What Can Happen if You Mix Benzodiazepines & Narcotics?

Several Prescription Drugs Spilled From Fallen Bottle Near Glass of Alcohol

Prescription medications can have profound effects on the body and brain. They also have the potential to cause side effects. When these medications are combined with one another, these side effects can be magnified and lead to potential health risks. The stronger the medications, the stronger and more dangerous some of these effects can be.

Two kinds of highly powerful medications are narcotics (also known as opioids) and benzodiazepines. Both of these types of medications are central nervous system depressants. While their specific actions on the body and brain are different, they have similar effects that can be multiplied when combined and result in risks to mental and physical health and even to the user’s life.

Physical Effects of Benzodiazepines

Medical News Today describes benzodiazepines as medications used to treat numerous mental and physical conditions, including:

  • Anxiety
  • Panic disorders
  • Sleep disorders
  • Seizure disorders
  • Restless leg syndrome
  • Alcohol dependence

The drugs help with these conditions because they affect the brain’s production and use of a neurotransmitter called gamma-aminobutyric acid, or GABA, which has a tranquilizing effect on the brain and body; in fact, benzos are often also referred to as tranquilizers. By slowing down messages coming from the brain, these drugs can create a sense of calmness and relaxation in the individual that prevents the symptoms of the above conditions. Some of the types of benzos include:

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Physical Effects of Narcotics

On the other hand, narcotics are medicines based on extracts from the opium poppy, which have the ability to block the pain response in the body. As described by the National Institute on Drug Abuse, these medications can be derived from these extracts, or they can be partly or fully synthetic, meaning that the medicines are human-made in a laboratory without opium extracts at all.

These medications, like benzos, react with neurotransmitter receptors in the brain to slow messages. However, the opioid receptors narcotics interact with are different from the GABA system in the brain. As a result, opioids produce their pain-reducing and calming effects in a different way. Still, some of the physical side effects are the same, as discussed further below.

Some of the best-known opioid medications include:

  • Morphine
  • Codeine
  • Oxycodone (OxyContin)
  • Hydrocodone (Vicodin)
  • Fentanyl

Even alone, opioid medications can cause severe physical and mental symptoms that, if the person overdoses, can lead to death or at least to long-term or permanent mental or physical damage. While overdose is much less likely with benzos, there is still a risk. On top of that, mixing either of these medications with each other and other substances can lead to severe health and life risks.

Using Benzos and Narcotics Together

Sometimes, people with multiple prescriptions may not be aware of how the drugs interact with one another. In this case, they may be taking either narcotics or benzodiazepines and end up with a prescription for the other from another doctor. This can lead to the person accidentally overdosing because of a lack of awareness of the consequences.

In other cases, individuals might try using benzos and opioids together to get high. Both drugs create a powerful euphoric effect, and some individuals attempt to enhance that effect by combining the two drugs; sometimes, alcohol is also used with one or both drugs. Whether the person uses the substances together by mistake or on purpose, there are some major health risks that can result due to the effects of combining narcotics and benzos.

Combined Effects

Because narcotics and benzodiazepines are both central nervous system depressants, they have some similar physical effects on the body even though their specific action in the brain is different. As described in an article from Drug and Alcohol Dependency, some of the side effects common to both drug types include:

  • Suppressed breathing
  • Heart arrhythmia
  • Organ damage
  • Anoxia
  • Addiction
  • Depressed cognition
  • Coma
  • Death
  • Decreased oxygen to the brain (hypoxia)

This is even true of the combinations of benzos and the mild, supposedly nonaddictive forms of opioid medications used to treat opioid addiction, such as buprenorphine and methadone.

Immediate Risks and Long-term Effects

Render illustration of Neurological Damage title on medical documents

The biggest immediate risk to using benzos and opioids together is the risk of coma or death. In fact, a study from Pain Medicine indicates that death risk among individuals who use both benzodiazepines and narcotics is 10 times higher than for those who use narcotics alone.

Even if the individual does not experience overdose death, there can be severe damage to the body or brain. For example, hypoxia can result in some forms of brain damage or dementia that are unable to be cured or reversed. Another potential result of using or abusing both opioids and benzos on a long-term basis is addiction, a chronic brain disease that requires comprehensive treatment and a lifelong commitment to recovery to avoid relapse.

But Aren’t Prescription Safe?

There is a misperception that getting a drug through a prescription means that the drug is completely safe and can’t hurt a person, as explained by the Substance Abuse and Mental Health Services Administration; however, this is false. Even legitimate use of some medications can be risky, and narcotics and benzos are powerful examples of this.

An article from the Postgraduate Medical Journal states that the risks of using prescription opioids can even occur if a person is following the prescription instructions accurately. Part of the risk can come from drug-drug or drug-alcohol interactions, like using opioids and benzos together. This is because using these drugs together or with other substances can amplify the negative side effects, making overdose more likely. These substances don’t have to be other medications or illegal drugs. Sometimes, everyday substances can combine with narcotics or benzodiazepines to raise these risks even higher.

Adding Alcohol to the Equation

As mentioned, another substance that can be dangerous in combination with narcotics or benzos is alcohol. Drinking alcohol can have a sedative effect on the body similar to that produced by benzos and opioids, leading to further, quicker suppression of breathing and heart rate. Even consumption of moderate amounts of alcohol combined with the powerful effects of opioids and benzodiazepines can lead to a person experiencing overdose, coma, and death. For this reason, alcohol should always be avoided when taking either narcotics or benzos.

The Postgraduate Medical Journal article explains that a person who uses any combination of narcotics, benzos, and alcohol is much more likely to experience complications and potential overdose. Because of this, it is important for doctors or pharmacists to emphasize the risks and to be aware of all medicines the individual is using to avoid these potential interactions. The challenge arises if any individual is dealing with dependence on or addiction to any of the substances. This can create complications if the person hides information about use of any substance that may have a negative interaction with the prescribed medications.


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Getting Help

When a person is dealing with chronic conditions that require prescription medications, it is always important to be honest with the prescribing doctor to avoid the potential for dangerous drug interactions like those described above. For this reason, a person who is dealing with addiction to alcohol, benzos, or opioids and who is prescribed other substances is at high risk if the addiction is not treated and complicating medications are prescribed.

There is help for people struggling with addiction to drugs or alcohol. A reputable, research-based treatment program can provide treatments, therapies, and resources that help individuals understand the risks and challenges of addiction, the need for continual treatment, and the importance of staying motivated and committed to long-term recovery.

About The Contributor
Editorial Staff
Editorial Staff, American Addiction Centers
The editorial staff of Sunrise House is comprised of addiction content experts from American Addiction Centers. Our editors and medical reviewers have over a decade of cumulative experience in medical content editing and have reviewed thousands... Read More