Addiction

[Ripley200]

I've been taking Xanax 0.05mg for 13yrs every day would you cosider this an addiction?

[Ripley200]

I can go one or two days (at most) without Xanx--sooner or later if I don't take it, I will have tighten in my chest, heart palapations,  I will get bad nervousness, etec.  So, even though its a low dose, the dosage has never been changed its always 0.5mg.  

I cannot stop taking it, or slow down the medication and I don't consider it an addication.
I don't understand why the doctor never bothered to change the medication???    
So, one day when I did talk to the doctor and requested to be taken off this medication or to replace it with another the dr. said "no".
So where do I go from that???

[dave42a]

I would certainly agree with Dr. junig. with that said, should you want to stop the xanax because you feel that your anxiety is controlled and I have a strong suspicion that 0.5mg is doing very little other than a placebo effect if you have been taking it for such a long period of time, then you wont have a hard time with any withdrawal. Perhaps you would want to go down to 0.25mg for a while but I would  hope you would do it in consultation with your doctor. You may or may not know that benzo withdrawal is associated with seizures but I have never heard of someone having  a seizure coming off of such a low dose but why not be on the safe side, right?  Often patients can stay on a stable dose of a benzo for a long period of time and have their anxiety controlled. however, in my experience with people taking the drug over a period of time, most need to raise the dose, at least slightly,  to get the same anxiolytic benefit. good luck to you
  

[J T Junig, MD PhD]

For reasons I will get into the question isn't so much whether I consider it to be an addiction, as whether YOU consider it an addiction.  

The dose of a medication alone does not provide enough information to determine whether someone is 'addicted' to a substance.  That said, I suspect that you are actually taking 0.5 mg, not 0.05 mg, which would be a fraction of the lowest pill size available and would have minimal if any effect.  Even 0.5 mg is a very low dose for someone taking Xanax for 13 years.

The main issue that gives doctors pause to prescribing Xanax and other 'benzodiazepines' (valium, klonopin, librium, ativan, etc) is the tolerance that those medications cause.  Tolerance is the effect where the body becomes accustomed to a medication, and larger and larger doses are required to get the same effect.  This is one component of physical tolerance, the other being 'withdrawal' in response to stopping the medication.  The fact that your dose is so low tells me that you have closely controlled your use of the medication, or used very little of it over the years.

Does this mean it is not an 'addiction'?  Not necessarily.  Addiction isn't so much the use of a drug, but rather the 'relationship' the person has with the drug.  A person can be addicted, for example to alcohol, and drink little or no alcohol for months or years.  But if the person is constantly thinking about drinking he may be an alcoholic.  A person taking a very low dose of Xanax may have an addiction if he constantly thinks of Xanax, constantly wishes he had more available, frets over running out of Xanax early, etc.

Which brings us back to your opinion as to the relationship that you have with the substance.  One set of questions used to evaluate the relationship with a substance would be the 'CAGE' questions:
-Do you think about Cutting down?
-Do you get Angry when people talk to you about your drinking?
-Do you feel Guilty about your drinking?
-Do you ever have an Eye opener i.e. drink in the morning?