Cautionary Tales with Tim Harford Presenting: Drug Story - On Xanax and Anxiety
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Mar 20, 2026 Dr. Andrew J. Saxon, psychiatrist and professor emeritus, provides expert commentary on benzodiazepines and anxiety. The conversation covers how Xanax works in the brain and why alprazolam can be especially addictive. They also explore counterfeit pills and fentanyl risk, long term dependence and withdrawal, and alternatives like CBT and mindfulness.
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Long Quiet Use Turned Into Hidden Dependency
- Martha McPhee had her first panic attack in 2006 and was prescribed Xanax which calmed her immediately.
- Over 16 years she used tiny doses nightly and for sleep, believing doctors who said it was benign until it escalated and she later quit cold turkey.
Xanax Delivers Instant Relief That Masks Long Term Risks
- Benzodiazepines like Xanax work within 30–60 minutes by amplifying GABA, producing rapid, extensive relief unlike SSRIs which take weeks.
- That immediate effect creates a potent sense of clinician and patient gratification that can mask long-term problems.
Cultural Shift From Barbiturates To Benzodiazepines
- Benzodiazepines replaced riskier barbiturates and quickly became cultural phenomena with Valium reaching massive use in the 1960s–70s.
- Xanax launched in 1981 targeting psychiatrists and acute clinical anxiety, becoming the most prescribed benzo in years after focused marketing.
