medically reviewed

The Effects of Mixing Xanax and Alcohol

Read more on how mixing Xanax and alcohol can result in breathing becoming slow and shallow which can lead to life-threatening complications.

Xanax (a brand name for alprazolam) belongs to a class of drugs known as benzodiazepines.1,2 Xanax is approved for use in treating anxiety disorders, including generalized anxiety disorder, anxiety with depression, as well as panic disorder, with or without agoraphobia.1, 2 Xanax is a central nervous system, or CNS depressant and works to increase the inhibitory signaling of a neurotransmitter called GABA for the short-term relief of symptoms of anxiety.2, 3, 4

A survey conducted in 2018 showed that, among Americans:

  • More than 30.7 million people aged 12 or older used benzodiazepines in the last year.5
  • More than 5.4 million people aged 12 or older misused benzodiazepines in the last year.5
  • Nearly 17.7 million people aged 12 or older used Xanax in the last year.5
  • 1 million people aged 12 or older misused Xanax in the last year.

Alprazolam is one of the most commonly prescribed benzodiazepines for the management of anxiety; in the U.S., it is the most commonly prescribed psychotropic medication.6 It accounted for more than 48 million prescriptions dispensed in 2013 even though many prescribers recognize its pronounced potential for misuse.6

Along with diazepam, alprazolam is one of the most frequently diverted benzodiazepines encountered on the illicit market. 7 In the last decade, it has also been one of the most-common benzodiazepines involved in drug-related emergency department visits.6 Commonly abused for its pleasantly sedating effects, many people who misuse Xanax continue doing so as a result of the reinforcing dopamine activity associated with its use.18

If you’re concerned that you or a loved one might be misusing Xanax and alcohol, you’re right to worry. Please don’t hesitate to take the first step today and call us for a confidential conversation at 1-888-685-5770 .

Side Effects of Xanax

Even when taken as prescribed for therapeutic purposes, Xanax is associated with some side effects. Potential side effects include: 2

  • Sleepiness.
  • Difficulty concentrating.
  • Decreased coordination.
  • Headaches.
  • Dizziness.
  • Light-headedness.
  • Fatigue.
  • Irritability.
  • Joint pain.
  • Dry mouth.
  • Constipation.
  • Changes in sex drive.

If you or a loved one are taking Xanax in larger amounts or more frequently than prescribed, aren’t under the care of a doctor, or combine it with other substances or medications, side effects could be more significant. More serious side effects can include:2

  • Impaired memory.
  • Marked drowsiness.
  • Severely impaired coordination.
  • Confusion.
  • Trouble speaking.
  • Fainting.
  • Loss of consciousness.
  • Respiratory depression / shortness of breath.
  • Depression.
  • Hallucinations.
  • Seizures.
  • Suicidal thoughts.

Some side effects, especially in the context of concurrent alcohol or other substance use, can be significant. Seek immediate medical attention for anyone exhibiting severe symptoms such as seizures or difficulty breathing.

Free and low-cost alcoholism treatment is available.

Long-Term Effects of Xanax Abuse

In addition to its notoriously high abuse liability, relative to some other benzodiazepines, Xanax is associated with more severe withdrawal symptoms developing after a shorter period of use.6 Beyond an increased risk of significant dependence and the likelihood of a troublesome withdrawal syndrome, there are several other potential long-term effects to consider in cases of chronic use. Such effects include:8 

Physical: Cumulative risks of trauma from falls or accidents in association with altered level of consciousness, decreased motor skills, and incoordination. Increased risk of significant physiological dependence and associated withdrawal, which can include symptoms of anxiety, agitation, insomnia, muscle cramps, sensory distortion, nausea, vomiting, hallucinations, tremors, and seizures. 

Mental: Depression, problems with memory, increased risk of suicidality, hallucinations, over-reliance on Xanax to get through the day, difficulty focusing on tasks, trouble with visual and spatial abilities, loss of self-confidence. Increased risk of developing patterns of polysubstance use (e.g., drinking while taking Xanax) to augment the desired effects of the drug.

Legal/Financial: Buying illicit Xanax can be expensive and place you at risk of legal ramifications. Visiting more than one doctor for prescriptions, going to multiple pharmacies, buying Xanax from other people, stealing medication, and driving under the influence can result in arrest and incarceration. Driving while on Xanax increases the risk of car accidents. 

Vocational/educational: Reduced ability to focus on tasks can cause people to be less productive.

Social: Addiction can increase feelings of isolation, and may strain relationships with family and friends. 

Signs and Symptoms of Xanax Addiction

According to the American Society of Addiction Medicine (ASAM), addiction is a treatable yet chronic disease involving the use of drugs and/or alcohol that or becomes compulsive and often continued despite negative or harmful consequences.9

Individuals diagnosed with a substance use disorder (SUD) involving Xanax (i.e., a sedative, hypnotic, or anxiolytic use disorder)  must meet at least two of the below criteria within the same 12-month period:10

  • Experiencing difficulties in functioning at work, school, or home because of use.
  • Having strong cravings or urges for Xanax.
  • Persistently wanting to take less or being unable to control use.
  • Quitting or cutting back on hobbies, socializing, or important work activities because of use.
  • Spending a lot of time getting, using, or recovering from Xanax.
  • Using after it has caused or worsened problems in relationships with others.
  • Using after knowing that it has caused or worsened a chronic physical or psychiatric issue.
  • Using for a longer time or in a larger amount than planned.
  • Ongoing use in settings where it is dangerous, like while driving.
  • Developing tolerance, meaning that a larger amount is needed to achieve the desired effect, or there is less of an effect if the same amount is used.
  • Experiencing withdrawal symptoms if you stop or cut back or needing to continue taking the drug to prevent the onset of such symptoms.

What Are The Dangers of Mixing Xanax and Alcohol?

Xanax and alcohol both depress certain central nervous system functions, such as breathing; using them together can increase the risk of severe side effects and a potentially fatal overdose.3, 8 Combining these substances can increase the likelihood of certain symptoms such as dizziness, excessive drowsiness, difficulty concentrating, reduced motor control, falls and other injuries, erratic behavior, memory impairment, trouble breathing, respiratory arrest, and even death.2, 11, 7, 12 

Alcohol overdoses may occur when areas of the brain controlling basic life-support functions—such as heart rate, breathing, and temperature control—become overwhelmed with the amount of alcohol in the bloodstream and begin to shut down.13 Adding Xanax, another CNS depressant, to the mix further increases the risk of such an overdose.13

Read More Effects From Mixing Alcohol:

How to Safely Detox from Xanax and Alcohol

The symptoms of alcohol withdrawal can range in intensity. Severe withdrawal symptoms can quickly become life-threatening for individuals who’ve developed a significant level of physical dependence and, for this reason, alcohol detox efforts commonly involve close medical supervision.14 Such symptoms can include anxiety, agitation, insomnia, increased body temperature, elevated heart rate, increased blood pressure, increased sensitivity to light and sound, delirium, hallucinations, delusions, tremors, and seizures.14

Withdrawal from Xanax shares many of the same symptoms as that of alcohol withdrawal, and may similarly benefit from close monitoring.3, 14 Xanax withdrawal may include anxiety, confusion, elevated heart rate and blood pressure, distorted sensory perception, hallucinations, delirium, and seizures.1, 3, 10, 14

mixing xanax and alcohol

Since both Xanax and alcohol withdrawal carry many of the same risks and are managed similarly, detox commonly takes place in a medical setting, which facilitates round-the-clock monitoring of symptom progression as well as the administration of pharmacologic or other medical interventions when necessary to keep people safe and comfortable.14 Tapered doses of benzodiazepine sedatives (e.g., chlordiazepoxide) or, in rarer cases, anticonvulsant medications may be utilized to help you detox safely by minimizing the risk of seizures, agitation, delirium, etc.14,15

Medical detox is often the starting point on the road to recovery from addiction. It is a process that combines medical supervision and medication to keep you as safe and comfortable as possible while dealing with the symptoms of withdrawal.16

How to Get Help For Xanax and Alcohol Addiction

Medical detox is only the first element of a more comprehensive course of addiction treatment. Once withdrawal has been successfully managed, rehab is the next phase of your recovery journey.17 Treatment may be provided in a variety of settings which include individual and group therapy sessions designed to help participants maintain sobriety, improve relationships with family and friends, learn vocational skills and manage legal issues if applicable.17 Certain medications (e.g., naltrexone, acamprosate, disulfiram) may be used to discourage continued drinking behavior, while others may be started or continued to manage any underlying anxiety or other mental health issues as needed.17

There are two main types of rehab settings, inpatient and outpatient. Inpatient or residential treatment involves a stay at a facility for the duration of treatment, where a treatment team is able to provide supervision and support throughout the day.17 Along with focusing on recovery from addiction, some facilities may treat co-occurring mental health disorders as a part of a comprehensive treatment plan.17

In certain instances, such as when the magnitude of physical dependence and subsequent risk of withdrawal is relatively low, as well as when personal support systems are strong, outpatient detox and, later rehabilitation efforts may be a good fit for someone in recovery. Outpatient programs often provide similar types of programming as inpatient facilities but may be relatively less time-intensive. Individuals are able to return home or to other living situations outside of treatment hours. Individual and group therapy is still provided along with mental health treatment, and participation in self-help is encouraged.17

Ready to Seek Help For Xanax and Alcohol Addiction?

Recovering from Xanax and alcohol addiction can be challenging. However, with the proper care and support, you can safely manage your withdrawal from these substances at the start of long-term recovery. If you are finding yourself overwhelmed with where and how to begin your recovery, call us 24/7 to discuss your treatment options. We understand that the effects of mixing Xanax and alcohol have impacted your life, but we’re here to help and want to see you get back to living a happier and healthier life of sobriety.

Complete the free and confidential form below to see if your insurance may cover substance use disorder treatment.

Sources:

[1]. National Alliance on Mental Illness. (2019). Alprazolam (Xanax).

[2]. MedlinePlus. (2019). Alprazolam.

[3]. Food and Drug Administration. (2016). Xanax.

[4]. Griffin, C.E. 3rd, Kaye, A.M., Bueno, F.R., & Kaye, A.D. (2013). Benzodiazepine pharmacology and central nervous system-mediated effects. The Oschner Journal, 13(2), 214-223.

[5]. Substance Abuse and Mental Health Services Administration. (2019). Results from the 2018 national survey on drug use and health: Detailed tables.

[6]. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of addiction medicine12(1), 4–10.

[7]. Drug Enforcement Administration. (2017). Drugs of abuse: A DEA resource guide.

[8]. Longo, L.P. & Johnson, B. (2000). Addiction: Part I. Benzodiazepines — Side effects, abuse risk and alternatives. American Family Physician, 61(7), 2121-2128.

[9]. American Society of Addiction Medicine. (2019). Definition of Addiction.

[10]. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Arlington, VA: American Psychiatric Publishing.

[11]. National Institute of Alcohol Abuse and Alcoholism. (2014). Harmful interactions.

[12]. University of Michigan. (2020). The effects of combining alcohol with other drugs.

[13]. National Institute on Alcohol Abuse and Alcoholism. (2019). Understanding the Dangers of Alcohol Overdose.

[14]. Center for Substance Abuse Treatment. (2015). Detoxification and substance abuse treatment. Treatment Improvement Protocol (TIP) Series, No. 45. HHS Publication No. (SMA) 15-4131. Rockville, MD: Center for Substance Abuse Treatment.

[15]. Kaltimani, S., & Bharadwaj, B. (2013). Clinical management of alcohol withdrawal: A systematic review. Industrial Psychiatry Journal, 22(2), 100-108.

[16]. National Institute on Drug Abuse. (2016). 8: Medical Detoxification.

[17]. National Institute on Drug Abuse. (2018). Principles of drug addiction treatment: A research-based guide (3rd edition).

[18]. National Institute on Drug Abuse. (2012). Well-Known Mechanism Underlies Benzodiazepines’ Addictive Properties.