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Effects of Mixing Alcohol and Xanax

Medically Reviewed by: Charley Allen

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Xanax and alcohol are both legal drugs. While Xanax is intended only for medical use, it is often abused for recreational purposes. On their own, Xanax abuse and alcohol abuse are highly dangerous. However, when people combine the two substances they put themselves at a high risk of overdose and other potentially life-threatening consequences.

What is Xanax?

Xanax is the most common brand name for a drug called alprazolam. Alprazolam is part of a class of drugs known as benzodiazepines. Benzodiazepines are prescribed by psychiatrists and medical professionals to treat a variety of conditions. They are most commonly utilized to treat anxiety disorder and panic disorder, though they have also been found effective for insomnia, agitation, muscle spasms, seizures, alcohol withdrawal, and as a premedication for anxiety-inducing medical or dental procedures. Benzodiazepines are tranquilizer drugs that work by depressing the central nervous system.

Most benzodiazepines are classified as Schedule IV drugs by the United States Drug Enforcement Agency (DEA). This means the government recognizes that these drugs, despite offering significant medical benefits, have the potential for abuse and the development of physical dependence.

Alprazolam was initially developed as an alternative to the benzodiazepine diazepam, also known as Valium. Valium, one of the earliest benzodiazepines, was widely prescribed but was known to have a high potential for abuse and addiction. When alprazolam entered the market, physicians hoped that it would offer a safer means of treating mental health disorders. Alprazolam proved to be a successful medication. By 2017, it had become the 21st most widely prescribed medication in the United States. It is also a major recreational drug, especially among young people.

Because Xanax leads quickly to physical dependence, it is often abused by people who are holding legitimate prescriptions. These individuals may alter the medication by crushing it to obtain pleasurable effects more quickly. Common routes of administration used by people abusing include snorting Xanax, smoking, and injecting. Doing so significantly increases the risk that a person will develop an addiction or suffer from a drug overdose.

However, Xanax also enjoys enormous popularity on the black market. It is one of the most commonly sold prescription medications, and along with Valium, it is the most commonly distributed benzodiazepine medication. Young people in possession of legitimate Xanax prescriptions frequently sell their medications, though often recreational users obtain the drugs from professional drug dealers as well. They may abuse Xanax under the mistaken belief that, because it is a prescription medication, it must be safe.

In fact, Xanax is one of the most dangerous recreational drugs on the market. It is also an increasingly popular drug of abuse among young people. Emergency room visits due to Xanax abuse have been doubling every few years. Between 1999 and 2015, Xanax-related deaths have multiplied sevenfold, from 1,135 to 8,791 deaths per year. While young people are often tempted to abuse Xanax because of its euphoric and sedating effects, the drug’s physically addictive nature can rapidly destroy — and often end — their lives.

Side Effects of Xanax

Alprazolam, otherwise known as Xanax, primarily affects the brain’s gamma-aminobutyric acid (GABA) receptors. Benzodiazepines are depressants that shut down the brain’s neuronal activity. This phenomenon is responsible for Xanax’s therapeutic effects in the treatment of anxiety. Xanax helps people feel sedated, drowsy, and relaxed. These feelings are frequently sought after by recreational drug users as well. However, the drug also leads to a number of less pleasurable side effects as well. Common side effects of Xanax include:

  • Slurred speech
  • Fainting or dizziness
  • Memory problems or amnesia
  • Decreased saliva production
  • Changes in sex drive
  • Loss of interest or pleasure
  • Feeling empty or finding it difficult to function during daily tasks
  • Difficulty with coordination and balance
  • Lack of inhibition
  • Impulsive, erratic, or violent behavior
  • Depression
  • Aggression
  • Hallucinations
  • Blacking out
  • Blurred vision
  • Drowsiness
  • Lightheadedness
  • Discouragement
  • Significant personality changes
  • Psychotic episodes

When alprazolam is taken as prescribed, the chances of experiencing the more severe side effects of the drug are lower. However, individuals who abuse the drug are more likely to experience these dangerous symptoms of Xanax abuse. People who crush and snort Xanax, inject Xanax, or smoke Xanax will not only experience effects more quickly, they will experience a wider range of more potent side effects. Taking higher quantities of Xanax than prescribed, taking the drug more frequently than prescribed, or taking Xanax over a long period of time can lead to addiction and life-threatening symptoms.

If an individual suffers from Xanax dependence or addiction, it is essential that they get outside help as soon as possible. Some side effects, such as seizures or difficulty breathing, require immediate medical attention. Individuals engaging in polysubstance abuse who use alcohol alongside Xanax have increased chances of experiencing these life-threatening symptoms.

Risks of Long-Term Xanax Abuse

With prolonged use of Xanax, physical dependence is inevitable. In fact, physical dependence on Xanax can occur in a short period of time, even within a few days. This is because the drug releases high quantities of dopamine in the brain. Dopamine is a neurotransmitter that is naturally produced in people’s brains when they accomplish a goal or engage in a healthy activity. It is sometimes known as the brain’s reward chemical. Dopamine makes people feel good, and when it is released it trains the brain to repeat whatever behavior caused the release. Xanax releases enormous quantities of dopamine when it is used, which drives people to return again and again to the drug.

Over time, people who abuse Xanax develop a tolerance to the drug. This means that their brains and bodies have adapted to Xanax abuse, causing them to no longer be able to achieve the same effects using the same dosages. As a result, in order to obtain their accustomed high and avoid Xanax withdrawal symptoms, individuals with a tolerance need to take higher doses or take doses at an increased frequency. In an effort to stay one step ahead of tolerance and withdrawal, many young people find themselves requiring more Xanax than they can reasonably manage to obtain.

Even individuals who have a strong desire to free themselves from this vicious cycle of Xanax abuse are generally unable to do so. Xanax withdrawal is physically and emotionally painful. Xanax withdrawal symptoms also last longer than the symptoms associated with withdrawing from other drugs. While opioid withdrawal symptoms, for instance, tend to peak after a week and resolve entirely after several weeks, benzodiazepine withdrawal often lasts many months. It can wax and wane in severity. Individuals with severe physical dependence who quit Xanax “cold turkey,” rather than gradually lowering their dosages, can even experience life-threatening withdrawal symptoms. Painful as Xanax addiction is, most people are helpless to quit Xanax on their own and remain addicted.

Over time, Xanax addiction gradually strips a person’s life bare of everything other than their drug abuse habit. Effects of Xanax addiction include:

  • Mental effects. People who regularly abuse Xanax have an increased susceptibility to mental health disorders such as major depression, anxiety disorder, and psychosis. Xanax abuse causes frequent blackouts and can result in permanent memory problems. It also dramatically increases a person’s risk of suicidal ideation, hallucinations, and psychotic episodes. Most people have difficulty functioning in everyday life, with reductions in their confidence, visual and spatial abilities, and concentration. To compensate for these difficulties, many people increase their reliance on Xanax and engage in patterns of polysubstance abuse.
  • Physical effects. Because Xanax alters people’s consciousness and impairs their coordination, people who abuse Xanax have a higher likelihood of suffering from a fall, accident, and other physical injuries. Individuals who smoke, snort, or inject Xanax can develop respiratory problems, sinus problems, and infections through improper needle usage. The physical withdrawal effects that occur when a person stops using Xanax can lead to nausea, insomnia, muscle pain, tremors, and even life-threatening seizures.
  • Work and educational effects. Xanax addiction causes people to prioritize drug use above their work or educational goals. Xanax also impairs a person’s ability to function. This can cause a person to be less productive at work or at school, and in many cases, it can cause people to lose their jobs or be kicked out of school.
  • Legal and financial effects. Obtaining Xanax is expensive, and individuals who have lost work due to their addictions may be unable to pay for the high quantities of the drug that they require. Xanax addiction can cause people to go into debt, and many people turn to criminal behavior to obtain their illicit drugs.
  • Interpersonal effects. While Xanax is often used to treat social anxiety, when it is abused it generally leads to social devastation. People abusing Xanax are prone to erratic, aggressive, and dangerous behaviors that can alienate friends and family members. Others simply detach from their loved ones because they have prioritized drug use above all else. Ultimately, Xanax addiction is a deeply isolating condition.

What Happens When You Mix Xanax and Alcohol?

Xanax is a dangerous recreational drug on its own, but it poses even more risks when it is abused with other substances. Young people frequently combine Xanax with other drugs, including alcohol and opioids. For many people with Xanax addictions, Xanax isn’t even their primary drug of choice. They may use Xanax in an effort to mitigate the negative side effects of other substances or accentuate the perceived positive effects. Young people who are experiencing an alcohol-induced hangover may turn to Xanax to feel better, or they may abuse Xanax while drinking alcohol in an attempt to increase the potency of the latter substance.

Xanax and alcohol are both depressants. In fact, their mechanism of action is very similar. Xanax causes the brain to release higher quantities of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA), which is responsible for the drug’s sedating and tranquilizing effects. Alcohol also affects the neurotransmitter GABA, and it also increases the effects of another inhibitory neurotransmitter, glycine. Both Xanax and alcohol decrease the excitability of neurons in the brain and thereby reduce brain and central nervous system activity.

As powerful depressants, alcohol and Xanax are both capable of causing overdoses. However, when the drugs are combined their effects accentuate each other. The result is a significantly increased likelihood of overdose. When the depressant effects of the alcohol and Xanax become too much for the body to handle, a person can suffer central nervous system depression. When this happens, their vital functions can stop entirely. Respiratory depression can cause a person to suffer from slowed breathing or they may stop breathing entirely, depriving organs of vital oxygen, and ultimately leading to death.

A number of other symptoms are likely to occur when a person mixes alcohol with Xanax. Common symptoms of this type of polysubstance abuse include:

  • Increased risk of physical dependence and addiction. Because both drugs release high quantities of dopamine, physical dependence is likely with either drug. When the drugs are combined, the amount of dopamine increases. This makes it not only more likely for a person to use either drug, but more likely for them to engage in polysubstance abuse with both drugs.
  • Fatigue and lethargy. Alcohol and Xanax work together to shut down brain functioning, which can make people feel lightheaded, tired, and unable to concentrate.
  • Aggression and irritability. While both alcohol and Xanax sedate people, they also remove inhibitions. People who combine alcohol and Xanax are more likely to engage in impulsive, erratic, and even violent behavior. This can put themselves and others at risk.
  • Cognitive issues. Combining alcohol and Xanax can cause people to feel spaced out. At higher doses, they may feel like their thinking is slowed. Both drugs decrease blood flow to the brain, which reduces a person’s ability to engage in problem-solving, critical thinking, planning, and self-control.
  • Difficulty forming new memories. The synergistic effects of alcohol and Xanax can lead to blackouts at even very low doses. Individuals who regularly abuse the two substances may be unable to recall long periods of their lives. Chronically abusing Xanax and alcohol can lead to permanent brain changes that make it difficult to form new memories.
  • Liver and kidney damage. The role of the liver and kidneys is to metabolize and process toxic substances. When an individual regularly abuses Xanax and alcohol, these organs may be unable to keep up. At best, this means that the drugs will metabolize more slowly. At worst, it means potentially fatal organ failure.
  • Psychosis and permanent neurological damage. Individuals who abuse both drugs are more likely to experience hallucinations and psychotic episodes. 
  • Unconsciousness. Central nervous system depressants like alcohol and Xanax shut the brain and body down. When combined, the likelihood of unconsciousness or comatose states increases.
  • Overdose. The synergistic effects of these two substances can lead to respiratory or cardiac issues. By shutting down the areas of the brainstem that control automatic life-sustaining functions like breathing, alcohol and Xanax can lead to life-threatening overdoses.

Polysubstance Abuse Statistics

The opioid epidemic has made opioids the most notorious recreational drugs in the United States. There is certainly good reason to be concerned: in 2017 alone, opioid overdoses were responsible for the deaths of over 47,000 United States citizens and many thousands of more worldwide. However, it is important to understand that even though synthetic opioids like fentanyl are responsible for the majority of drug overdose deaths, they are not the sole cause. In fact, a recent study found that over 30% of people who overdose on opioids were using benzodiazepines simultaneously. This fact, which is largely glossed over, points to the seriousness of polysubstance abuse among young people.

Polysubstance abuse refers to the practice of abusing more than one psychoactive substance. Individuals with polysubstance dependence suffer from physical dependence on multiple drugs. When most people think of addicts, they imagine someone who is specifically addicted to one “substance of choice.” In fact, many people suffer from addictions to alcohol and multiple drugs simultaneously, and they may simply abuse drugs indiscriminately without having a clear preference. It is difficult to determine how many people suffer from polysubstance use disorder, but a recent analysis of the National Epidemiological Survey on Alcohol and Related Conditions found that approximately 0.5% of adults in the United States met the conditions for polysubstance dependence. However, some populations are more susceptible to polysubstance addiction than others. Males and young adults were found to be the most at-risk groups.

Alcohol is the most widely abused drug in the world, and Xanax is the 21st most widely prescribed medication in the United States, with more than 25 million prescriptions as of 2017. Given that both medications have synergistic effects, it is no surprise that they are frequently abused alongside each other. 88,000 people die every year from alcohol-related causes. As with opioid overdose deaths, these alcohol-related deaths are often also attributable to Xanax abuse. As Xanax continues to enjoy popularity among young people, these preventable deaths will likely continue to rise in the near future.

Recovery is Possible at Design for Recovery

Xanax and alcohol addiction are serious conditions that require outside help. Some people spend years trying to manage their addictions on their own under the mistaken belief that they simply need to exert more will power and self-control. Others suffer quietly because they are ashamed of their addictions. Many people are reluctant to reach out for help because they believe these drugs are safe. While alcohol and Xanax are both legal substances, that does not change the fact that they are highly addictive and extremely dangerous. The dangers of both drugs are magnified when they are used together, putting people at significant risk of a life-threatening overdose. While some addicted people manage to quit alcohol and Xanax for short periods of time, unless they address the underlying issues behind their addictions and develop a new set of coping tools, they are likely to relapse and return to the vicious cycle.

The sooner you reach out for help, the better. Not only are both addictions progressive disorders that tend to get worse over time, concurrent abuse of Xanax and alcohol is likely to lead to serious conditions, from automobile accidents to damaged relationships, unemployment, and death. Even people in the early stages of their addiction have likely begun to experience some of these consequences, in addition to isolation and loss of freedom.

Design for Recovery is a sober living West LA that helps people get sober and rebuild their lives in the process. At Design for Recovery, we offer a safe and supportive environment where young men can escape their isolation. Our dedicated staff work to help them develop the skills and coping tools they need to get sober and stay sober. Moreover, we understand that tackling and addiction involves more than just saying no to drugs. Most people use substances like alcohol and Xanax because of unresolved or painful issues in their lives. Residents at Design for Recovery learn a new set of values and take steps forward every day toward new life goals. By the time they graduate, they have already begun to repair relationships, build new ones, work new jobs, and get their legal and financial lives in working order. At Design for Recovery, we believe addiction is optional and that you don’t have to recover alone. Reach out today.

Other Related Articles:

Ibuprofen and Alcohol

Meth and Alcohol

Heroin and Alcohol

Marijuana and Alcohol

Ambien and Alcohol


Edited by: David Beasley

David Beasley - Design for Recovery

David Beasley is a certified RADT (Registered Alcohol/Drug Technician). David, moved to California from North Carolina after many failed attempts to get sober.

Medically Reviewed by: Charley Allen

Charley earned his Masters of Clinical Psychology from Antioch University, Los Angeles, and is a California Licensed Marriage and Family Therapist (LMFT).He teaches mindfulness to both adults and children in group setting such as schools, corporate workplaces, and medical treatment facilities.

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