like Xanax and Valium, alone.
[callout]
[columns count="2"]

<strong>Symptoms of an opioid overdose can include: </strong>
<ul>
 	<li>Pinpoint pupils</li>
 	<li>Unconsciousness</li>
 	<li>Slowed, irregular, depressed, or stopped breathing</li>
</ul>

<strong>Symptoms of benzodiazepine overdose include: </strong>
<ul>
 	<li>Confusion</li>
 	<li>Slow or shallow breathing</li>
 	<li>Unresponsiveness, either awake or unconscious</li>
</ul>
[/columns]
[/callout]

One of the two biggest problems with mixing opioid painkillers like Vicodin or oxycodone with benzodiazepines like Xanax or Valium is the issue of oversedation. This is the inability to wake up or respond to stimuli, which can put individuals at risk of falling, if they are standing up, or causing a serious car accident, if they are driving. People could also slip into a coma.

Additionally, both opioid painkillers and benzodiazepines can change breathing patterns – specifically, they can both depress breathing. This condition leads to a lack of oxygen to the brain, eventually shutting down vital organ systems, leading to brain damage and even death.

[callout title="Get Help for Opiate and Benzodiazepine Abuse"]
If a person overdoses on benzodiazepines like Xanax or Valium, painkillers like Vicodin or oxycodone, or a combination of these medications, it is important to get emergency medical help as soon as possible. Call 911, and stay with the person until help arrives.

For people who struggle with an addiction to prescription painkillers, benzodiazepines, or both, comprehensive addiction rehabilitation can help. With adequate care, people can overcome their addictions and avoid overdose.
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Dangers of Mixing Opiates and Benzodiazepines: Vicodin, Xanax, Oxycodone and Valium

According to the book <a href="https://books.google.com/books?id=pkpTBQAAQBAJ&amp;printsec=frontcover&amp;dq=The+Benzodiazepines:+Use,+overuse,+misuse,+abuse&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjpuqi439nNAhUGyoMKHfdEAJIQ6AEIHDAA#v=onepage&amp;q=The%20Benzodiazepines%3A%20Use%2C%20overuse%2C%20misuse%2C%20abuse&amp;f" target="_blank" rel="noopener"><em>Benzodiazepines</em></a>, Xanax (alprazolam) was developed as an alternative medication to Valium (diazepam) for the treatment of anxiety, particularly panic attacks.

Both Xanax and Valium are benzodiazepines, which are tranquilizer drugs or central nervous system depressant drugs that are primarily designed to treat anxiety and panic disorders.

<img class="alignright size-medium wp-image-48281" src="https://americanaddictioncenters-org-uploads.s3.amazonaws.com/uploads/2018/07/xanax-and-alcohol-300x240.png" alt="Risks of mixing xanax and alcohol" width="300" height="240" />
Benzodiazepines are generally classified as Schedule IV controlled substances by the <a href="https://www.dea.gov/drug-scheduling" target="_blank" rel="noopener">United States Drug Enforcement Administration</a> (DEA), indicating that they have some potential for abuse and the development of physical dependence. Xanax has become one of the most prescribed benzodiazepines. Despite the intent to develop a safer drug that was less prone to abuse than Valium, Xanax is also a potential drug of abuse.

Benzodiazepines are typically not primary drugs of abuse but most often abused with other drugs. One of the most common combinations is the use of Xanax with another benzodiazepine or with alcohol.

&nbsp;

<a name="Mechanism"></a>
<h2>The Mechanism of Action of Xanax and Alcohol</h2>
According to the two-volume set <a href="https://books.google.com/books?id=_MySDAAAQBAJ&amp;printsec=frontcover&amp;dq=The+Oxford+Handbook+of+Substance+Use+and+Substance+Use+Disorders,+Volume&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwjeobjk9cTSAhVRfiYKHSGKD_EQ6AEIHDAA#v=onepage&amp;q=The%20Oxford%20Handbook%20of%20Substance%20U" target="_blank" rel="noopener"><em>The Oxford Handbook of Substance Abuse and Substance Use Disorders</em></a><em>,</em> Xanax facilitates the release of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) in an indirect manner and increases the concentration of dopamine in the central nervous system. This combination results in both the sedative/tranquilizing effects of Xanax as well as the mild euphoria that is associated with its use.

Alcohol is a substance that produces varied different effects depending on the dosage. At low doses, many individuals feel stimulated and invigorated, whereas at more moderate to higher doses, individuals find themselves becoming more sedated or relaxed. The primary effects of alcohol are to affect the concentration of the inhibitory neurotransmitter GABA, increasing the effects of the inhibitory neurotransmitter glycine (which is prevalent in the spinal cord and brain stem and decreasing actions of neural transmitters that are excitatory. Alcohol use also affects dopamine levels in the brain mostly through its influence on a particular serotonin receptor. Thus, the mechanism of action for both Xanax and other benzodiazepines and alcohol share numerous similarities.
<div class="panel-block bg-brown pad-all">Even though most sources report that abuse of benzodiazepines like Xanax more commonly occurs in conjunction with abuse of other drugs, polysubstance abuse figures can be unreliable.  According to the <a href="https://www.samhsa.gov/data/sites/default/files/NSDUH-FFR2-2015/NSDUH-FFR2-2015.htm" target="_blank" rel="noopener">Substance Abuse and Mental Health Services Administration</a> (SAMHSA), the yearly rate of emergency room visits for co-occurring benzodiazepine and alcohol use remained stable at around 20,000 cases per year until 2008 when it jumped to around 27,000 cases nationally and remained at that level until SAMHSA stopped collecting information for the Drug Abuse Warning Network (DAWN) surveys.</div>
<h2>Effects Associated with Mixing Xanax and Alcohol</h2>
<img class="alignright size-medium wp-image-43040" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2017/03/getting_treatment-300x200.jpg" alt="counselor" width="300" height="200" />When taken within its therapeutic dosage range, Xanax is generally considered to be safe. When individuals take small doses of both Xanax and alcohol, the potential for severe interactions is minimized compared to the potential effects that could occur with higher doses. At lower doses, both substances are easily metabolized, but when individuals begin using higher doses of one or both substances, this puts significant strain on the system. Having one beer and one Xanax is obviously not as problematic as drinking a 12-pack of beer and taking six or seven Xanax. Obviously, larger amounts of either or both substances during same time period lead to greater potential effects and interactions between the two drugs.

Individuals who use Xanax and alcohol together will experience the effects of both substances, but technically, the specific effects and reactions that occur as a result of using these drugs together will depend on whether one consumes more alcohol relative to Xanax or more Xanax relative to alcohol. Using larger quantities of alcohol compared to Xanax will result in significantly more lethargy and sedation; however, because mixing the drugs will result in synergistic effects, using significantly more Xanax and alcohol will also produce levels of sedation and lethargy, but individuals may also experience more euphoria as opposed to overt depression or irritability. Thus, individuals using both drugs will experience heightened effects of anxiety reduction, sedation, lethargy, decreased motor reflexes, etc. However, individuals who consume significantly more alcohol relative to Xanax are far more likely to become unconscious or pass out quickly, although certainly use of both drugs in any amount can lead to unconsciousness and even comatose states.

Moreover, because the liver makes metabolizing alcohol a priority over almost all other substances, individuals who drink significant amounts of alcohol while taking Xanax will eliminate Xanax from their system at a slower pace than if they just take Xanax alone. This can result in a dangerous buildup of Xanax in the system.
<div class="panel-block bg-dkblue pad-all text-white">

Numerous sources have documented the dangers of potentially mixing benzodiazepines like Xanax and alcohol. According to the book series <a href="https://books.google.com/books?id=Yu9eBwAAQBAJ&amp;printsec=frontcover&amp;dq=Neuropathology+of+Drug+Addictions+and+Substance+Misuse+Vol+3&amp;hl=en&amp;sa=X&amp;ved=0ahUKEwiGjazx9MTSAhVCQyYKHVdwCgcQ6AEIHDAA#v=onepage&amp;q=Neuropathology%20of%20Drug%20Addictions%20and%20Substanc" target="_blank" rel="noopener"><em>Neuropathology of Drug Addiction and Substance Abuse</em></a><em>,</em> these dangers include:
<ul>
 	<li><em>Relaxation and euphoria</em><strong>:</strong> The use of both drugs will immediately result in increased feelings of relaxation, a marked reduction in anxiety or perceived stress, and mild feelings of euphoria. These effects most often occur at smaller doses. As individuals take larger doses of one or both drugs, sedation typically takes over.</li>
 	<li><em>Fatigue, lethargy, and lightheadedness</em>: Individuals taking both Xanax and alcohol will most likely experience some level of lightheadedness. This may be a result of decreased blood pressure (see below). Lightheadedness can be particularly dangerous when an individual is rising from a sitting or lying position, and the more Xanax and/or alcohol one consumes, the more significant the situation is likely to be. In addition, lightheadedness may continue after one has recovered from their substance use.Fatigue and lethargy are very common symptoms following the use of Xanax and alcohol together. Fatigue and lethargy can be expressed both physically and mentally with individuals moving more slowly, feeling more tired, lacking energy, and experiencing problems with concentration, thinking, and even memory.</li>
 	<li><em>Aggression and irritability</em>: Several early studies have found that individuals who use alcohol and benzodiazepines like Xanax together are far more prone to become aggressive, irritable, and angry than individuals who use either substance alone. Even though these drugs produce increased feelings of relaxation and less vulnerability to stress, they also inhibit an individual’s ability to self-monitor their feelings and behaviors, and interfere with their ability to inhibit impulsive actions. As individuals take these drugs in greater quantities, these effects become even more salient. Individuals who have a history of issues with impulse control, anger, outbursts of anger, etc., will often demonstrate this effect rather quickly. Even individuals who do not have a history of violence or anger management issues may become more irritable and aggressive, and demonstrate outbursts of anger under the influence of these drugs.</li>
 	<li><em>Cognitive issues</em>: Individuals taking alcohol and Xanax in combination will inevitably suffer some cognitive issues. These are dose-dependent; typically, at lower doses, an individual will feel rather “fuzzy” or “spaced out”, and they may move or think more slowly than normal. At higher doses, these effects can become far more significant.</li>
</ul>
</div>
Due to the synergistic properties of both drugs resulting in decreased flow of blood to the brain and increases in inhibitory neurotransmitters, individuals will often begin to experience significant issues with critical thinking, problem-solving, reasoning, self-control, planning, and judgment. In addition, as individuals begin to use more of one or both substances, they may become confused and will not be able to make sense of their environment.

Because of the increased action of inhibitory neurotransmitters, individuals will often experience difficulty forming new memories while under the influence of these drugs. Taking these drugs in sufficient quantities increases the risk that one will suffer a blackout, where one is still responding to the environment (albeit in an impaired way) but later has no memory of the events that occurred. Again, this is the result of the synergistic effects of these drugs inhibiting the functioning of neurotransmitters that are excitatory and that function in many different types of cognitive abilities, including the ability to form new memories. Chronic use of these drugs may produce lasting changes in the brain that inhibit these functions.
<div class="border pad-all">
<ul>
 	<li><em>Cardiovascular and respiratory effects</em>: The general action of these drugs taken singularly is to suppress the functioning of the autonomic nervous system. When used in combination, their synergistic effects can enhance these actions. Obviously, one of the major dangers in using any central nervous system depressant is the drug’s ability to shut down functioning in areas of the brain stem that control automatic life-sustaining functions, such as heart rate, respiration, etc. Even individuals who do not use these drugs at dangerous levels but continue to use them in combination may suffer numerous respiratory and cardiac issues due to chronically slowing these functions and making one system more vulnerable to infections and other disorders. Taking too much of one or both of these drugs can shut down these areas in the brain, and an individual can stop breathing, which can be fatal. Even chronically decreased oxygen flow (hypoxia) to areas of the brain and other organs as a result of chronic use of central nervous system depressant drugs can result in significant brain or other organ damage.</li>
 	<li><em>Increased potential for unconsciousness or comatose states</em>: Continuing to engage in the use of these drugs in combination increases an individual’s potential to become unconscious or even comatose.</li>
 	<li><em>Increased potential for liver and kidney damage</em>: Chronically mixing these drugs burdens the liver to metabolize them and rid them from the system. Similar burdens are placed on the kidneys as the system attempts to eliminate the substances. Individuals who chronically abuse multiple drugs are at increased risk to develop liver and kidney damage and disorders compared individuals who use these drugs singularly.</li>
 	<li><em>Increased risk for overdose</em>: Using central nervous system depressants in combination with one another increases the potential to overdose on either or both drugs. Individuals may lose track of how many Xanax they take, how much alcohol they drink, or be unable to judge how much more of either drug they can handle. In addition, because the drugs are metabolized at different rates and alcohol is typically metabolized before any other substance, individuals may still have dangerously high levels of Xanax in their system even after several hours. This can lead to a potentially dangerous situation if the person starts taking drugs again.</li>
 	<li><em>Increased potential for peculiar effects</em>: When individuals mix drugs, they become more prone to developing unusual side effects or even allergic reactions to one or both drugs.</li>
 	<li><em>Increased potential for psychosis or neurological effects</em>: Mixing Xanax and alcohol increases the potential that one will experience hallucinations and/or delusions or even seizures compared to when using either drug alone.</li>
 	<li><em>Increased potential for the development of physical dependence</em>: Both Xanax and alcohol can produce physical dependence in individuals who use them for a significant length of time. Using both drugs chronically can increase this potential and the potential for very complicated polysubstance abuse issues.</li>
 	<li><em>The development of a substance use disorder</em>: There is a direct relationship between using more substances together chronically and the development of a substance use disorder. Individuals who chronically misuse Xanax and alcohol are increasing their risk to develop a formal substance use disorder to one or both drugs.</li>
</ul>
</div>
<a name="Conclusions"></a>
<h2>Conclusions</h2>
<img class="alignleft size-medium wp-image-43327" src="https://admin.americanaddictioncenters.org/wp-content/uploads/2017/04/talking-to-psychologist-90048494-300x200.jpg" alt="" width="300" height="200" />Individuals who abuse benzodiazepines often abuse them with other drugs, such as alcohol. Due to the mechanism of action of both drugs and the synergistic effects that both drugs produce when taken together, this can be a particularly dangerous combination and may result in serious short-term and long-term effects.

[callout]
<h4>Dangers of Mixing Alcohol and Drugs</h4>
<ul>
 	<li><a href="/alcoholism-treatment/mixing-ambien">Ambien</a></li>
 	<li><a href="/ativan-treatment/mixing-alcohol">Ativan</a></li>
 	<li><a href="/benzodiazepine/and-alcohol">Benzodiazepines</a></li>
 	<li><a href="/ketamine-abuse/mixing-alcohol">Ketamine</a></li>
 	<li><a href="/alcoholism-treatment/mixing-klonopin">Klonopin</a></li>
 	<li><a href="/marijuana-rehab/mixing-alcohol">Marijuana</a></li>
 	<li><a href="/alcoholism-treatment/mixing-opiates">Opiates</a></li>
 	<li><a href="/synthetic-cannabinoids/mixing-alcohol">Synthetic Cannabinoids</a></li>
</ul>
[/callout]

Amanda Lautieri, B.A.

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