Xanax junkies

A popular drug for panic attacks can cause life-threatening addiction. But that hasn’t stopped Upjohn from marketing it to an unsuspecting public
November 19, 2007 3:52:56 PM

This article originally appeared in the November 6, 1992 issue of the Boston Phoenix.

Ever had a panic attack? If not, you will soon. The Upjohn Company is busy educating the public about panic disorder, and though the diagnosis is legitimate, Upjohn’s interest is proprietary: it manufactures Xanax, the only drug approved for the treatment of panic.

Symptoms of a panic attack include rapid heartbeat, chest pain, and dizziness. The typical patient is a woman who, after several attacks in a shopping mall or in traffic, ends up too scared to go out at all. But lo and behold: symptoms disappear if she starts taking Xanax.

Xanax (a/k/a alparzolam) belongs to the class of minor tranquilizers known as benzodiazepines. Compared with other classes of drugs used to treat panic, Xanax kicks in more quickly and produces fewer unpleasant side effects. Patients like Xanax and doctors share their gratification. But after several months, when the consensus is that patients should be weaned off the medication, they find out the bad news. They’re addicted. (Hereafter, the term “dependent” will be used. The psychiatric establishment reserves “addiction” to describe the behavior associated with obtaining illegal drugs.)

For some conditions, such as anxiety or TMJ (tempomandibular-joint pain, which is sometimes caused by muscle tightening), small amounts of Xanax are prescribed — two milligrams a day or less. But many panic patients need more than four milligrams of Xanax a day. On that dosage, they’re sure to become so dependent that if they stop medication abruptly, they might have a seizure and die. Even if they taper off slowly, withdrawal symptoms often persist for weeks. Experts recommend a strict tapering regimen that lasts months — but even then, panic symptoms may come back worse than ever.

Xanax isn’t the only way to treat panic. The best doctors tailor treatment to the individual, often using first medication and then “cognitive/behavioral” therapy, designed to help the patient analyze her or his fears and then confront them. And though research suggests that psychotherapy has a lower rate of relapse than drug therapy, Upjohn thinks medication works best.

The story begins in 1981, when Xanax was introduced. By 1987 the palindromic upstart had replaced Valium as America’s most prescribed tranquilizer. Soon afterward, clinical trials established Xanax as an effective treatment for panic disorder, and in 1990 the Food and Drug Administration (FDA) approved Xanax for panic patients.

In recent years Halcion and Xanax have accounted for almost half of Upjohn’s earnings. But as Halcion came under siege in 1991 for the unpredictable responses it provoked (think George Bush in Japan), Upjohn began to depend on Xanax. It raised the price of the drug by 10 percent last year, then again by nine percent this past February. This year revenues from the panic pill are expected to reach well over $600 million.

To maintain profits, Upjohn needs cheerleaders like Jerilyn Ross, president of the Anxiety Disorders Association of America (ADAA). Ross makes speeches encouraging panickers to seek treatment, and she recently appeared in a video news release paid for by Upjohn to push Xanax. (Video news releases are the TV equivalent of advertorials, promotional clips slickly produced to resemble the news.)

Of course, Ross needs Upjohn as well. Upjohn has contributed to the ADAA every year since 1984, and last year it bankrolled an ADAA opinion poll about panic.

In 1989 Upjohn gave $1.5 million to the American Psychiatric Association (APA), which used the “unrestricted” (i.e., “no string attached”) grant to produce educational videos about panic, anxiety, and depression.

“People don’t understand mental illness, and there’s a valid educational job to be done,” says John Blamphin, the APA’s director of public affairs. “On the other hand, Upjohn has medications for anxiety disorder and panic. The more people know about the illnesses and get into treatment, the more likely their [Upjohn’s] medications are going to be prescribed.”

When asked about Upjohn’s promotion of panic, company spokesman Godfrey Grant explained, “We’re trying to do something that is in our interest, but it is also a legitimate project to make the public more aware” of a disabling illness.

At the APA’s annual meeting this past May in Washington, DC, Upjohn’s self-interest was symbolized by a black Xanax sign on a pole. The sign revolved high above the convention-center floor, towering over exhibits for other over-hyped psychoactive drugs, such as Prozac and BuSpar. At the foot of the pole, Upjohn’s Panic Interactive Learning Center seated eight at a time. Curious visitors could don headphones and touch their personal video screen to active segments offering the medical overview, case histories, or physicians’ perspectives. Naturally, all the doctors urged medication for panic.

Upjohn wasn’t just hawking at the APA convention; it also funded a three-hour symposium, “Panic Disorder: Consensus for the ’90s.” Speakers included Dr. James Ballenger, of the Medical University of South Carolina, who declared that tranquilizer dependence is “probably the most controversial issue in psychiatry” today.

In a recent interview Ballenger blamed the uproar on media hysteria, claiming the benefits of Xanax as a treatment for panic usually outweigh the risks. “Patients hear things that unnecessarily scare them,” he intoned, “and they feel guilty about becoming dependent. But dependence is not a weakness. It’s a physiological condition.”

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I don't understand why people who have panic conditions--which I have personally have--are stigmatized for using the most effective medicine available for panic attacks. I tried everything from psychoanalysis to herbal remedies (valerian root, etc) and nothing worked. People who have not experienced a panic attack have no idea how frightening, debilitating, and risky this disease can be. I used to get panic attacks driving in fast traffic; often I had to stop and pull over. I was risking my own and other's lives. Xanax completely eliminated this problem. People don't get up in arms over diabetes patients who are dependent on insulin for life...Why is worse to be dependent, even for life, on a drug if it helps a person lead a normal life? I didn't do anything to bring this on to myself--it runs in my family, I think. My mother has the same condition. It seems we as a society stigmatize and demonize anything we don't understand. I guarantee that if you experienced a panic attack, your views would change. We can't let the fact that there are thousands of individuals who will take anything to alter their consciouness, to affect the ability of patients who need this drug to get it, or make it harder to get. I don't think the gov't should be deciding what people put in their bodies in the first place, unless that action causes them to hurt someone...but that's another discussion. A lot of people end up in prison from buying benzodiazepines on the street because they couldn't find a doctor to prescribe them--usually because they look a certain way, or fit a certain profile. Doctors, not DEA agents, should be deciding whether a patient needs a drug or not. Personally, I don't see the problem of dependence, if it helps a person..The only problem that could arrise is if that person's supply of medicine were cut off, as apparently some want to do. Why is it that in this country everyone seems compelled to try to make everyone else believe and live as they do? My medicine doesn't affect you! Why are Americans so intent on getting into other people's business? You can see this same attitude reflected in our foreign policies, which is why we are in the political mess we are today; and this is the reason why other nations despise us! Not for our freedoms..what freedoms? They hate us for our freedoms, so let's get rid of them, seems to be the attitude that has allowed the erosion of our Constitution and Civil Liberties. I believe as Ben Franklin did: those who are willing to give up freedom for temporary, or illusionary, security, deserve neither liberty nor security.

POSTED BY Alan Veil AT 11/20/07 9:40 AM
I agree with Alan. I have taken Xanax for many years (as well as tried many herbal remedies, unsuccessfully). I don't go buy it off the streets to get high. I have severe panic attacks, and use Xanax when I need it. That is the difference between a user/addict and a person on medication!!! An addict will get high off anything they can get! Xanax just happens to be one of those drugs. Would you take a child/adult off medication or stop manufacturing a medication for ADD or ADHD because some jerk addict has decided that they can get high by crushing and sniffing that drug or the dealer for selling it? It's the same for any other drug out there that produces a high. Is the government going to take it away or stop the manufacture of any medication just because some people CHOOSE to abuse it? The war on drugs should be more focused on drug dealers, distributors and abusers, not on people trying to live a normal life with a doctor monitoring a prescribed medication.

POSTED BY Jac AT 11/25/07 11:59 AM
By the way, you are also wrong about Xanax being the "only drug approved for the treatment of panic." Maybe you should do a little research. Xanax is a medication that belongs to a group of drugs known as benzodiazepines; Valium was the first; there are at least 15 different variations of this group of drugs. And there are also a few different forms of panic, or anxiety, disorder. Xanax is probably the most powerful of them, or one of the most powerful, and it goes to work fast. If you have panic attacks, then Xanax is the preferred drug because of these attributes...But a doctor may precribe Valium for another type of patient, or Klonopin for someone with a low, constant level of anxiety. It would be great if Xanax were not addictive...unfortunately, from Valium to Morphine, the most effective drugs have side effects. However, if you are taking a drug under the supervision of a doctor, on a regular schedule, and with very little chance of not being able to get your medication, which is when, yes, you could suffer severe withdrawal symptoms...Just like if a diabetic were cut off from his insulin supply. With Bush in the White House, I actually do worry about this some, for I have no doubt that he has aspirations of turning this country into a dictatorship...He's already destroyed the 4th amendment, and has seriously injured the 1st..if S1959 passes, it will finish it off. THIS is the stuff you should be worried about! Not the side-effects of life-saving drugs prescribed by doctors to people with a legitimate condition. We allow people to drink, have guns, take pain medication (hospice), etc. All of these things are abused by some people; we, as legitimate patients, can't help what these people do...there are always a few bad apples that try to ruin it for everyone else.Do we allow them to succeed? NO, of course not. I could not function normally without my medication; it is too bad that it is addictive, but that's our choice to make, together with our doctors. And as far as the "war on drugs" goes, I find it astonishing that the people who are mostly arrested are done so for the possession of small amounts of cannabis--a plant. The demonization of this plant is amazing: we've legalized alcohol and tobacco, which claim hundreds of thousands of lives per year. Yet how many people have died from smoking the "evil weed"? 0. No one. The only reason this herb is illegal and targeted is due to political reasons: they don't want hemp, the male species, containing very little THC, to be around because one can make about a 1000 things out of this plant, including paper and would also make an excellent, non-food source of bio-fuel. The other reasons have to do with various factors: the alcohol industry doesn't want it around..they don't want people to find out that there is a much safer alternative to alcohol that doesn't leave you feeling like you were run over by a truck the next morning. The gov't doesn't want to admit that it's been lying to the American Public for decades...And then pharmaseutical companies don't want it around, because it has a host of very positive medical benefits, and they've even found a way to burn it at a temperature that just releases the cannabinoids without combusting any of the harmful chemicals...What's funny, and points out how true this is, is that Big Pharma has a pill called Marinol, that is pure T.H.C. (the psychoactive ingredient in cannabis), and it's down to a Schedule 3 now...which says, basically, that the drug is thought to have very low potential for abuse, and medical applications. Most people who are sick and take medical marijuana do not like Marinol, because it takes up to an hour to hit, then hits hard...There are none of the other cannabinoids found in natural cannabis that help to reduce the intensity of the psychoactive THC, and which also provide many of the health benefits derived from use of this herb. When smoked, the effect is immediate, and patients can control the level of THC they are receiving very easily...Yet, whole cannabis is still a schedule 1--which says that it has high potential for abuse, and no health benefits. Now, if you want to attack Big Pharma, there's a story for you--if you have the cojones to run it.

POSTED BY Alan Veil AT 12/04/07 10:46 AM

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