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Alcohol and Xanax: What Happens When They Mix?

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Alcohol and Xanax (alprazolam) are both legal substances. They are also both addictive substances. In 2020 over 60 million Americans binged on alcohol and 4.8 million Americans misused prescription benzodiazepines like Xanax.


Abusing alcohol or Xanax is dangerous and can be deadly. According to the CDC, non-fatal and fatal overdoses on benzodiazepines like Xanax increased by 24% from 2019 to 2020. Alcohol-induced overdose deaths increased by 25% during the same time period. While abusing Xanax or alcohol on its own is already dangerous, taking the two together can significantly increase those dangers. The combination also ups your risk of long-term physical and mental health problems.

Why Do People Mix Alcohol and Xanax?

People may take Xanax while they’re drinking alcohol in an effort to get “more of a good thing.” Alcohol and Xanax are both depressants. They slow down your central nervous system (CNS) by enhancing your brain’s gamma-aminobutyric acid (GABA). GABA is a neurotransmitter that helps you feel relaxed and calm by blocking certain CNS activity. GABA also helps you sleep.


Both Xanax and alcohol can make you feel calm and less inhibited. Some people may take Xanax with alcohol in hopes of intensifying these desirable effects. The problem is that this combination is always risky. Mixing alcohol and Xanax can be dangerous and even fatal.

Dangers of Mixing Xanax and Alcohol

Taking Xanax and alcohol together compounds the dangers of taking them separately. Xanax can exaggerate the effects of alcohol and vice versa. When you mix alcohol and Xanax together, you’re at increased risk for several physical and mental side effects.

Physical Side Effects of Mixing Alcohol and Xanax

  • Slowed breathing
  • Decreased heart rate
  • Poor coordination and delayed motor skills
  • Dizziness
  • Blurred vision
  • Slurred speech
  • Sleepiness
  • Overdose on Xanax and alcohol
  • Coma
  • Death

Behavioral Health Side Effects of Mixing Alcohol and Xanax

  • Memory impairment
  • Uncharacteristic behavior
  • Hostility
  • Agitation
  • Aggression
  • Anxiety


What makes mixing alcohol and Xanax especially dangerous is the risk of respiratory suppression. Since these substances slow down your central nervous system, when taken together, they may slow breathing so much that you overdose or go into cardiac arrest.


How much it takes for an alcohol or Xanax overdose depends on your physical make-up and health. There is no way to know until it happens. It can be easy to take dangerous amounts of Xanax or alcohol because of the effects they have on your memory. You may forget that you already took Xanax and take it again, or drink more than you normally would.


Your body can get overwhelmed as it tries to process alcohol and Xanax at the same time. This keeps both substances in your body longer. You may think you’re more sober than you are. Mixing Xanax and alcohol can lead to situational danger. For instance, poor coordination and delayed reactions can lead to falls or car accidents if you’re driving.

Long-Term Effects of Xanax and Alcohol Abuse

Besides the possibility of overdose and death, alcohol and Xanax abuse can have long-term consequences to your physical and mental health. Abusing both substances puts you at risk for the detrimental effects of taking either alone.


Long-term risks of alcohol and Xanax abuse include:

Addiction

Regularly abusing Xanax or alcohol can lead to a full-blown addiction. Your brain and body get used to having these substances in your system. This can cause changes in brain chemistry. Your central nervous system begins relying on them for certain functions. You develop a tolerance and dependency and experience withdrawal symptoms when you go without Xanax and alcohol.

Cognitive Issues

Both Xanax and alcohol have been shown to impair cognitive functioning. They can have a negative impact on:

  • Short- and long-term memory
  • Learning
  • Spatial recognition

Liver Problems

Most people know that alcohol can damage your liver, but long-term, heavy Xanax use can also impair liver functions. Xanax can elevate your liver enzymes, leading to liver inflammation and liver tissue damage. If you combine the two substances, liver damage can be even more severe.

Mental Health Disorders

Xanax and alcohol affect neurotransmitters responsible for:

  • Mood and behavior
  • Motivation
  • Anxiety


Over time, they can deplete chemicals that stabilize your mood and nervous system. This can lead to anxiety and depression symptoms.

Poorer Quality of Life

You cannot compartmentalize alcohol and drug addiction. Alcohol and drug abuse impact all parts of your life. Your relationships struggle. You don’t do as well at work or school. You may even run into financial or legal problems because of the choices you make while you’re under the influence of drugs and alcohol. All these consequences impact your overall well-being and happiness.

Withdrawal Symptoms of Alcohol and Xanax

If you’ve been abusing alcohol and Xanax, you’ll likely go through withdrawal when you stop using them. Even people who use Xanax as prescribed for a long period of time need to slowly taper off the drug. Withdrawal symptoms for alcohol or any type of drug affect your body and brain and depend on factors like:

  • What substance(s) you’re abusing
  • How long you’ve been abusing drugs and alcohol
  • How much drugs and alcohol you use
  • Your physical health
  • Co-occurring mental health disorders
  • Co-occurring medical conditions
  • Age


Alcohol and Xanax withdrawal is like detoxing from other depressants. You can experience alcohol withdrawal symptoms and Xanax withdrawal symptoms more intensely than just detoxing from one of the substances.


As your central nervous system adjusts to the absence of these two substances you may experience withdrawal symptoms like:

  • Erratic breathing
  • Fast or fluttering heartbeat
  • Nausea
  • Hallucinations
  • Headache
  • Restlessness
  • Tingling in extremities
  • High blood pressure
  • Chills and sweating
  • Fever
  • Vomiting
  • Delirium tremens
  • Seizures
  • Confusion
  • Loss of consciousness
  • Coma


The time it takes you to detox from alcohol and Xanax depends on individual factors and how severe your substance use is. Generally, withdrawal symptoms begin within the first day of being off alcohol. Severe withdrawal symptoms peak at two to three days into the process. Usually, the most uncomfortable symptoms of detox are over within five to seven days. But often people have lingering psychological withdrawal symptoms for weeks or months. This is called post-acute withdrawal syndrome (PAWS). It can include:

  • Insomnia
  • Low mood
  • Anxiety
  • Fatigue
  • Irritability
  • Confusion

These symptoms occur as your brain chemicals rebalance themselves. Your brain is used to depressants being in your system and helping produce certain brain chemicals. Without Xanax or alcohol, it takes time to begin producing regular amounts of these chemicals on your own. These are chemicals tied to mood, movement, memory, and motivation so these types of functions will be affected until the body repairs itself.

Do You Need Medical Detox for Alcohol and Xanax?

One of the most dangerous substances to detox from is alcohol. You should never attempt to quit alcohol cold turkey on your own. Though rare, some people have died from delirium tremens during alcohol withdrawal. Xanax withdrawal symptoms are not as severe as alcohol withdrawal, but if you’re mixing these two substances, you should always go through medically assisted detox. Detoxing from more than one substance makes the process more complex. Only a medical professional knows what protocol will be safest and most effective for your individual situation.


Alcohol and drug detox includes:

  • Physical exam and assessment to determine appropriate detox protocol
  • 24/7 medical supervision
  • Regular monitoring of your vital signs
  • Immediate attention to medical emergencies
  • Regular comfort-level checks
  • Prescription medications to ease withdrawal symptoms
  • Drug taper schedules, as clinically appropriate
  • Holistic approaches to aid symptoms, if available and clinically appropriate


Medical detox is not like the kind of detox that’s portrayed in movies, where a character detoxes alone in a bare room by themselves. You’ll have a private room or share one with another patient. You’ll have a comfortable bed, furnishings, and usually a television. Nurses will check on you regularly, and you have a call button for immediate help. There are also typically common areas you can use as you feel up to it.

How Do You Treat Alcohol and Xanax Addiction?

Medical detox is the first step in treatment for alcohol and Xanax abuse. To prevent further abuse after you eliminate these substances from your body, you need to address the reasons behind your addiction. You must also gain an understanding of alcohol and drug addiction and learn skills and practices that can prevent relapse. A professional addiction treatment program can help.


Addiction treatment centers offer inpatient rehab and outpatient rehab options. The level of care you need is based on the severity of your addiction, clinical needs, and support system. In addiction treatment you’ll explore why you abuse substances. Sometimes substance abuse with drugs and alcohol are a way to self-medicate emotional pain from:

  • Trauma
  • Co-occurring disorders like depression and anxiety
  • Dysfunctional relationship patterns
  • Grief and loss
  • Excessive stress
  • Poor self-esteem


In drug and alcohol rehab, you will begin addressing and healing from these challenges with the help of approaches like:

  • Individual therapy
  • Group therapy
  • Family therapy
  • Trauma therapies like eye movement desensitization and reprocessing (EMDR)
  • Holistic activities like yoga, fitness, mindfulness, and expressive therapies
  • Life skills training
  • Relapse prevention skill building
  • 12-step groups or alternatives to the 12 Steps, like SMART Recovery
  • Psychiatric interventions like prescription medications that complement behavioral therapies in the case of a dual diagnosis


In addiction treatment, you’ll learn a new way of life in recovery that is fulfilling and intentional. Recovery is hard work, but it’s worth it.

Concerned About Your Substance Use?

If you or a loved one is struggling with Xanax or alcohol addiction, call Footprints to Recovery today for a free, confidential consultation. We will answer all your questions about treatment and help you determine the next steps.

References

  1. https://www.samhsa.gov/data/sites/default/files/reports/rpt35325/NSDUHFFRPDFWHTMLFiles2020/2020NSDUHFFR1PDFW102121.pdf
  2. https://www.cdc.gov/drugoverdose/featured-topics/ioad-benzo-overdose.html
  3. https://www.cdc.gov/nchs/pressroom/podcasts/2022/20220318/20220318.htm
  4. https://medlineplus.gov/druginfo/meds/a684001.html
  5. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC165791/
  6. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3268458/
  7. https://pubmed.ncbi.nlm.nih.gov/
  8. https://pubs.niaaa.nih.gov/publications/aa63/aa63.htm
  9. https://www.ajmc.com/view/benzodiazepine-and-unhealthy-alcohol-use-among-adult-outpatients
  10. https://www.aafp.org/pubs/afp/issues/2013/0815/p224.html
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