Xanax and Alcohol

Xanax is the brand name for alprazolam. It is used to treat anxiety disorders. However, when consumed with alcohol, the combination can lead to serious side effects and symptoms.
Evidence Based
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Overview: What is Xanax? 

Xanax is the brand name for alprazolam. The medication belongs to a class of drugs known as benzodiazepines. 

Xanax treats anxiety disorders. These conditions include: 

  • Generalized anxiety disorder
  • Anxiety with depression
  • Panic disorder, with or without agoraphobia.

Xanax is a central nervous system depressant. It boosts the inhibitory signaling of a neurotransmitter known as GABA for the short-term relief of anxiety symptoms.

Nearly 17.7 million patients aged 12 or older used Xanax in 2018. Of this group, 5.1 million people misused Xanax in the same year.

Results From the 2018 National Survey on Drug Use and Health: Detailed Tables, Substance Abuse and Mental Health Services Administration (SAMHSA), 2019
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Side Effects of Xanax 

Even when taken as prescribed, Xanax can provide discomforting side effects. Potential side effects include:

  • Sleepiness
  • Difficulty concentrating 
  • Decreased coordination
  • Headaches
  • Dizziness
  • Lightheadedness
  • Fatigue
  • Agitation or irritability
  • Joint pain
  • Dry mouth
  • Constipation
  • Changes in sex drive

People who misuse or abuse Xanax (in large amounts or more often than prescribed) may experience severe side effects. If Xanax combines with other substances, prescription drugs, or medications, intense side effects can also occur.

More serious side effects include:

  • Memory loss or impairment 
  • Significant drowsiness
  • Severely impaired coordination
  • Confusion
  • Difficulty speaking 
  • Fainting
  • Loss of consciousness
  • Shortness of breath
  • Depression
  • Hallucinations
  • Seizures
  • Suicidal thoughts
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Xanax and Alcohol Interaction

Xanax and alcohol depress the central nervous system (CNS). They both have individual sets of side effects that affect a person’s behavior and mental state.

When Xanax and alcohol combine, the effects can be dangerous.

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Dangers of Mixing Xanax and Alcohol 

Mixing Xanax and alcohol can increase the risk of severe side effects. In extreme cases, the combination can lead to a fatal alcohol and Xanax overdose. 

Combing these drugs can lead to symptoms, including:

  • Dizziness
  • Significant drowsiness
  • Difficulty concentrating
  • Reduced motor control
  • Falls and other injuries
  • Erratic behavior
  • Memory loss or impairment 
  • Difficulty breathing
  • Respiratory arrest
  • Death

Benzodiazepines like Xanax, along with alcohol, significantly slow respiration when taken alone. However, when someone takes Xanax and alcohol together, the combination of both sedative drugs can lead the brain to fail to signal to the lungs to breathe.

In severe cases, breathing stops altogether. The user essentially suffocates to death.

Likewise, when used with alcohol, Xanax can also affect the neural activity or cause one’s heart to stop beating.

This risk of death occurs whenever someone takes Xanax in combination with alcohol, other sedatives, opioid prescription drugs, or illicit opiates.

As both alcohol and Xanax have unique sets of side effects that affect a person’s mental state and behavior, they should never be used together. 

Overdose Risks & Symptoms: Xanax and Alcohol 

When mixing Xanax and alcohol, some side effects can be extremely dangerous. In severe cases, an alcohol and Xanax overdose can occur.

Alcohol abuse overdoses arise when parts of the brain controlling essential life-support functions become overwhelmed with the amount of alcohol in the bloodstream. These functions then begin to shut down. 

These life-support functions include heart rate, breathing, and temperature control.

When another central nervous system depressant like Xanax is used with alcohol, the risk of overdose increases.

If someone is overdosing from alcohol and Xanax use, they made exhibit the following symptoms:

  • Significant confusion
  • Severe coordination issues or loss of balance
  • Significant drowsiness and an inability to stay awake
  • Significantly slowed breathing
  • Unresponsiveness
  • Loss of consciousness
  • Coma

An alcohol and Xanax overdose can lead to severe short and long-term effects, including:

  • Respiratory depression
  • Seizures
  • Death

If you see someone experiencing symptoms of an alcohol and Xanax overdose, seek immediate medical help.

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Alcohol & Xanax Addiction Treatment Options

If you or a loved one is addicted to alcohol and/or Xanax, it’s essential to seek treatment.

The symptoms of alcohol withdrawal can differ in intensity. Serious withdrawal symptoms can quickly become dangerous and life-threatening for some people. Because of this, alcohol detox usually involves close medical supervision.

Withdrawal symptoms of alcohol addiction can include:

  • Mental illness such as anxiety or depression
  • Agitation
  • Insomnia
  • Increased body temperature
  • Increased heart rate
  • Increased blood pressure
  • Heightened sensitivity to light and sound
  • Delirium
  • Hallucinations
  • Delusions
  • Tremors
  • Seizures

Withdrawal symptoms from Xanax share many of the same symptoms as that of alcohol withdrawal. As such, Xanax withdrawal also often requires close medical monitoring.

Withdrawal symptoms of Xanax can include:

  • Mental illness such as anxiety or depression
  • Confusion
  • Increased heart rate and blood pressure
  • Distorted sensory perception
  • Hallucinations
  • Delirium
  • Seizures

There are various treatments available for Xanax and alcohol addiction.

Medical Detox

Since both Xanax and alcohol withdrawal are managed similarly, medical detox is recommended.

Medical detox is often the first step of recovery from alcohol and Xanax addiction. The treatment usually combines medical supervision and medication. This keeps patients safe and comfortable while dealing with the symptoms of withdrawal.

Detox takes place in a medical setting. The facilities usually structure round-the-clock monitoring of withdrawal symptom progression.

Other medical interventions keep patients safe and comfortable at an inpatient medical detox.

Tapered doses of benzodiazepine sedatives, such as chlordiazepoxide and valium, may also help patients detox safely. These sedatives minimize the risks of severe withdrawal symptoms. Symptoms include seizures, agitation, and delirium. In rarer cases, anticonvulsant treatments may be used instead.

Rehab

Once withdrawal from alcohol and Xanax in an inpatient treatment center has been effective, rehabilitation is usually the next stage of recovery.

There are two primary types of rehab settings. These are inpatient and outpatient. Inpatient or residential rehabilitation involves a stay at a medical facility during the continuation of treatment.

During inpatient rehab, a medical team provides supervision and support for recovering addicts.

Whether an inpatient or outpatient rehab, patients may attend individual and group therapy sessions. These meetings help participants:

  • Maintain sobriety
  • Improve relationships with family and friends
  • Learn new skills to recover from addiction
  • Manage legal issues if necessary. 

Along with focusing on recovery from alcohol and drug addiction, some rehabilitation schemes treat co-occurring mental health disorders as part of a broader treatment plan.

Medication-assisted treatment is also effective. Specific medicines such as naltrexone, acamprosate, or disulfiram may discourage alcohol abuse. Others may manage any underlying anxiety or other mental health issues.

Counseling 

Counseling can take place during inpatient rehabilitation or as an outpatient treatment.

Individual counseling involves a patient meeting a substance abuse therapist for one-on-one sessions. Participants usually discuss recovery, mental health, and any problems met on the way to recovery.

Patients may also attend group therapy classes. These sessions are either run by a counselor or self-help groups, such as 12-step addiction programs.


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Resources

Alprazolam (Xanax), National Alliance on Mental Illness, 2019, https://www.nami.org/About-Mental-Illness/Treatments/Mental-Health-Medications/Types-of-Medication/Alprazolam-(Xanax)

Griffin, C.E. 3rd, Kaye, A.M., Bueno, F.R., & Kaye, A.D, Benzodiazepine pharmacology and central nervous system-mediated effects, The Oschner Journal, 13(2), 214-223, 2013, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3684331/pdf/i1524-5012-13-2-214.pdf

Xanax, Food and Drug Administration, 2016, https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf

Longo, L.P. & Johnson, B, Addiction: Part I. Benzodiazepines — Side effects, abuse risk and alternatives, American Family Physician, 61(7), 2121-2128, 2000, https://www.aafp.org/afp/2000/0401/p2121.html

8: Medical Detoxification, National Institute on Drug Abuse, 2016, https://www.drugabuse.gov/publications/teaching-addiction-science/brain-actions-cocaine-opioids-marijuana

Alprazolam, MedlinePlus, 2017, https://medlineplus.gov/druginfo/meds/a684001.html

Results From the 2018 National Survey on Drug Use and Health: Detailed Tables, Substance Abuse and Mental Health Services Administration (SAMHSA), 2019, https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2018R2/NSDUHDetailedTabs2018.pdf

Drugs of abuse: A DEA resource guide, Drug Enforcement Administration, 2017, https://www.dea.gov/sites/default/files/sites/getsmartaboutdrugs.com/files/publications/DoA_2017Ed_Updated_6.16.17.pdf#page=59

The effects of combining alcohol with other drugs, University of Michigan, 2020, https://uhs.umich.edu/combine

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Updated on: August 7, 2020
Author
Ellie Swain
About
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Medically Reviewed: July 18, 2020
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Annamarie Coy,
BA, CADACII/ICADC, ICPR, MATS
About
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