Is Alprazolam A Controlled Substance? Understanding Alprazolam Classification, Uses, and Warnings

Medically Reviewed By:

Dr. Po-Chang Hsu, M.D., M.S.

Last medically reviewed May 6, 2024

Is Alprazolam A Controlled Substance?

Key Points

  • Alprazolam is a Schedule IV benzodiazepine for anxiety and panic disorders.
  • Alprazolam is prescribed for anxiety and panic relief, muscle relaxation, sedation, and aiding sleep.
  • Common side effects of Alprazolam include drowsiness, dizziness, weakness, confusion, dry mouth, and headaches.
  • Controlled substances, which the CSA regulates, are categorized into schedules based on abuse potential and accepted medical use.
  • Regulations involve DEA registration, prescription requirements, recordkeeping, security, enforcement, and state-specific laws governing controlled substances.

Is Alprazolam A Controlled Substance?

Alprazolam is a Schedule IV controlled substance that is most often prescribed for the treatment of anxiety and panic disorders.[1] It is classified as a benzodiazepine. Benzodiazepines affect the central nervous system and produce a calming effect.

How Alprazolam Works

Alprazolam works by enhancing the effects of the gamma-aminobutyric acid (GABA) neurotransmitter. This reduces excessive brain activity that contributes to anxiety and panic symptoms. It is usually sold under the name Xanax and comes in tablet form.

It’s important to use alprazolam only under the guidance of a healthcare professional, as it can be habit-forming.

Intended Effects of Alprazolam

Alprazolam, like other benzodiazepines, can improve the quality of life for those who struggle with anxiety disorders or panic attacks. This prescription medication can be beneficial when used appropriately under medical supervision and may alleviate the following [2]

  • Anxiety: Alprazolam is prescribed to reduce symptoms of anxiety disorders. It works to lessen nervousness, worry, and tension.
  • Panic attacks: If you have panic attacks, alprazolam can help to calm intense feelings of fear or discomfort during an attack.
  • Muscle relaxation: All benzodiazepines have muscle relaxant properties. This is helpful if you experience muscle tension as a result of anxiety.
  • Sedation: Alprazolam brings about a calming and sedative effect. This is helpful if you have acute anxiety or panic symptoms.
  • Sleep: Due to its sedative effects, alprazolam can be prescribed for short-term management of insomnia.

Side Effects of Alprazolam

Side Effects of Alprazolam

Like all benzodiazepines, Alprazolam is known to have the potential for side effects.[3] Here are a few of the most common side effects.

  • Drowsiness: Alprazolam may cause drowsiness or sleepiness. This can impair cognitive and motor function.
  • Dizziness: You may experience feelings of lightheadedness or dizziness when using Alprazolam, especially if you stand up too quickly.
  • Weakness: Using Alprazolam may lead to feelings of weakness or fatigue.
  • Confusion: You might experience confusion or difficulty concentrating while taking Alprazolam.
  • Dry mouth: Dry mouth is one of the more common side effects of Alprazolam.
  • Headache: Headaches are another common side effect of Alprazolam usage.
  • Nausea and vomiting: You may experience nausea and vomiting while your body gets used to the medication.
  • Blurred vision: Alprazolam may cause changes in vision, such as blurred vision or difficulty focusing.
  • Changes in appetite: Alprazolam may affect your appetite, leading to increased or decreased hunger.
  • Constipation: Constipation can occur as a side effect of Alprazolam use.
  • Libido: Changes in sexual desire or performance may occur while taking Alprazolam.
  • Tolerance: Prolonged use of alprazolam can lead to tolerance, meaning higher doses may be required to achieve the same effect. It can also lead to physical and psychological dependence, making it difficult to stop without experiencing withdrawal symptoms.
  • Withdrawal symptoms: Abruptly stopping the use of Alprazolam can cause withdrawal symptoms like rebound anxiety, insomnia, irritability, agitation, tremors, sweating, and even seizures in severe cases.

What Is A Controlled Substance?

A controlled substance is a drug or a chemical whose manufacture, possession, or use is regulated by the government. This regulation is often due to a potential for abuse or addiction. Regulations are put in place to prevent the misuse, diversion, and illegal distribution of substances that have a high potential for harm.

Controlled substances are categorized into different schedules based on their accepted medical use. The scheduling system helps to classify substances according to their risk factors.

What Are The Various Schedules Of Controlled Substances?

There are several different schedules of controlled substances, as classified by the Drug Enforcement Administration (DEA):[4]

  • Schedule I: Schedule I substances have a high potential for abuse and also have no accepted medical use in the United States. Examples include heroin, LSD, and ecstasy.
  • Schedule II: Schedule II substances have a high potential for abuse but do have accepted medical uses that include restrictions. Examples include opioids like fentanyl, morphine, and oxycodone, as well as stimulants like methamphetamine.
  • Schedule III: Schedule III substances have a lower potential for abuse and have accepted medical uses. Examples include opioids like hydrocodone and codeine, as well as some steroids and certain medications containing codeine or hydrocodone in combination with other drugs.
  • Schedule IV: Schedule IV substances have a lower potential for abuse compared to Schedule III drugs and have accepted medical uses. Examples include benzodiazepines like alprazolam (Xanax), diazepam (Valium), and the sleep aid zolpidem (Ambien).
  • Schedule V: Schedule V substances have the lowest potential for abuse among controlled substances and have accepted medical uses. Examples include medications containing small amounts of codeine and other narcotics.

How are controlled substances regulated?

Controlled substances are regulated through federal and state laws in the United States. Here are a few examples.

  • Controlled Substances Act: The CSA is the primary federal law governing controlled substances’ regulation. It establishes the schedules for controlled substances and oversees the manufacture, distribution, dispensing, and use of said medications. The Drug Enforcement Administration (DEA) is responsible for enforcing the CSA.
  • Drug schedule: The CSA categorizes controlled substances into five schedules based on their potential for abuse, accepted medical use, and safety.
  • Registration requirements: Individuals and entities involved in the manufacture, distribution, prescribing, dispensing, and handling of controlled substances must register with the DEA and obtain the appropriate registration or license. This includes manufacturers, distributors, pharmacies, healthcare practitioners, and researchers.
  • Prescription requirements: Controlled substances must adhere to prescription requirements based on their schedules. Schedule II substances require a written or electronic prescription, while lower schedules may allow prescription refills. Prescriptions for controlled substances must also meet certain criteria, including limitations on the quantity and refills allowed.
  • Record keeping: Entities handling controlled substances must maintain detailed inventory, dispensing, and distribution records. They must also report certain transactions to regulatory authorities, such as suspicious orders or losses of controlled substances that are being managed.
  • Security requirements: Controlled substances must be stored, transported, and dispensed in accordance with strict security measures.
  • Enforcement: The DEA enforces controlled substance regulations through inspections, investigations, and enforcement actions against violators. Violations of controlled substance laws can result in criminal prosecution, fines, imprisonment, and license loss.
  • State regulations: Individual states may have controlled substances regulations besides federal laws. Examples of these regulations include prescription practices, monitoring programs, and enforcement measures. These state laws may vary.

Get The Help You Need

If you or a loved one is struggling with dependence or addiction, help is available. Many treatment centers nationwide have inpatient and outpatient programs available to you, depending on your needs. Be sure to get the help you need.

Frequently Asked Questions

Will you experience withdrawal symptoms if you stop using Alprazolam?

If you use Alprazolam for an extended time or at high doses, you may indeed experience withdrawal symptoms if you stop using the medication suddenly.[5] Alprazolam withdrawal symptoms may include:

  1. Rebound anxiety: Anxiety symptoms that were being addressed by your dose of Alprazolam may return and be as intense or even more intense than they were previously.
  2. Insomnia: You may experience difficulty falling asleep or staying asleep, which may occur during withdrawal.
  3. Irritability: Feelings of irritability are common during Alprazolam withdrawal.
  4. Tremors: Shaking or tremors, especially in the hands, may occur as your body adjusts to the absence of alprazolam.
  5. Sweating: Excessive sweating, particularly during sleep, is a common withdrawal symptom of Alprazolam.
  6. Muscle cramps: Muscle aches, cramps, and pain may occur as your body adjusts to the absence of alprazolam.
  7. Nausea: Gastrointestinal symptoms like nausea, vomiting, diarrhea, and cramps can occur during withdrawal.
  8. Headaches: Headaches are a common withdrawal symptom associated with alprazolam stoppage.
  9. Sensory disturbances: During withdrawal, you may experience heightened sensitivity to light, sound, or touch.
  10. Difficulty concentrating: Cognitive difficulties like difficulty concentrating or thinking clearly may occur during withdrawal.
  11. Heart palpitations: Rapid or irregular heartbeats may occur during Alprazolam withdrawal. These often require medical supervision.
  12. Seizures: In extreme cases, withdrawal from Alprazolam can lead to seizures, especially if you use the medication at high doses or for a longer time.

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[1]Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2017). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10.

[2]Bounds, C. G. (2024, January 30). Benzodiazepines. StatPearls [Internet].

[3]MedlinePlus. (2021, May 15). Alprazolam: MedlinePlus Drug Information.

[4]Drug scheduling. DEA. (n.d.).

[5]What Are the Symptoms of Xanax Withdrawal. (2023, January 20). Healthline.