We Asked a Doctor If 56 Xanax in One Month Is Really That Crazy

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Hip-hop seems to have a new trendy drug every year. It doesn’t seem that long ago that rappers were in love with MDMA, but the newest culprit is a medication that is typically taken to reduce anxiety: Xanax. Last January, A$AP Yams was found dead after mixing Xanax, which is a form of benzodiazepine, with codeine cough syrup. More recently, artists like Future and Father have glorified its use, prompting musicians like OG Maco and Chance the Rapper to publicly decried its use amongst their young fans. The drug is typically prescribed for anxiety disorders and insomnia, and is extremely addictive on its own. But when mixed with alcohol, the effects of Xanax are compounded and the result is a euphoric feeling of carelessness that can drive some people to dependance.

The drug itself is nothing new, with Lil Wayne rapping “I am a prisoner, locked up behind Xanax bars” back in 2008 on “I Feel Like Dying.” But with some doctors prescribing the pills for everything from lack of sleep to combating nerves from flying, the drugs seems to be easier than ever to obtain. Combine this accessibility with the drug’s relatively low price point of $10 for a bar (ranging in dosage from 1mg to 2.5mg) and you can see why it’s become enough of an epidemic that some rappers feel the need to warn young fans.

To find out what exactly Xanax does when it’s in your system, we decided to Ask A Smart Person and interview Arielle Salama, who is an outpatient and emergency psychiatrist at Toronto’s St. Michael’s hospital. Dr. Salama works in the emergency room and deals with the drug often, so we wanted to know how much Xanax it takes to overdose, and if Future’s claim of doing “56 bars all in one month” is as dangerous as some have claimed.

Noisey: So what exactly is Xanax?
Dr. Salama: Xanax is a benzodiazepine, which is a family of drugs. Ativan, which is the corporate name of Lorezepam, or Klonopin, are two other common forms of the drug. I’d say that half of everyone who comes in is on one of those.

When would someone genuinely need those drugs?
Those drugs would be prescribed for typically for anxiety disorders, panic attacks, insomnia or alcohol withdrawal.

Alcohol withdrawal?
The way that works, and the reason why Xanax is more addictive, is because all of the drugs in that family are habit forming drugs and you develop a tolerance towards them. But the reason why Xanax is the worst one is because it’s super fast acting compared to the others, which is kind of like a condition for addiction. So all of those drugs, the way that they act in the brain, is actually similar to the way alcohol acts. Alcohol has a lot of other effects too that these drugs don’t, so they’re cleaner, but you don’t want to combine them with alcohol because like then it’s basically like drinking a lot. But if someone is dependent on alcohol, it changes the way those receptors work, so if someone’s a very very heavy drinker and they stop drinking right away, they can die of alcohol withdrawal. So let’s say you drink a ton of alcohol everyday and then you just stop, then you go into the hospital, we put you on a protocol of Ativan or Valium, one of those benzodiazepine drugs to stop you from having a seizure and dying. It basically lets you taper down slow.

How many Xanax do you have to take at once for it to be potentially life threatening?
People can take up to 6mg in a day. That wouldn’t be life threatening, but would be a lot. It would also depend on your tolerance level. So if 6mg is the upper limit for Xanax, that would be like 3-5 pills a day. I think if you took that many at once, you wouldn’t be doing well. I mean the thing with these drugs when they get to be most dangerous is if they’re combined with alcohol or with opioids.

Continued below…

Is codeine an opioid?
Yeah codeine is an opioid. That’s how Heath Ledger died, because he had all 3 of those drugs in his system at once. If you overdose on opioids you can shut down your respiratory system, but all of 3 of those types of substances don’t let you respond to the signals that basically force you to breathe, so if you combine any 2 or 3 of them you’re definitely in more trouble.

Future claims to have done 56 Xans in one month.
I mean it depends on the dosage. I wouldn’t recommend that someone takes that much, but he’s actually within the limit, like a pharmacy will dispense that to you, it’s completely above board. The thing is he would probably be using them with a bunch of other stuff.

Yeah the line right after says that he’s still drinking.
Yeah I don’t think that’s necessarily something to brag about. But there’s probably just a bunch of anxious people who are taking 56 bars in one month.

If you’re addicted to Xanax, what kind of steps can you take outside of just simply taking less?
So basically you would want to switch to a longer acting one, so if you were going to wean yourself off of it and you’re on Xanax, because it’s so short acting, you should just work with your doctor to switch to something like the Klonopin or Valium that are longer acting and then you wean those ones off gradually.

Cool, so the cure is just more drugs.
Yeah, longer acting and then eventually less and less, that’s kind of the safest way to make it happen. I’ve heard of cases with elderly people and it’s so hard for them to get off of this medication that they can be admitted into hospitals. It’s very hard to get off of for some people. Clonazepam is what Stevie Nicks used to be addicted to, other than cocaine, and she had to go to rehab for that, so they’ve been around for a very long time.

Slava Pastuk is the Editor of Noisey Canada. He is on Twitter.