For years, the rates of anxiety — and the use of a fast-acting prescription drug to alleviate its symptoms — have been on the rise. The pandemic, experts say, has dramatically pumped up those numbers. A new Netflix film “Take Your Pill: Xanax” spotlights the alarming number of Americans using the medication Xanax to calm their anxiety.
Each year an estimated 19.1% of U.S. adults experience some form of anxiety disorder, according to the National Institute of Mental Health. That translates into 40 million American adults, the National Alliance on Mental Illness noted. The National Institute of Mental Health estimates that 31.1% of U.S. adults will experience an anxiety disorder at some point during their lives.
And many — 17 million in 2020 — have eased their anxiety with prescriptions for Xanax, the filmmakers said.
What is "Take Your Pills: Xanax" about?
The film tells its tale by interweaving the stories of people who use the medication with the opinions of experts who say that while Xanax is quite effective at quieting anxiety, it is a powerful drug that should ideally be used short term.
But often, that’s not how it’s used.
The film’s executive producers, NBC special anchor Maria Shriver and her daughter, Christina Schwarzenegger, said in a Nov. 30 TODAY segment that they were alarmed by what the film taught them about Xanax usage, especially in young people.
“I think the huge desire for a lot of people, especially in our generation, is the need for a quick fix,” Christina Schwarzenegger said, adding that she's experienced anxiety herself.
“People are scared,” Shriver added. “They’re scared about the climate. They’re scared about our politics. They’re scared about their jobs. And there is Xanax. And people can buy it on social media.”
What does "Take Your Pills: Xanax" reveal about using Xanax?
Listening to patients in the film describe how effective the drug is, it’s easy to understand how someone might end up using it for years.
“I could almost feel it kick in with a click, like a magic elixir,” one Xanax user named Scott said in the film.
But there’s a dark side for some. John, a middle-aged man from Colorado, was given a prescription for Xanax when he was in college, according to the film. He started out at a 1-milligram dose, which over the years crept up to 3 milligrams.
Everything seemed OK until his doctor reduced the dose from 3 mg to 2.5 mg. According to the film, that reduction kicked off a plethora of disturbing and scary symptoms: hypersensitivity to sounds and smells, heart palpitations, a sensation that his skin was burning, brain fog and crushing fatigue. But neither John nor the many doctors he consulted made the connection between the dose reduction and the symptoms.
When John finally realized his symptoms stemmed from Xanax, he began to slowly and carefully reduce his dose. “Knowing what I know now, I would never have taken that first prescription,” he told the filmmakers.
Cutting back or quitting cold turkey can be dangerous, experts say.
“Stopping cold turkey can result in seizures,” Dr. Will Cronenwett, chief of general psychiatry at the Northwestern University Feinberg School of Medicine, tells TODAY.com. “Xanax locks onto the same receptors in the brain as alcohol.” The drug can also be fatal if combined with other sedating medications or alcohol, he adds.
Cronenwett isn’t surprised by the increasing numbers of people with anxiety disorders. “We live in an unsettled time,” he says. “There’s inflation. The war. Stuff in the news. And we’re still dealing with COVID and what that did to our baseline anxiety levels.”
“In my practice since the pandemic I’ve seen a great deal more people with complaints of anxiety,” Cronenwett says. “People feel less safe, and feeling unsafe about yourself in the world is similar to the feeling of anxiety disorder.”
While there are plenty of doctors prescribing Xanax for anxiety, “it shouldn’t be a first-line medication,” Cronenwett says. “It tends to act quickly and wear off fairly quickly. Often people feel they need to use it more and more frequently. And then the thought of living without it becomes frightening. In some cases, it can begin to look like addiction.”
Many people don’t understand how powerful Xanax is.
Phoebe, who had a family history of drug addiction, was hesitant to take the medication, she said in the film. But her doctor suggested it might help her. “The first time I took it, I said, 'Oh, I understand why people get addicted to this,'” she recalled. “I need to be careful with this one. Definitely.”
“I was able to get a lot of relief with a pretty low dosage, and I think having that healthy fear of addiction made it so that I really focused on the medication as a tool for me to make space for non-medication things to work in my life,” she told the filmmakers.
What's the safest, most effective way to use Xanax?
A much healthier choice than Xanax is psychotherapy coupled with antidepressants, but it takes time to feel a difference, Cronenwett says. “I understand the feeling that if you can get quick relief, why not,” he adds. “But if you need it on a daily basis, you need to find something more sustainable.”
Experts agree that Phoebe’s strategy can work.
“(Xanax) can take the edge off of symptoms, so you can work on your skills,” Cronenwett says. “Ideally you get to the point where you don’t need it.”
Xanax also makes sense if you are using it in rare “situations that stir up a lot of anxiety, like being on a plane or getting a dental procedure,” Lily Brown, Ph.D., director of the Center for the Treatment and Study of Anxiety at the University of Pennsylvania, tells TODAY.com.
But even those types of uses can become problematic, Brown says. “If you start to say, 'I can only fly if I have my medication with me,' it becomes a security blanket,” she adds. “That’s not a problem until it’s not possible to have it with you.”
What are some drug-free ways to cope with anxiety?
Rather than drugs, Brown's practice exclusively uses exposure therapy, a "psychological treatment developed to help people confront their fears," according to the American Psychological Association.
“We prefer it because our goal is teaching people that they can be in situations that cause anxiety. They learn the ability to tolerate the anxiety," Brown explains.
“For a lot of people, the anxiety in and of itself becomes intolerable. It’s the fear of the fear. People with panic disorder fear the panic attacks. They’re so terrified that their body will start having anxiety symptoms, and they do all sorts of thing to stifle it,” she says.
Exposure therapy is a type of cognitive behavioral therapy, or CBT.
“CBT, when applied to anxiety, generally provides an understanding of the relation between thoughts, behavior and emotions,” Thea Gallagher, Psy.D., an anxiety specialist and assistant professor at NYU Langone Health, tells TODAY.com.
Taking a medication like Xanax doesn’t help in the long term, she says. “When you stop, you don’t have the skills to tolerate anxiety. With CBT, it gets easier over time to tolerate the fear.”
For those not ready to commit to CBT, there are some ways you can help yourself, Gallagher says. These include:
It's best to practice these skills before you're in a situation where you're experiencing severe anxiety, Gallagher says.
How to watch "Take Your Pills: Xanax"
"Take Your Pills: Xanax" is streaming on Netflix.