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OxyContin vs. Xanax | Comparing Opioids & Abuse Potential

Peter Manza, PhD profile image
Reviewed By Peter Manza, PhD • Updated Sep 25, 2023 • 9 cited sources

OxyContin and Xanax are distinctly different prescription medications with unique functions. 

OxyContin, an opioid pain reliever, is typically prescribed to alleviate moderate to severe discomfort related to chronic pain conditions, post-surgery recovery or terminal illnesses. 

Xanax is a benzodiazepine medication commonly prescribed to treat anxiety and panic disorders. Xanax works by increasing levels of gamma aminobutyric acid (GABA) in the brain to produce relaxing effects that calm and sedate users.

Both OxyContin and Xanax have a high potential for misuse, leading to an opioid use disorder in the case of OxyContin or a benzodiazepine use disorder in the case of Xanax.

What Is OxyContin?

OxyContin is the brand name for an opioid analgesic pain reliever, oxycodone, that’s intended to provide moderate to severe pain management.[1] With the extended-release formulations available, OxyContin users may get relief for up to 12 hours per dose.[2]

OxyContin is often prescribed when other pain relievers do not provide effective and long-acting pain relief or when more intensive relief is desired. Common uses for OxyContin include the following:[1,2]

  • Management of chronic pain: OxyContin may be prescribed to those suffering from chronic pain conditions like severe backache or arthritis as well as cancer-related pain.
  • Post-surgery or injury pain management: In situations where short-term pain relief is needed after a surgery or injury, OxyContin may be prescribed. This is usually only in cases where acute pain is expected to be severe.
  • Comfort during terminal illness: Terminally ill patients, such as advanced cancer patients, may be prescribed OxyContin to enhance their quality of life, especially in situations where treatment or the disorder is defined by intense pain.

In many cases, OxyContin misuse starts with a legitimate medical prescription. But as tolerance to the opioid builds, people begin to take the drug more frequently than prescribed, take it at higher doses or combine it with use of other substances like alcohol. Any time the drug is used outside the parameters of a valid prescription, it is misuse. 

In the U.S., 3 million people have a past or current opioid use disorder (OUD).[7] Many of these people misuse OxyContin in addition to other opioids. Once they are no longer able to obtain OxyContin from their doctor, they often turn to nonmedical sources, such as friends, family members or other illegitimate sources.[8]

Like all opioids, OxyContin has incredibly high misuse potential. Dependence on the drug forms quickly with continued use, and OUD follows.

What Is Xanax?

Xanax is a prescription medication containing alprazolam, a benzodiazepine medication prescribed to treat anxiety and panic disorders.[3] By acting on neurotransmitters in the brain, the drug helps to alleviate symptoms like excessive worry, panic attacks and social anxiety.

Xanax may be prescribed for different conditions, including these:[4]

  • Anxiety disorder: Benzodiazepines like Xanax may be prescribed to manage generalized anxiety disorder (GAD), a condition characterized by excessive or unrealistic anxiety and worry in multiple life situations. 
  • Panic disorder: Anti-anxiety medications like Xanax help to treat panic disorder, an unpredictable form of anxiety defined by episodes of acute fear. 
  • Social anxiety disorder: If social anxiety is severe enough to debilitate the ability to function at work or with family, Xanax may be prescribed for acute situations.
  • Other conditions: In certain instances, Xanax may be prescribed to manage insomnia or alcohol withdrawal as well as for certain medical procedures that require relaxation.

Although Xanax can provide immediate relief of symptoms, it has very high misuse potential. Misuse of Xanax could quickly turn into a benzodiazepine use disorder. Due to these potential risks, this medication should only be prescribed short term and at the minimum effective dosage.[3]

Even with new protocols in place to limit dosing and the potential for misuse as much as possible, a recent survey found that alprazolam use increased from about 18 million prescriptions written in 2004 to almost 20 million written by 2018.[5]

Comparison of OxyContin vs. Xanax 

Use caseOpioid to provide relief from moderate to severe painBenzodiazepine to manage anxiety and panic disorders
Mechanism of actionBinds to opioid receptors, reducing pain perceptionEnhances GABA activity, producing calming effects 
Side effectsNausea, vomiting, constipation and respiratory depression Shortness of breath, severe dizziness, confusion and memory impairment 
Risk of dependenceHigh due to opioid nature, potential for OUDHigh due to benzodiazepine class, risk of benzodiazepine use disorder
Dosage formsExtended-release tablets and liquid formulationsImmediate-release and extended-release tablets
Half-lifeApproximately 3.5 to 6.5 hours Around 11.2 hours
Prescription classificationSchedule II controlled substance Schedule IV controlled substance 
Withdrawal symptomsSevere withdrawal symptoms upon cessation of use; medical supervision requiredSevere withdrawal symptoms upon cessation of use; medical supervision required
Overdose riskHigh risk due to respiratory depressionHigh risk, especially when combined with other substances
Common interactionsOther opioids, alcohol and CNS depressantsAlcohol, CNS depressants and certain medications 
Medical supervisionRequires close monitoring due to addiction riskRequires close monitoring due to addiction risk
Duration of effectsExtended pain relief (12 hours)Calming effects for a relatively short duration
Use during pregnancyCan pose risks; consult doctorGenerally not recommended during pregnancy
Use among elderlyCaution due to side effects and falls riskCaution due to increased sensitivity
Price range$0.26 per 5-mg unit$5.56 per 0.25-mg unit
Sources: [1-4,6,9]

Signs of OxyContin Addiction

Signs of OxyContin, or oxycodone, dependence vary depending on how long the person has been using the drug, if they are using other substances, and physical characteristics like gender and weight. In general, some common symptoms of OxyContin addiction (OUD) may include the following:[2,7]

  • High tolerance after prolonged use 
  • Dependence on the drug
  • Uncontrollable cravings for more of the drug
  • Neglecting commitments to use OxyContin instead
  • Social isolation
  • Doctor shopping in attempts to get multiple prescriptions
  • Risky choices
  • Abandoning hobbies
  • Mood swings
  • Physical changes, such as weight loss 
  • Secrecy

Signs of Xanax Addiction

Signs of Xanax (alprazolam) addiction can manifest in various ways, many of which overlap with signs of OUD. This can make it difficult for family members or friends to determine which drug is the primary issue if a loved one seems to be struggling. 

Some of the common symptoms of Xanax addiction include the following:[4]

  • Increased tolerance for Xanax
  • Withdrawal symptoms when without the drug after dependence has set in 
  • Obsession with getting and using Xanax
  • Loss of control over use
  • Isolation and social withdrawal
  • Doctor shopping to get multiple prescriptions
  • Continued use despite negative consequences in life
  • Neglecting responsibilities and hobbies
  • Financial issues
  • Irritability
  • Changes in sleep patterns

Finding Help Online

OxyContin and Xanax are powerful pharmaceutical medications. Each is safe when used appropriately and with medical supervision, but both also carry a high potential for misuse and adverse side effects. Dependence on either of these drugs can happen within weeks of regular use or misuse. The repercussions of misuse can be life-altering, if not life-threatening.

At Bicycle Health, we offer an effective solution for recovery from OUD through medications like Suboxone and a comprehensive accountability and treatment plan. With Medication for Addiction Treatment (MAT), opioid cravings and withdrawal symptoms are managed, so you can focus on the therapeutic work you are doing.

If you have an OUD related to OxyContin use, we can help you to stop using the drug and to start building a better life. Learn more about our MAT program and how we can help you or your loved one heal when you reach out today. 

Reviewed By Peter Manza, PhD

Peter Manza, PhD received his BA in Psychology and Biology from the University of Rochester and his PhD in Integrative Neuroscience at Stony Brook University. He is currently working as a research scientist in Washington, DC. His research focuses on the role ... Read More

  1. OxyContin Fast Facts. National Drug Intelligence Center. Accessed August 4, 2023.
  2. Questions About Oxycontin. Alabama Department of Mental Health. Accessed August 4, 2023.
  3. George TT. Alprazolam. StatPearls. Published January 2023. Accessed August 4, 2023.
  4. Xanax: Alprazolam tablets, USP. Pharmacia & Upjohn Company. Accessed August 4, 2023.,021434s006lbl.pdf
  5. Mikulic M. (2022). Number of alprazolam prescriptions in the U.S. 2004-2020. Statista. Accessed August 4, 2023.
  6. OxyContin tablets. Therapeutic Goods Administration. Published November 25, 2010. Accessed August 4, 2023.
  7. Azadfard M, Huecker MR, Leaming JM. Opioid addiction. StatPearls. Published January 2023. Accessed August 4, 2023. 
  8. Carise D, Dugosh KL, McLellan AT, Camilleri A, Woody GE, Lynch KG. Prescription OxyContin abuse among patients entering addiction treatment. Am J Psychiatry. 2007;164(11):1750-1756. doi:10.1176/appi.ajp.2007.07050252
  9. Oxycodone vs Xanax comparison. Accessed August 22, 2023. 

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