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‎ The September issue is here featuring Blake LivelySUBSCRIBE





Magazine


QUITTING XANAX: ONE WRITER'S STORY

By Martha McPhee
July 25, 2024
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PILL FRIENDS
Xanax worked like magic: “ease spreading through me pleasantly until I felt
normal again,” McPhee writes.Chad Wys, Arrangement In Skintones 5, digital
c-print, 2016.
Save this storySave
Save this storySave

In 2006, I started taking Xanax and continued, more rather than less, for the
next 17 years. The drug was first prescribed to me after I experienced a panic
attack. I had thought that I was dying. My children were two and six years old.
We were at home—my husband had gone for the day and the babysitter was late. I
started sweating and had this urge to run, to get outside. I didn’t know what
was wrong, but my heart felt weird and I didn’t want to die in front of my kids.
So I stuffed them in a stroller and went down to the street—West 106th in
Manhattan—hoping to intercept the sitter. There she was in the lobby. She took
the children. I didn’t explain. On the street, the noises were loud, the light
galactic. I think it was summer. I was walking but had no idea where I was
going. Fear crawled over me like ants.

A good friend appeared out of nowhere. He smiled and then stopped and asked what
was wrong. I fell against him and told him I was dying. He reassured me,
instructed me to breathe, then hailed a cab to take me to my doctor.

I loved my doctor, an old man with a tremor. He did an EKG, asked some
questions. I started to feel normal. Eventually he explained that I’d had a
panic attack, and that they run themselves out. He prescribed a mild dose of
Xanax, said it would take the edge off, told me I could bite the pill in half
for an even milder dose.



A month or two passed. I was in the subway when the space started to close in on
me. The ground felt like glass. I fled because I didn’t want to die down there
in front of all those strangers. On the street, I made myself breathe, told
myself what was happening, recalled the Xanax and went home in a cab to take
one. The pill worked like magic, ease spreading through me pleasantly until I
felt normal again.

We are an anxious nation, an anxious world. Look at the news and it is there for
everyone to see. Some 16 percent of the US adult population takes medication for
mental health (a figure measured pre-pandemic; one wonders what it is today).
Years ago, at a party with a new friend, I was admiring her calm happiness. “I’m
drugged,” she said matter-of-factly and with a joyous smile. She then pointed to
people around the room and told me: “He’s on Prozac, she’s on Zoloft,” and on
and on until almost everyone in the room was accounted for.

But this is nothing new. Soma immediately comes to mind, the mythical drug of
Aldous Huxley’s Brave New World. “All the advantages of Christianity and
alcohol; none of their defects…the warm, the richly colored, the infinitely
friendly world of soma-holiday. There is always soma, delicious soma, half a
gramme for a half-holiday, a gramme for a weekend, two grammes for a trip to the
gorgeous East, three for a dark eternity on the moon.”



The name was borrowed by Huxley from the ancient Rigveda, where it is repeatedly
praised as a divine potion that bestows euphoria and courage. Other elixirs for
inner turmoil tumble
down to us from sources as old as myths. Mandrake, hellebore, hyoscyamus, opium
poppy, ergot fungi, peyote, cannabis. Telemachus took nepenthe, Juliet some kind
of nightshade, Anna Karenina laudanum. “These are the tranquilized Fifties,”
Robert Lowell wrote, famously giving voice to a cultural condition in which
sedatives, prescribed as casually as breath mints, seemed the remedy for modern
anxiety. Each era has its own reasons for anxiety. If there were a coat of arms
for human nature, one element of the heraldry would be a hand reaching for a
little something to take the edge off—better living through chemistry.

Most nights I’d bite half a tablet—2 a.m., wide-eyed, my brain electric. Some
nights half a tablet wouldn’t work, so I’d take another bite.

I never took a lot of Xanax. The dose was so small that doctors rarely saw
anything amiss. My dependence happened slowly: At some point early on, I
discovered that taking the drug could help me sleep—help me fall asleep, help me
go back to sleep when I awoke in the middle of the night. I kept the canister of
tablets on my bedside table, like a totem to ward away the sleep demons. Sleep
had troubled me since I was a teenager, when my mother would give me pills of
calcium in the middle of the night.



Doctors I saw over the years, they’d say, “Well, Martha, you also need to sleep.
It’s a small dose you’re taking of Xanax. Don’t worry.”

Most nights I’d bite half a tablet—2 a.m., wide-eyed, my brain electric. Some
nights half a tablet wouldn’t work, so I’d take another bite. I never needed
more than 1.5 tablets. The prescription was written for .25 mg, 2x per day; a
one-month supply amounted to 60 pills, which could last two to three months. The
cost, after insurance, was $2.37. Cheap and easy.

In the mornings, I’d wake up feeling rested. I’d have my coffee and start the
day. For years, I didn’t think much about this. It was my pattern, how I managed
my sleep. If doctors weren’t concerned, then why should I be? In my household,
my kids, my husband—they knew that Xanax was my thing. (I did not tell my
sisters. I have five. Sisters can be like mirrors. When one sister learned I
took Xanax on occasion, she warned me that it might cause dementia, that I
shouldn’t risk it. “Read the studies,” she said.) Sometimes when my husband
couldn’t sleep, he’d take one. Like me, he is a writer, a poet, vulnerable to
the pressures of the creative life. Once he took my Xanax for several nights,
depleting my supply. I got furious. I worried the doctor would think I was
overindulging. But when I asked her for a refill sooner than usual, she didn’t
bat an eye.

This is not a story about how doctors are bad and pills are evil. I believe in
medicine, and there is a good place for Xanax when used properly. But I didn’t
use it properly.

If people for millennia have sought quick remedies with magic potions to life’s
turbulences, in the past 150 years the chemist has been the innovator,
harnessing this need. In the realm
of sedatives, the hunt for the fastest acting, least harmful, least addictive
medication has fueled an industry. In the 1800s bromides came about, an
alternative to alcohol and opium used for centuries. In the early 1900s we had
barbiturates, followed by carisoprodol and meprobamate—with brand names like
Seconal, Miltown, even Soma. Red Devils (or simply Reds) was the street name for
Seconal. All of them captured my imagination as a child when I heard those names
tossed about by adults who had trouble sleeping.

In the mid-1900s, benzodiazepines were created by Leo Sternbach for the firm
Hoffmann-La Roche. The first in this class was Librium, soon followed by Valium,
which immediately became famous among housewives for calming their nerves.
Valium would become the pharmaceutical industry’s first $100 million product and
the Western world’s most widely prescribed drug. By 1966 it was the protagonist
of the Rolling Stones’ song “Mother’s Little Helper.”




When Xanax (its generic name is alprazolam) came along, it was fast-acting, had
a short half-life, and was processed swiftly by the body—all of which
distinguished it from earlier benzodiazepines, including Valium. By the time I
started taking it, in 2006, millions of other Americans were doing the same.
According to Yale Medicine, “between 1996 and 2013, the number of
benzodiazepines prescribed for adults increased 67 percent to 135 million
prescriptions per year, and the quantity prescribed per patient more than
tripled during that period.” Prescriptions for alprazolam peaked in 2014 with
28 million filled. And though prescriptions have since declined (in 2021 there
were 15 million), the addiction rate to sedatives of all kinds has increased.

Xanax is intended for short-term use only, and for targeted situations—panic
attacks, fear of flying, and other phobias. It is not a sleep aid and was not
approved for treating insomnia by the Food and Drug Administration. Its
addictive properties can be difficult to notice but can draw you up short.

When my kids were in the early double digits, it occurred to me that I didn’t
have enough life insurance. I applied for more. I was required to fill out
forms, have blood drawn, was visited by a representative for the underwriter.
Somehow from somewhere, they retrieved the medications I took regularly. There
was only one. A few weeks later I received a letter informing me that I had been
denied. I was too high a risk. Xanax was the culprit. But even this didn’t cause
alarm; I recalled the doctors’ mantra: “You need to sleep, Martha.”

Around 2018, my daughter started asking me for Xanax to help her sleep. She was
a stressed-out high school student applying for college. On occasion, she nabbed
a few from my totem canister. At first, I hid them. Then I realized I needed to
set a good example, so I quit cold turkey. I had a rough go for several days. I
couldn’t sleep. I couldn’t concentrate. I felt like a live wire. But I was
determined. Eventually, my body adjusted. I did not throw the canister away.
Rather, I gave it to my husband for safekeeping—just in case.



The year 2020 rolled around, and by April I was having a nibble again. I
realized if I had a glass of wine or two…or three…(alcohol sales were up and
liquor stores were deemed, conveniently, an essential service during lockdown),
I’d fall asleep but then wake up wide-eyed and racing in that old familiar way.
A bite of Xanax would put me back to sleep.

I only took the Xanax at night, but started needing more. During the day I was
jazzed, anxious about everything—stuff that I needed to be anxious about and
stuff that I didn’t need to be anxious about. We were in the pandemic, living in
my childhood home—a farm in New Jersey—with my mother who had late-stage
dementia, the children now college-aged stuck far away from their lives. There
were the usual money worries, work worries, my tendency to try to fix
everything. The anxiety came out in my tone. In the lines of my face. In my
posture. I attributed this to family history—the long line of anxious people
that I descend from. I became a shrunken shriveled stick twig, weighing not more
than a hundred pounds. I cried. I fainted. I screamed at my husband. In Italian
there is one word that captures it all: sciupata. I was sciupata: damaged,
spoiled, ruined, run-down, worn out, wasted, squandered. Sometimes I’d wonder if
my body could keep going like this; it didn’t feel like it could.

In 2023, a new doctor for me, a new life for us all. This doctor didn’t mince
words: “You cannot keep this up. You must stop.” She raised the risk of dementia
from long-term use. A new shrink said the same thing and explained that I was
suffering from rebound anxiety—that desire to race out of my own skin. When I
was on Xanax, my anxiety, rather than go away, went into storage mode, where it
accumulated only to be released as soon as the drug wore off.

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It took a few months for me to gather the courage to quit again. When I finally
did, I kept the Xanax canister front and center on my bedside table so I could
have a conversation with it. I am not going to be fooled, tempted, provoked by
you. Once again, I didn’t taper. (I do not recommend this. It can be dangerous.)
It was like I was on speed. I couldn’t sleep. It felt like my brain was
ricocheting around my skull, my body sucked into a black hole in the center of
me. The fallout lasted a few weeks. I tried meditation, picked up yoga again,
practiced breathing. But it was hard.

When I told my doctor that I had stopped taking Xanax, she became emotional.
“You did?” she asked. “Do you know how hard that is?”

I kept the remaining tablets for about three weeks. I was on the upward climb to
feeling better when I took them off my nightstand and poured them into the
toilet. I will never take another Xanax—not ever—is what I was saying with that
act. “Don’t write that in your article,” my friend Kate said about flushing
them. She is a clinical psychologist at the University of Chicago. “That is not
the safe way of disposing of medicine. It gets in the water, contaminates it.”



For a while I was mad. I wanted to blame Xanax for everything—my elevated A1C,
high bad cholesterol, frail bones. But blaming never accomplishes much. I could
have better informed myself about Xanax. All the information anyone needs is
available on the internet. Instead I turned a blind eye on myself.

Eventually, I felt all right. I felt calm. All the anxiety I suffered for so
long was artificial. My natural state is several decibels lower. I am not as
volatile, not as easily provoked, not quite as sad or mad or anxious. My
children and husband noticed. My sisters noticed. I was more relaxed, more
playful, but I still had trouble sleeping. Managing sleep is a practice; it
takes discipline and self-control—less wine and sugar, more breathing. I have
had to look at my own habits and vices that interfere rather than ignore them by
taking a pill. And a sleepless night now and again no longer panics me; the
price of the alternative isn’t worth it.

FAMILY TIES
The author (right) with her daughter Livia in October, 2023.


Photo courtesy of Martha McPhee

In this period, my daughter, Livia, and I saw a Nan Goldin work at the Louisiana
Museum of Modern Art outside of Copenhagen, a 24-minute digital slideshow
capturing images of Goldin’s addiction to OxyContin. In the darkened screening
room, Livia, who is 24 years old, asked, “Did taking Xanax feel like going into
your mother’s arms?” Though my experience was nothing like Goldin’s, the line
Livia drew from Goldin to me pierced, reminding me that for most of my
children’s lives I had not been myself.

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We were in Copenhagen for a conference on health care innovation through the
arts, as I had become curious about a burgeoning practice to treat anxiety and
depression by prescribing museum visits. There were various European health care
groups who knew that engagement with art could treat depression, anxiety, and
other mental disorders—and the conference was meant to bring them together so
that they could have a critical mass of influence. Various doctors spoke: One
said that his days are filled with patients who seek prescriptions when what
seems to be wrong is loneliness. Another emphasized that there is only one
dopamine, and art and social connection is the better place to get it.



In the Louisiana Museum, it wasn’t lost on me, a novelist, that a work of art,
Goldin’s, was doing the job that art has always done, allowing us to see
ourselves in someone else’s predicament. The predicament of the individual
mirrors the predicament of the culture.

Fourteen months after going cold turkey, I returned to my new GP for an annual
physical. When I told her that I had stopped taking Xanax, she became emotional.
“You did?” she asked a few times. “Do you know how hard that is? Without any
support? On your own?” She had to pause for a breath, which caused tears to
prick in my own eyes.

My doctor, she asked, “Do you mind if I share your story with my patients? I
have so many who need to hear this. I won’t mention your name.”






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