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Local health officials, including one of Newtown Prevention Council’s co-chairs and an emergency room physician who lives in and has treated youths from town, believe that an increasing number of local teens may be experimenting with and abusing the antianxiety drug Xanax (alprazolam).
Health District Director and Newtown Prevention Council (NPC) Co-Chair Donna Culbert told The Newtown Bee that she became concerned when a number of local young people said that Xanax use and abuse is growing more widespread among their peers. The interviews were solicited as a follow-up to the release of the NPC’s latest substance abuse survey, which does not specifically address or pose questions about Xanax by name.
“We have an interest in being proactive about this,” Ms Culbert said. “Xanax was the top prescribed drug in 2016, and we’re seeing a significant level of consumption whether it’s prescribed or being obtained without a prescription. This is by no means an issue that is unique to Newtown, but I anticipate the Prevention Council looking at this specific drug issue in 2018.”
Newtown resident and Danbury Hospital emergency room physician William Begg, MD, said that he shares a dire concern with peers across the country not only about the sheer volume at which Xanax is being prescribed — particularly to young people — but about the number of youths who are obtaining the drug off the street or from their own families’ medicine cabinets.
Dr Begg is even more worried because increasingly, counterfeit Xanax is being sold to young people after being cut with other drugs, including deadly fentanyl.
Ms Culbert believes the abuse of Xanax has the potential of growing into as large a public health crisis as the recent opioid epidemic, in part because younger users are lulled into a false sense of security about the drug because it is so widely prescribed by physicians. And Dr Begg was pleased to hear the NPC is turning its attention to this new trending drug abuse issue.
“You’re definitely on top of the issue,” he said. “This is trending across the country at the high school and middle school levels — Xanax is easily dispensed and there have been some cases around the country where multiple students have been brought to ERs because they were [abusing] Xanax. We know this trend is underreported, but we see it gaining a lot of traction at high school and middle school ages.”
Dr Begg said he saw one recent survey where it was found that Xanax had surpassed marijuana to become the second leading cause of DUI arrests after alcohol. That is because the recreational doses of Xanax that he and his colleagues are seeing being consumed far surpass what is normally prescribed in a clinical situation.
“If somebody has clinical anxiety, they would likely start by being prescribed 0.25 milligrams, or 0.5 milligrams as needed because it is very addictive,” he said. “But we see young people who are unfamiliar with it taking two or even five milligram doses, which is really dangerous because it makes them really lethargic, and can cause them to pass out.”
Mixing Other Substances
Unfortunately, the emergency room specialist said, most recreational users and those addicted to Xanax are too often consuming them with other substances, which can be a deadly combination, particularly with alcohol because the combination will depress respiration and can be fatal.
“All you have to do is Google ‘Xanax and teens’ and you’ll see that routinely, teens are taking two to four milligrams at a time. And when we’re prescribing it to an adult for the first time, we’re giving them 0.25 milligrams, we’re talking a dose that is 15 times more potent,” said Dr Begg. “And too many of these teens are already on other types of drugs like Zoloft or Ritalin. So you toss in some Xanax, typically consumed in an unprescribed large dose, and that is what is bringing more of these teens into the hospital in multiple numbers.
“And when they obtain this off the street, they don’t know the true dosage and it can be cut with other drugs like fentanyl, which can really be a killer,” he said. “There are just so many reasons why this is a growing concern.”
Both Dr Begg and Ms Culbert are warning Newtown residents who may have Xanax in their homes to either lock up the drug, or if it is no longer being used, to dispose of it.
“The Newtown Police Department has a drug drop-off box that is available 24/7,” Ms Culbert said. “They make it really easy to get rid of any unused or unwanted drugs that may be lying around. Any visiting teen, whether it’s a relative or a friend of your child’s, may go looking for these drugs and take them if they are not secured.”
“Teenagers have a tendency to experiment with prescription medications they find around the house,” Dr Begg concurred. “This is something we frequently see — a teen who has taken another family member’s medication. So locking up all your medications is the easiest way to prevent young people from getting into them.”
According to the Connecticut Department of Consumer Protection (DCP), which is charged with overseeing prescription drug distribution, Xanax is the most prescribed controlled substance in the state. Xanax is among a class of controlled drugs known as Benzodiazepines, which if used in combination with opioids increases the risk of overdose.
In 2016, the DCP reports that roughly between 16,000 and 24,000 Xanax pills were legally prescribed to consumers in Newtown, a number similar to neighboring communities of Bethel, Southbury, Monroe, and New Milford. Across Connecticut, Benzodiazepines are by far the most prescribed, outpacing opioid prescriptions by nearly 130,000 (593,345 vs 466,020).
Ms Culbert said she gets the impression that as many Newtown youths are receiving legitimate prescriptions as are those obtaining Xanax from nonmedical sources.
“And when it’s coming from someone on the street, they really don’t know what they are taking,” she said. “That’s the scary part.”
Addiction And Overdose
According to the federal Substance Abuse and Mental Health Services Administration (SAMHSA), Xanax is typically abused because of the sense of calm and relaxation it causes in the user. Some people abuse Xanax by taking it in higher doses and combining it with other drugs or alcohol in order to achieve the desired high.
Xanax affects the brain and central nervous system. It boosts a brain chemical called gamma-aminobutyric acid (GABA), which slows down the nerve cell activity in the brain, producing a calm and relaxed feeling.
An overdose on Xanax can be fatal, especially if the drug is taken with alcohol or other drugs. Overdose can also occur if the pills are crushed or chewed, as the drug is designed to be time-released into the system.
Xanax overdose symptoms include confusion, slowed heart rate, extreme drowsiness, difficulty breathing, fainting, loss of balance, muscle weakness, and coma.
Treatment for a Xanax overdose will depend on how much of the drug was taken and whether other drugs or alcohol were also consumed. In the event of an overdose, medical providers may pump the stomach to remove as much of the unabsorbed Xanax as possible.
It is important for anyone suffering from a Xanax overdose to be honest with the emergency medical personnel about exactly what substances were taken and how much.
SAMHSA states that 70 percent of teens with a Xanax addiction get the drug from their family’s medicine cabinet.
Tolerance to Xanax develops quickly, requiring the user to take more of the drug to achieve the desired effects. Someone with a Xanax addiction may take up to 20 to 30 pills per day.
A user deciding to stop taking Xanax may experience withdrawal effects, such as tremors, fatigue, and impaired coordination. The onset of withdrawal symptoms is a sign that a physical dependence has developed.
If a user wishes to stop taking Xanax after dependence on the drug has formed, it is not recommended to quit “cold turkey” or without medical supervision. The symptoms of Xanax withdrawal are similar to those of alcohol or barbiturate withdrawal, and the severity of the symptoms can vary.
If convulsions occur, withdrawal from Xanax can be deadly.
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