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Dangers of Mixing Xanax (Alprazolam) and Alcohol

Written by:
Dr. Linda May
DO
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Their inclusion does not guarantee they will be prescribed to any individual, as treatment decisions are ultimately at the discretion of healthcare providers. Healthcare providers may prescribe other medications or recommend non-pharmacological treatment based on the patient’s unique health circumstances and needs. Read more

Xanax has a boxed warning [1*] , the most serious type of warning from the Food and Drug Administration (FDA). Xanax’s active ingredient alprazolam has a risk of abuse, misuse, and addiction; concomitant use of Xanax and opioids can be life-threatening. Xanax is also a controlled substance, indicating its high potential for misuse or dependence. Specific federal and state laws limit the amount of this medication that can be prescribed or dispensed within a certain period of time.

Highlights

  • Mixing Xanax and alcohol can slow the brain’s activity down so much that it increases the risk of serious side effects, including respiratory depression, blackouts, and fatal overdose.
  • Combining these substances can result in long-term liver damage, impaired memory, and potential addiction.
  • Signs of alprazolam and alcohol abuse include extreme drowsiness, memory lapses, and mood changes.
  • Withdrawal from Xanax or alcohol alone is challenging, but withdrawing from both can be life-threatening and requires medical supervision.

Figures show that the number of alprazolam prescriptions exceeds 15 million in the United States [2*] (as of 2021), and over 60% of adults admit to drinking alcohol on a regular basis. Excessive use of either substance is harmful, but when taken together, the consequences can be severe as the sedative effects of Xanax and alcohol are significantly amplified.

In the United States in 2010, alcohol was involved in 27.2% of benzodiazepine-related visits [3*] to the emergency department and over a fifth of benzodiazepine-related deaths. Read on to learn the details of this interaction and how to avoid such adverse effects.

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The Mechanism of Action of Xanax

Xanax is the brand name for alprazolam, a benzodiazepine that is primarily used in the management of anxiety. But how does it work? Xanax is a sedative and acts as a central nervous system depressant, enhancing a vital neurotransmitter, known as GABA. GABA is one of the main inhibitory transmitters that helps to slow down brain activity, promoting a sense of calmness. This also results in the sedative properties for which alprazolam and other benzodiazepines are prescribed, including muscle relaxation, a reduction in brain activity, and sleep regulation.

Side Effects of Xanax

Some of the common side effects of Xanax are the following:

  • Drowsiness
  • Light-headedness
  • Dry mouth
  • Low blood pressure
  • Increased salivation
  • Skin allergy

Usually, mild to moderate side effects do not require medical attention, but it’s necessary to see a doctor if you notice a severe allergic reaction, changes in memory and speech, severe drowsiness or unsteadiness, and other disturbing symptoms.

The Mechanism of Action of Alcohol

Alcohol also exerts a depressive effect on the central nervous system, enhancing the effects of GABA and slowing down the brain’s activity. The main issue with alcohol is that it is often consumed in a social setting, which contributes to more frequent use as one wouldn’t drink that much alone.

Additionally, frequent use of alcohol can, in some cases, lead to binge drinking. The CDC reports that approximately 17% of adults binge drink [4*] , and when under the influence of alcohol, people can make impulsive decisions, including mixing alcohol and Xanax.

“It's important to remember that benzodiazepines, like alprazolam, and alcohol both work in the same area of the brain. So taking them together can lead to serious consequences and is, quite frankly, dangerous. A lot of patients are unaware of this so it's important to discuss this with your healthcare provider and be honest about your alcohol consumption.”
Dr. Michael Chichak, MD
Medical provider at MEDvidi

Side Effects of Alcohol

Some of the common side effects of alcohol consumption are listed below:

  • Poor vision
  • Headaches
  • Inability to concentrate
  • Reduced reaction times
  • Impaired coordination
  • Nausea
  • Anxiety
  • Insomnia

The Danger of Mixing Xanax and Alcohol

As was mentioned above, almost one-third of benzodiazepine-related visits to the emergency department result from mixing these medications with alcohol. Xanax is a sedative, so mixing it with alcohol can intensify the effect of the other on the body. This can cause severe, even fatal, consequences. Below is a list of some of these more serious outcomes:

  • Respiratory depression. Both substances work by increasing the amount of GABA in the brain, slowing down many vital functions. So, mixing them can cause your brain to slow down to the point where it forgets to tell your body to breathe, and this can be fatal. This is known as respiratory depression, a condition that causes low oxygen levels, unconsciousness, and in extreme cases, death.
  • Impaired memory and cognitive function often occur after mixing Xanax and alcohol. As both of them slow down the brain’s activity, they can alter one’s ability to process information, form memories, and make decisions. This can also result in blackouts.
  • Risk of overdose. Symptoms of Xanax overdose can include but are not limited to extreme drowsiness, confusion, impaired reflexes, and loss of consciousness. Without immediate medical treatment, a Xanax and alcohol overdose can be fatal. Benzodiazepines were involved in 16.8% of overdose deaths [5*] in the United States between January 2019 and June 2020.
  • Liver damage. The liver processes all medications and other substances we consume. However, when consumed together, alprazolam and alcohol put extra strain on this organ. Chronic use of alcohol alone can lead to substantial damage to the liver, and when combined with alprazolam, the risk is even higher. The liver may also struggle to metabolize both substances at the same time, leading to toxicity and long-term damage, such as liver cirrhosis and liver failure [6*] .
  • Addiction and dependence. Xanax is a highly addictive substance, and addiction can take effect in as little as three to four weeks. When combined with alcohol, the risk of developing an addiction to either or both substances (known as polysubstance abuse disorder) increases.
Consult on the pros and cons of Xanax and discuss the most important instructions with a medical expert online.

Signs That Someone Is Mixing Xanax and Alcohol

When someone is combining Xanax and alcohol, the increased sedative effects trigger several noticeable signs and symptoms. One of the most commonly observed signs is extreme drowsiness and tiredness, resulting from the increased action of GABA. Also, this combination can impair the brain’s ability to coordinate muscle movements and speech. Memory lapses or blackouts, where individuals cannot recall events that happened after they had taken the mix, and mood changes, such as sudden emotional shifts or increased irritability, may also occur.

If you notice any of these signs and suspect that someone is mixing Xanax and alcohol, it’s important to seek help. Contact your local healthcare professional, or reach out to the many organizations focusing on medication and alcohol addiction treatment.

Xanax Use Versus Misuse

It can be challenging to spot when someone is abusing Xanax as it has many real-world medical uses. A Xanax prescription can only be administered by a medical professional, in-person or online, and if one is prescribed Xanax, they should follow the received instructions. Normal use of Xanax means that the person is taking the medication as it has been prescribed and for a valid medical diagnosis. Misuse, on the other hand, can take on several different forms, including:

  1. Taking alprazolam in a way that differs from how it is prescribed
  2. Taking a higher dose of the medication than what is prescribed
  3. Taking this medication without a proper benzodiazepine prescription
  4. Using alprazolam with other substances, such as alcohol
“It's so important for providers to take the time to discuss with their patients the potential interactions Xanax has when it is combined with any medications, from Tylenol to opioids and alcohol. By making patients aware, many serious side effects can be avoided!”
Dr. Linda May
Dr. Linda May, DO
Medical provider at MEDvidi

Can I Drink After I’ve Stopped Taking Xanax?

Alcohol consumption is harmful to health regardless of the amount even when you are not taking any medications. It is also important to be cautious when consuming alcohol once you have stopped taking Xanax as the medication can linger in your system for some time. Typically, Xanax will stay in your system for around 2.5 days, but this depends on many different factors, such as your age and the dose you were taking. If you have any questions about drinking alcohol after you have stopped taking alprazolam, speak to a healthcare professional.

Xanax Withdrawal

Xanax withdrawal can be a challenging process, particularly if it has been taken for a long time or at a high prescribed dose. The symptoms of Xanax withdrawal [7*] can range from mild to severe and may include anxiety, insomnia, irritability, sweating, and, in more serious cases, seizures. The risk of experiencing serious withdrawal symptoms is increased for those who have been abusing Xanax or combining it with alcohol. Remember to discuss the tapering schedule with your healthcare provider instead of stopping the medication abruptly if you experience severe withdrawal.

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Alcohol Withdrawal

Alcohol withdrawal [8*] is a complex and potentially life-threatening process. Symptoms can include tremors, anxiety, nausea, vomiting, and seizures. These symptoms and their severity are exacerbated if alcohol withdrawal occurs alongside alprazolam withdrawal.

Dangers of Mixing Alcohol With Other Benzodiazepines

Mixing alcohol with other benzodiazepines, such as Valium, Ativan, or Klonopin can cause serious health implications. As with Xanax, when other benzodiazepines are combined with alcohol, their effects can be amplified to a dangerous level, leading to the symptoms and serious side effects we have already discussed.

Final Thoughts

Mixing Xanax and alcohol is far more dangerous than many people realize; their combined effects can have serious consequences. Recognizing the signs of misuse and understanding the severe risks involved is important to protect your health and identify those at risk around you.

Sources

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8 sources
  1. ALPRAZOLAM tablet
    Source link
  2. Number of alprazolam prescriptions in the U.S. from 2004 to 2021
    Source link
  3. Benzodiazepine and Unhealthy Alcohol Use Among Adult Outpatients
    Source link
  4. Data on Excessive Alcohol Use
    Source link
  5. Trends in Nonfatal and Fatal Overdoses Involving Benzodiazepines - 38 States and the District of Columbia, 2019-2020
    Source link
  6. Alcoholic Liver Disease
    Source link
  7. The benzodiazepine withdrawal syndrome
    Source link
  8. Alcohol Withdrawal Syndrome
    Source link
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Written by:
Dr. Linda May
DO
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