What Happens When You Combine Alprazolam (Xanax) and Alcohol
Xanax is a brand name for alprazolam, a drug used to treat anxiety and panic disorders. Xanax is part of a class of anti-anxiety drugs called benzodiazepines.
Like alcohol, Xanax is a depressant. That means it slows down nervous system activity.
Serious side effects of Xanax include:
- memory problems
- loss of coordination
Serious side effects of drinking too much alcohol include:
- loss of consciousness
- impaired coordination
- alcohol poisoning
Xanax and alcohol can have dangerous side effects when taken together, enhancing their individual effects.
Read on to find out about side effects, overdose, and long-term effects of combining Xanax and alcohol.
Xanax and alcohol interaction
Taking Xanax with alcohol will intensify the side effects of both substances.
Researchers don’t know exactly why this happens. It likely has to do with the chemical interactions between Xanax and alcohol in the body.
A 2018 animal study suggests the presence of ethanol, the main ingredient in alcoholic drinks, can increase the maximum concentration of alprazolam in the bloodstream.
In turn, this can cause both an enhanced high or “buzz” as well as enhanced side effects. The liver also needs to work harder, since it breaks down both alcohol and Xanax in the body.
Both Xanax and alcohol have sedative effects. This means they can cause fatigue, drowsiness, or impairment. Taking either can leave you feeling sleepy.
Both substances also affect your muscles. This can make muscle control, coordination, and balance more challenging. You might stumble while walking or slur your speech.
These sedative effects increase when Xanax and alcohol are taken together.
Mood and behavioral effects
Xanax can lead to a depressed mood as well as irritability and confusion. It may also cause some people to experience suicidal thoughts, but it’s not common. Other rare side effects include:
- hostile behavior
Alcohol affects mood in a variety of ways as well. For some people, it causes a temporary mood boost, although it’s a depressant. Others may experience negative side effects, like feelings of sadness.
Alcohol also lowers inhibitions and impairs judgment. This makes it easier to do things you wouldn’t normally do.
In general, these mood changes and behavioral effects increase when Xanax and alcohol are taken together.
Xanax and alcohol are both associated with memory loss. This effect is greater when the two substances are combined.
Combining both substances increases your risk for a blackout. In other words, after taking Xanax and alcohol together, you might not remember what happened.
Physical side effects
Besides fatigue and drowsiness, the physical side effects of Xanax include:
- low blood pressure
- blurred vision
Xanax is also associated with gastrointestinal symptoms like nausea, vomiting, and diarrhea.
Drinking too much alcohol can also lead to headaches and blurred vision as well as gastrointestinal issues. Combining the two substances will increase your risk of experiencing physical side effects.
Long-term Xanax and alcohol use is associated with the development of physical and psychological dependence.
This means your body gets used to both substances and needs them to function without experiencing withdrawal side effects. Withdrawal symptoms can include anxiety, irritability, and seizures in some cases.
In the long term, taking Xanax and alcohol increases your risk for:
- changes in appetite and weight
- cognitive and memory impairments
- decreased sex drive
- liver damage or failure
- personality changes
- heart disease and stroke
- other chronic illnesses
Xanax and alcohol overdose
Combining Xanax and alcohol can result in a life-threatening overdose.
If you or someone you know is thinking about intentionally overdosing or having suicidal thoughts, call the National Suicide Prevention Lifeline at 800-273-8255 for 24/7 support.
Immediately call 911 if you believe someone is at immediate risk for suicide.
Xanax and alcohol overdose symptoms
MEDICAL EMERGENCYCall 911 immediately if someone has taken alcohol and Xanax and is exhibiting the following signs of overdose:
- impaired coordination
- impaired reflexes
- loss of consciousness
Taking high doses of either Xanax or alcohol can be fatal. When combined, these substances are more likely to cause death. Alcohol levels in Xanax- and alcohol-related fatalities tend to be lower than alcohol levels in alcohol-only fatalities.
Lethal dose of Xanax and alcohol
Xanax prescriptions for anxiety and panic disorders may range from 1 to 10 milligrams per day. Doses vary depending on the individual and form of Xanax (immediate or extended-release).
Even if you’ve been using Xanax for a while with no problems, adding alcohol can trigger unpredictable side effects.
A lethal dose depends on a lot of factors, such as:
- your body’s ability to break down (metabolize) both Xanax and alcohol
- your tolerance to either substance
- your weight
- your age
- your sex
- other health issues, such as heart, kidney, or liver conditions
- whether you took additional medication or other drugs
In short, a lethal dose for someone might not be lethal for someone else. There’s no recommended or safe dose: Taking Xanax and alcohol together is always dangerous.
Dangers of mixing alcohol with other benzodiazepines
Benzodiazepines, also known as benzos, have strong sedative effects. They can lead to dependence. Some common benzodiazepines include:
- alprazolam (Xanax)
- chlordiazepoxide (Librium)
- clonazepam (Klonopin)
- diazepam (Valium)
- lorazepam (Ativan)
The risks of mixing alcohol with the benzodiazepines listed above are comparable to the risks of mixing alcohol with Xanax.
In general, risks include:
- enhanced sedation
- mood and behavioral changes
- memory impairment
- physical side effects
This combination also increases the risk of a fatal overdose.
Other drugs, including opioids and SSRIs, can also adversely interact with benzodiazepines and alcohol.
When it’s an emergency
Call 911 or visit the emergency room right away if you or someone you know is exhibiting the signs of an overdose. Don’t wait for symptoms to get worse.
While you wait for emergency help, call the National Capital Poison Center at 800-222-1222. The person on the line can offer you additional instructions.
Seeking medical help for an addiction
If you think you or someone you know is misusing Xanax and alcohol, resources are available for help.
Speaking to a healthcare provider, like your primary physician, can help you understand your options. They can help you make decisions that reduce your risk of serious side effects.
You can find an addiction specialist through the American Society of Addiction Medicine’s Find a Doctor search feature. All you have to do is enter your ZIP code to search for doctors in your area.
You can also try searching the American Academy of Addiction Psychiatry’s Find a Specialist directory.
A healthcare provider can help you find a treatment center, but the Substance Abuse and Mental Health Services Administration (SAMHSA) also provides a list of treatment centers in your area.
Also, try calling the National Drug Helpline at 844-289-0879.
The National Institute on Drug Abuse features additional online resources for people with substance use disorders and their families.
Xanax amplifies the effects of alcohol and vice versa. It also increases the likelihood of an overdose. This combination is not safe at any dose.
If you’re currently using or considering taking Xanax, talk to a healthcare provider about your alcohol use. They can answer additional questions about how Xanax and alcohol interact.