What Happens When You Combine Alprazolam (Xanax) and Alcohol
FDA Warnings
This medication comes with boxed warnings. The Food and Drug Administration has issued these as its most serious warnings (FDA). Medical practitioners and people are informed about potential side effects of medications through boxed warnings.
When used with opioid drugs, benzos raise the risk of respiratory depression, coma, and even death. Xanax shouldn’t be used with an opiate, unless there are no other viable therapeutic options available.
Benzodiazepines can still lead to physical dependence and withdrawal if you stop using them suddenly, even when used as prescribed. Withdrawal presents a significant risk to life.
The usage of this medication may also lead to misuse and addiction. If you abuse Xanax, your risk of overdose and mortality increases.
Only use this medication as your doctor has prescribed. Consult your doctor if you are unclear if you can use this drug safely.
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
- seizures
- loss of coordination
Serious side effects of drinking too much alcohol include:
- seizures
- vomiting
- 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
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Sedation
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:
- rage
- aggression
- hostile behavior
Additionally, alcohol has a number of effects on mood. Despite being a depressant, it temporarily lifts some people’s spirits. Others could encounter unfavorable side effects, such as sorrow.
Aside from lowering inhibitions, alcohol also clouds judgment. This makes it simpler to take actions that you ordinarily wouldn’t.
In general, when Xanax and alcohol are taken simultaneously, these behavioral consequences and mood changes intensify.
Memory impairments
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, physical side effects of Xanax include:
- headaches
- 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 for experiencing physical side effects.
Long-term 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
- depression
- liver damage or failure
- personality changes
- cancer
- 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 EMERGENCY
Call 911 immediately if someone has taken alcohol and Xanax and is exhibiting the following signs of overdose:
- sleepiness
- confusion
- impaired coordination
- impaired reflexes
- loss of consciousness
Death
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
There are options available if you believe you or someone you know is abusing Xanax and alcohol.
You can better understand your options by talking to a healthcare professional, such as your regular physician. They can assist you in making choices that lower your likelihood of experiencing negative side effects.
The American Society of Addiction Medicine’s Find a Doctor search engine will help you locate an addiction expert. To find physicians in your region, all you need to do is enter your ZIP code.
The Find a Specialist directory of the American Academy of Addiction Psychiatry is another option.
In addition to offering a list of treatment facilities in your region, the Substance Abuse and Mental Health Services Administration (SAMHSA) may also assist you in finding a facility.
Call the National Drug Helpline at 844-289-0879 if you can.
Additional online resources are available for persons with drug use disorders and their families at the National Institute on Drug AbuseTrusted Source.
Takeaway
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.
Last medically reviewed on November 14, 2019
FDA Warnings
This drug has boxed warnings. These are the most serious warnings from the Food and Drug Administration (FDA). Boxed warnings alert doctors and patients about drug effects that may be dangerous.
- Taking benzodiazepines with opioid drugs increases your risk for severe sleepiness, respiratory depression, coma, and even death. Xanax shouldn’t be taken with an opioid unless there are no other available treatment options.
- Using benzodiazepines, even as prescribed, can lead to physical dependence and withdrawal if you stop taking the drug suddenly. Withdrawal can be life threatening.
- Taking this drug can also lead to misuse and addiction. Misuse of Xanax increases your risk of overdose and death.
- Only take this drug as your doctor prescribes. Talk with your healthcare provider if you have any concerns about safely taking this drug.
Does it feel the same for everyone?
Xanax, or its generic version alprazolam, doesn’t affect everyone in the same way.
How Xanax will affect you depends on several factors, including your:
- mental state at the time you take the drug
- age
- weight
- metabolism
- dosage
If you’re taking this anti-anxiety medication for the first time, it’s important to understand its side effects and potential interactions before use. Read on to learn what it should and shouldn’t feel like, and answers to other commonly asked questions.
What does Xanax feel like if you’re using it recreationally?
The effects of Xanax are frequently described as sedating or relaxing by those who use it recreationally or without a prescription.
Contrary to certain narcotics, like cocaine, which may provide a “high” or euphoric experience, Xanax users say they feel more drowsy, calm, and relaxed after taking it. These emotions could cause you to nod out or pass out for a few hours.
The inability to recall events for several hours due to memory loss or blackouts has also been observed by certain persons. Stronger effects will result from higher dosages.
What if you’re using it to treat an anxiety or panic disorder?
If you take this medication as it’s intended — it’s commonly prescribed to treat anxiety or panic disorders — you may feel “normal” after your first dose.
The sedating effect can help alleviate symptoms of anxiety and calm your body’s response to the anxiety or stress.
What if you drink alcohol after taking Xanax?
Alcohol increases the effects of Xanax and slows down how quickly your body can clear the drug from your system. If you take the medicine and then drink alcohol, you may experience extreme lethargy and prolonged memory loss.
It’s advised that you avoid combining the two substances. It’s possible that the combination will lead to dangerous, even deadly side effects. These include:
- difficulty breathing
- extreme drowsiness
- confusion
- seizures
What if you combine Xanax with another drug or medication?
You should avoid combining Xanax with several other drugs due to their interactions. Xanax can interact with many medications, including some:
- oral contraceptives
- antifungals
- antidepressants
- antibiotics
- heartburn drugs
- opioids
These medications may slow down the elimination of Xanax from your body and prevent it from leaving as rapidly as it should. This could eventually result in a toxic accumulation of the medication and an overdose.
To be sure there won’t be an interaction, discuss all of your existing prescriptions with your doctor or a pharmacist. They can evaluate the hazards and talk with you about them.
Xanax shouldn’t be taken with any medications, including over-the-counter ones, that can make you drowsy, decrease your breathing, or make you feel extremely lethargic. You run the chance of experiencing negative side effects from the combination of these medicines, including death.
What shouldn’t you feel when taking Xanax?
The effects of Xanax should be mild, but detectable. If the drug appears to be having a significant impact on you, you should seek emergency medical attention.
Symptoms to watch for include:
- extreme drowsiness
- muscle weakness
- confusion
- fainting
- loss of balance
- feeling lightheaded
You should also seek emergency medical attention if you experience signs of an allergic reaction. Signs may include swelling of the face, lips, throat, and tongue and difficulty breathing.
Likewise, if you experience signs of withdrawal, you should contact your doctor immediately. Xanax is a potentially habit-forming drug, so some people may develop a dependency or addiction without realizing it.
Symptoms of Xanax withdrawal can be serious. They include:
- depressed mood
- thoughts of suicide or self-harm
- confusion
- hostility
- hallucinations
- racing thoughts
- uncontrolled muscle movements
- seizures
Suicide prevention
- If you think someone is at immediate risk of self-harm or hurting another person:
- • Call 911 or your local emergency number.
- • Stay with the person until help arrives.
- • Remove any guns, knives, medications, or other things that may cause harm.
- • Listen, but don’t judge, argue, threaten, or yell.
- If you or someone you know is considering suicide, get help from a crisis or suicide prevention hotline. Try the National Suicide Prevention Lifeline at 800-273-8255.
Does the dosage change the way it affects you?
Xanax’s doses are available in milligrams (mg). They include:
- 0.25 mg
- 0.5 mg
- 1 mg
- 2 mg
As the dose rises, Xanax’s effects become more pronounced.
In general, doctors advise first-time Xanax users to start with the lowest dose feasible. It’s advisable to start with a lower dose and increase it gradually until you understand how the medication will impact you.
A deadly dosage may be used. This applies to everyone, from first-time users to those who have been taking Xanax as directed by their doctor for months or years. You shouldn’t take more medication than your doctor has advised.
High dosages are also linked to the “Rambo effect,” a perplexing side effect. This uncommon side effect appears when a Xanax user starts acting in ways that are highly out of character for them. This might involve thievery, promiscuity, or aggressiveness. It is unclear why certain individuals behave in this manner or how to foresee if it will occur to you.
How long does Xanax take to kick in?
Xanax is taken by mouth and absorbed quickly by the bloodstream. Some people may first begin experiencing the effects of Xanax within 5 to 10 minutes of taking the pill. Almost everyone will feel the effects of the drug within an hour.
One of the reasons why Xanax is so effective for treating panic is that peak impact from the dose comes quickly. Most people will experience it between one and two hours after taking their dose.
How long will its effects last?
The effects of Xanax are brief. Most people will feel the strongest impacts from the drug for two to four hours. Lingering effects or “fuzzy feelings” may stretch out beyond that for several more hours.
How long it takes for the drug to impact you will depend on several factors. They include:
- your weight and metabolism
- your age
- other medications you may be taking
It’s possible to build up a tolerance to Xanax quickly. If that happens, you may begin to notice it takes longer for you to feel the sedative effects of the drug, and the feelings may wear off more quickly.
What does it feel like when Xanax wears off?
The half-life of Xanax is approximately 11 hours. Half of the medication will have been removed from your bloodstream by that time by your body. The half-life of drugs varies depending on how each individual metabolizes them.
Most individuals cease experiencing the calm, tranquil, and sluggish feelings that Xanax is known for as the medicine wears off.
As the medicine leaves your system, any anxiety symptoms you were previously treated for, including a racing heart, might start to reappear. If you don’t experience these symptoms, you’ll start to feel more “normal.”
Is a Xanax comedown the same thing as withdrawal?
The comedown from Xanax is not the same as withdrawal. A comedown is the release of strong feelings after a drug’s peak effects. Since Xanax doesn’t provide a “high,” many users don’t experience a “comedown.”
However, when the chemicals in their brain adjust to the absence of the medicine, some people may suffer symptoms of sadness or anxiety, even though they have never had a problem with these disorders. Rebound anxiety or despair often lasts for a short while.
What does withdrawal feel like?
Xanax has high potential to be a habit-forming drug. Symptoms of withdrawal typically begin two to seven daysTrusted Source after your last dose. They can last two to eight weeksTrusted Source.
If you take Xanax, don’t stop it without talking to your doctor first. Some withdrawal symptoms can be dangerous. You need to follow a program with your doctor’s supervision to taper off the high doses and ultimately quit entirely.
Symptoms of withdrawal include:
- sleep problems and insomnia
- restlessness
- nervousness
- aggression
- poor concentration
- suicidal thoughts
- worsened anxiety or panic attacks
- depression
- seizures
Your doctor can administer medication to help ease these symptoms and prevent further complications.
The bottom line
If you’re considering taking Xanax or are curious about its potential to help you feel less anxious, talk with your doctor.
It’s also a good idea to tell your doctor if you’re using the drug recreationally. Xanax can interact with several common medications, resulting in serious side effects. Your doctor can monitor your overall health and help prevent complications.
Your doctor can also work with you to find a more sustainable, long-term medication to help soothe any symptoms you’re experiencing and alleviate your desire to use Xanax.
Last medically reviewed on June 20, 2018
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