What Are the Dangers of Mixing Xanax and Alcohol?

Alcohol and medicine. Drink, pills and bottle

Prescription medications like Xanax are important treatment options for many people who struggle with anxiety, panic attacks, and insomnia. Xanax is a short-acting benzodiazepine that is prescribed typically for as-needed treatment—to immediately provide calm, stop a panic attack, or help the person relax so they can sleep. In the rare instances when Xanax, or the generic version alprazolam, is prescribed for daily use, physicians typically do not prescribe it for longer than two weeks. The body will quickly develop a tolerance to this substance.

However, Xanax is only a Schedule IV drug, according to the Drug Enforcement Administration. This means that it is widely prescribed, and refills are easier to obtain. It is not believed to be as concerning as prescription painkillers or stimulants.

Because there is less concern about Xanax, the potential for misusing this drug is fairly high. There are warnings on Xanax’s labels not to drink and take the drug at the same time, but the drug’s half-life can mean that there are traces of the substance in the body that can interact with alcohol hours after a dose has been taken.

Unfortunately, many people mix Xanax with alcohol because they do not think the two drugs together can be harmful. This belief is unfounded. Both substances are sedatives that act on the same receptors in the brain, so when combined, these substances enhance each other’s effects, which can lead to poisoning or overdose very quickly.

What Happens When Alcohol and Xanax Are Combined?

Both Xanax and alcohol are sedative drugs, which act on receptors in the brain that manage gamma-aminobutyric acid (GABA). This neurotransmitter slows the speed at which neurons communicate with each other, allowing a sense of calm and relaxation to take hold. Substances like alprazolam and alcohol can bind to the GABA receptors in the brain instead of the GABA neurotransmitter. This causes the relaxed high associated with being drunk or taking a benzodiazepine.

Combining Xanax and alcohol makes these sedative effects more potent because the combination essentially doubles the amount of chemicals binding to the GABA receptors. This can be very dangerous, and it can cause an overdose or long-term health problems. According to the Food and Drug Administration (FDA), Xanax has a half-life of about 11.2 hours, so metabolites of the medication can remain in the body for almost a full day. Drinking while Xanax is still in the body can increase alcohol’s effects, which can cause faster intoxication, greater mental impairment, and a heightened lack of physical coordination.

Because both alcohol and Xanax act on the same area of the brain, they can have similar mental and physical side effects. Understanding how these overlap can help one understand why combining these substances is risky. It is also likely that the combination of drugs releases more dopamine than either substance alone, so this increases the risk of addiction to both Xanax and alcohol at the same time

Physical Effects of Both Substances

There are a few physical effects associated with alprazolam. Short-term physical side effects from Xanax include:

  • Sleepiness or drowsiness
  • Dizziness
  • Headaches
  • Dry mouth
  • Nausea
  • Stomach cramps
  • Constipation
  • Changes in appetite and weight
  • Impaired coordination as though drunk
  • Slurred speech

Alcohol has similar physical effects to Xanax, including:

  • Slurred speech
  • Loss of motor control, especially stumbling
  • Slowed reflexes
  • Stomach problems or discomfort
  • Nausea or vomiting
  • Changes to vision, including blurry or double vision
  • High blood pressure
  • Changes to blood sugar
  • Breathing rate changes

Mental Effects of Both Alcohol and Xanax

Xanax was designed to impact mental state, creating calm during a panic attack or episode of intense anxiety. However, there are some common mental side effects, including:

  • Paradoxical insomnia
  • Memory difficulty
  • Irritability or restlessness
  • Talkativeness
  • Trouble concentrating

Like Xanax, alcohol has a deep impact on the brain. Short-term effects can include:

  • Mood changes, mood fluctuations, and irritability
  • Greater sociability and, lower inhibitions
  • Difficulty thinking or solving problems
  • Memory loss or blacking out

Drug Overdose or Alcohol Poisoning?

Taking Xanax with alcohol increases the potency of both sedatives, which means that even smaller doses of these drugs together can lead to poisoning. Signs of alcohol poisoning include:

  • Extreme confusion
  • Vomiting
  • Forgetfulness
  • Slow or irregular breathing
  • Skin that is cold, clammy, or tinted blue from oxygen loss
  • Low body temperature, or hypothermia
  • Passing out
  • Seizures

Signs of a Xanax overdose include:

  • Muscle spasms or twitching
  • Poor coordination
  • Extreme confusion
  • Slow reflexes
  • Rapid heartbeat
  • Hallucinations
  • Chest pain
  • Abnormal heart rate
  • Slow or depressed breathing
  • Seizures

If someone exhibits any of these signs of 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

When either Xanax or alcohol is abused on a long-term basis, they can cause damage to the brain. Drinking too much for a long time is also associated with a lot of physical harm. Chronic health damage may happen faster when alcohol is combined with Xanax.

Effects of long-term alcohol abuse include:

  • Chronic high blood pressure
  • Heart arrythmias, high risk of heart attack, and cardiomyopathy
  • Other forms of heart disease
  • Liver damage, failure, and cancer
  • Cirrhosis, jaundice, and alcoholic hepatitis
  • Increased risk of cancers in the mouth, esophagus, colon, or breast
  • Hormonal changes
  • Weight gain leading to joint pain, diabetes, or other diseases associated with being overweight
  • Depression and/or anxiety
  • Chronic insomnia
  • Permanent damage to learning or cognition
  • Permanent memory loss

Long-term effects of abusing Xanax include a higher risk of mood disorders like depression or anxiety, memory loss, cognitive problems, and brain damage. Sedative effects on breathing and heart rate can also cause lasting damage, though not at the same level as alcohol.

When these two drugs are combined, the risk of long-term harm is increased.

Get Help to Quit Abusing Multiple Substances

Male smiling physician speaking with female patient

Many people accidentally mix alcohol with Xanax because they do not think about the potential 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. In other instances, people mix these drugs on purpose as an attempt at suicide.

Combining these drugs is very dangerous. Follow the prescribing physician’s orders, do not mix any prescription medication with alcohol, and do not intentionally mix intoxicating substances to create different effects. If you are worried about how much you drink or your reliance on Xanax, contact an addiction specialist at a rehabilitation program now for help.

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