Panicked strivers have replaced sullen slackers as the caricatures of the moment, and Xanax has eclipsed Prozac as the emblem of the national mood. Jon Stewart has praised the “smooth, calm, pristine, mellow, sleepy feeling” of Xanax, and Bill Maher has wondered whether the president himself is a user. “He’s eloquent and unflappable. He’s so cool and calm.” U2 and Lil Wayne have written songs about Xanax, and in her 2010 book Dirty Sexy Politics, John McCain’s daughter Meghan copped to dosing herself and passing out the day before the 2008 election “still in my clothes and makeup.” When news outlets began reporting that a cocktail of alcohol, Valium, and Xanax might have caused Whitney Houston’s death, it felt oddly inevitable. Coke binges are for fizzier eras; now people overdo it trying to calm down.
Anxiety can be paralyzing and life-destroying for those who suffer it acutely. But functional anxiety, which afflicts nearly everyone I know, is a murkier thing. Not quite a disease, or even a pathology, low-grade anxiety is more like a habit. Its sufferers gather in places like New York, where relentlessness and impatience are the highest values, and in industries built on unrelenting deadlines and tightrope deals. The shrinks say that these people—urban achievers—retain a superstitious belief in the magical powers of their worry. They believe it’s the engine that keeps them going, that gives them an edge, that allows them to work weekends and at five o’clock in the morning, until at last it becomes too much. That’s where the pills come in.
“I use my anxiety to be better at what I do,” says an executive at a boutique PR firm. “A certain amount of anxiety makes me a better employee but a less happy person, and you have to constantly balance that. If I didn’t constantly fear I was about to be fired or outed as a loser, I’m afraid I might be lazy.” She takes a melt-in-your mouth .25-milligram tab of Klonopin once a week, she estimates: at bedtime, if work stress has her too revved up, or on the subway in the morning if her schedule for the day is making her sweat. Anti-anxiety drugs are the salvation of those for whom opting out of the to-do list isn’t an option.
Xanax and its siblings—Valium, Ativan, Klonopin, and other members of the family of drugs called benzodiazepines—suppress the output of neurotransmitters that interpret fear. They differ from one another in potency and duration; those that enter your brain most quickly (Valium and Xanax) can make you the most high. But all quell the racing heart, spinning thoughts, prickly scalp, and hyperventilation associated with fear’s neurotic cousin, anxiety, and all do it more or less instantly. Prescriptions for benzodiazepines have risen 17 percent since 2006 to nearly 94 million a year; generic Xanax, called alprazolam, has increased 23 percent over the same period, making it the most prescribed psycho-pharmaceutical drug and the eleventh- most prescribed overall, with 46 million prescriptions written in 2010. In their generic forms, Xanax is prescribed more than the sleeping pill Ambien, more than the antidepressant Zoloft. Only drugs for chronic conditions like high blood pressure and high cholesterol do better.
“Benzos,” says Stephen Stahl, chairman of the Neuroscience Education Institute in Carlsbad, California, and a psychiatrist who consults to drug companies, “are the greatest things since Post Toasties. They work well. They’re very cheap. Their effectiveness on anxiety is profound.”
Benzos can also be extremely addictive, and their popularity can be gauged by their illegitimate uses as well. According to the federal Substance Abuse and Mental Health Services Administration, rehab visits involving benzodiazepine use tripled between 1998 and 2008. Though benzos have come to signify the frantic overwhelmed-ness of the professional elites (they were discovered in the autopsies of both Michael Jackson and Heath Ledger), SAMHSA says the person likeliest to abuse the drugs is a white man between the ages of 18 and 34 who is addicted to another substance—alcohol, heroin, painkillers—and is unemployed. Last year, a 27-year-old man named Dominick Glowacki demanded that a Westchester CVS hand over all its Xanax while he held up the store with a BB gun. Jeffrey Chartier, the Bronx lawyer who represented Glowacki, says he’s seeing more and more cases of benzo abuse among young men who aren’t working. “Two pills and two beers make them as high as drinking the whole six-pack.”
In these anxious times, Xanax offers a lot. It dissolves your worries, whatever they are, like a special kiss from Mommy. “Often referred to as God’s gift,” reads the fifth definition of Xanax on Urban Dictionary. “You could come home with your house on fire and not even care,” reads another. “You don’t give a fuck about nothing.” So reliably relaxing are the effects of benzodiazepines that SAMHSA’s director of substance-abuse treatment, H. Westley Clark, says they’ve gained a reputation as “alcohol in a pill.” And their consumption can be equally informal. Just as friends pour wine for friends in times of crisis, so too do doctors, moved by the angst of their patients, “have sympathy and prescribe more,” says Clark. There are a lot more benzos circulating these days, and a lot more sharing.