Prescription medications like Xanax are important treatment options for many people who struggle with anxiety and panic disorder.
Xanax is one of the most widely prescribed benzodiazepine sedatives.1 As a Schedule IV controlled substance, its potential for abuse and dependence is considered less pronounced than that associated with Schedule II drugs, including prescription stimulants and opioid painkillers.2 However, issues with physical dependence and addiction still arise, particularly when its used outside of how it was prescribed.
Though Xanax has helped many people manage their anxiety and panic disorders, it may also be associated with certain adverse side effects. Because of a risk of dangerously amplified side effects, there are warnings on Xanax’s labels not to drink alcohol and take the drug at the same time.3
Read on to learn more about:
- How alcohol and Xanax work when they are combined.
- The potential side effects of taking Xanax.
- What Xanax overdose or alcohol poisoning looks like.
- Getting help for polysubstance abuse.
What Happens When Alcohol and Xanax Are Combined?
Xanax (a brand name of alprazolam) is a relatively short-acting benzodiazepine that is prescribed as needed for short-term management of anxiety or panic.4 Studies into the effectiveness of Xanax have not been conducted beyond 4 months for anxiety disorder treatment and 10 weeks for panic disorder.3
Some patients who use Xanax on an open basis have reported 8 months of use without a loss of benefit for panic disorder, however some tolerance to the therapeutic effects of Xanax may develop with sustained use.3
In some cases, people may mix Xanax with alcohol because they do not think the two drugs together can be harmful. However, when combined, these substances can enhance each other’s effects, which can lead to an increase in serious side effects, including fatal overdose.3
This is because both Xanax and alcohol are both sedating central nervous system (CNS) depressant drugs, which act to increase the activity of the inhibitory neurotransmitter known as gamma-aminobutyric acid (GABA).5, 6
Because both alcohol and Xanax act to decrease certain types of neural activity throughout the brain and nervous system, the two substances may dangerously combine to result in profound sedation, severely slowed breathing, loss of consciousness, and death. Understanding how these substances overlap can help one understand why combining them can be risky.
How Long after Taking Xanax Can You Drink?
According to the Food and Drug Administration (FDA), Xanax has an average elimination half-life of about 11.2 hours,3 but the time to achieve full clearance of the drug depends on many factors, such as age and already existing medical conditions such as renal insufficiency. Even people in good health may experience different rates of clearance, resulting in variable half-lives in the range of 6 to 27 hours.
The safest way to consume alcohol would be to wait until after Xanax is completely out of your system so the two substances do not interact. Because each body is different, and metabolizes substances in a slightly different timeframe, it’s difficult to say exactly when a benzodiazepine like Xanax would be out of your system.
Note that drinking while Xanax is still in the body can intensify the combined intoxication, lead to dangerously impaired mental alertness,3 and increase the risk of injury from activities such as driving a car or operating machinery.
Potential Side Effects of Xanax
Although the drug may affect people differently, possible short-term physical side effects of Xanax include:3, 7
- Sleepiness or drowsiness.
- Dry mouth.
- Decreased blood pressure.
- Changes in appetite and weight.
- Musculoskeletal weakness.
- Slowed breathing.
- Slurred speech.
Mental Effects of Xanax
Xanax was designed to impact mental state, creating calm during a panic attack or episode of intense anxiety. However, though many are rare, there are some potential mental side effects, including:3, 7
- Changes in mood.
- Irritability or restlessness.
- Impaired concentration.
- Memory difficulty.
- Paradoxical stimulation.
- Sleep disturbances.
Xanax Overdose or Alcohol Poisoning?
The combined sedative properties of Xanax and alcohol can be dangerous, and could lead to toxicity and overdose.
Signs of a Xanax overdose include:3, 7
- Somnolence, or profound drowsiness.
- Extreme confusion.
- Poor coordination.
- Slowed reflexes.
- Slow or depressed breathing.
- Loss of consciousness.
Signs of alcohol poisoning or overdose include:8
- Extreme confusion.
- Slow or irregular breathing.
- Skin that is cold, clammy, or tinted blue from oxygen loss.
- Low body temperature, or hypothermia.
- Passing out.
If you are concerned that you or someone with you is experiencing a benzodiazepine, alcohol, or combined overdose, call 911 immediately. They need emergency medical attention, especially if both alcohol and Xanax were consumed.
Long-Term Harm from Abusing Alcohol and Xanax
Chronic use of either Xanax or alcohol can increase the risk of developing significant physiological dependence as well as the compulsive patterns of substance use common to substance use disorders, and the combination of both can increase the likelihood of polysubstance addiction over time. Over time, the development of both alcohol and Xanax dependence can result in the arrival of a significantly severe withdrawal syndrome when attempts to slow or stop use are made.
Additionally the increased potential for severe cardiac and respiratory depression posed by a combination of these two substances could increase the likelihood of oxygen deprivation and anoxic brain injury, which could result in lasting brain injury and devastating neurological consequences, if not death.9, 10
Alcohol alone is associated with the potential development of several chronic health conditions. Some of the potential effects of long-term alcohol abuse include:
- Chronic high blood pressure.
- Heart arrythmias, high risk of heart attack, and cardiomyopathy.
- Liver disease, such as alcoholic hepatitis, cirrhosis, liver failure, and cancer.
- Increased risk of cancers in the mouth, esophagus, colon, or breast.
- Hormonal changes and weakened immune system.
- Weight gain leading to joint pain, diabetes, or other diseases associated with being overweight.
- Depression and/or anxiety.
- Chronic insomnia.
- Chronic learning and memory deficits.
- Increased risk of dementia.
Get Help Quitting Multiple Substances
Some people may mix alcohol with Xanax because they are unaware of the potential health risks of the combination. Sometimes, people who abuse drugs will experiment by mixing these substances. In some cases, people who abuse one of these drugs will add the other so they can become more intoxicated.
Combining these drugs can be very dangerous. If you are worried about how much you drink or your reliance on Xanax, Sunrise House and American Addiction Centers can help. Call 973-862-4820 to talk to one of our Admissions Navigators. They’ll be able to answer your questions and help you find the right treatment you need.
- Drug Enforcement Administration—Diversion Control Division. (2019). Benzodiazepines.
- United States Drug Enforcement Administration. (n.d.). Drug scheduling.
- (2016). Xanax.
- National Alliance on Mental Illness. (2019). Alprazolam (Xanax).
- National Institute on Drug Abuse. (2018). Benzodiazepines and opioids.
- Davies, M. (2003). The role of GABAA receptors in mediating the effects of alcohol in the central nervous system. Journal of Psychiatry and Neuroscience 28(4), 263-274.
- (2017). Alprazolam.
- Mayo Clinic. (2018). Alcohol poisoning.
- National Institute on Drug Abuse. (2020). Commonly Used Drug Charts—Central Nervous System Depressants.
- Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
- Centers for Disease Control and Prevention. (2019). Alcohol use and your health.