Benzos and Alcohol

Estimated reading time: 34 minute(s)

Benzodiazepines form a popular category of medication originally synthesized to help people treat anxiety disorders, seizures, and sleep-related issues. These drugs slowly replaced barbiturates and currently represent one of the most commonly prescribed medications across the United States. Their development was based on the need to develop a tranquilizer that could replicate the effects of barbiturates without posing an equally high addiction risk. While the efficacy of benzos has matched those of barbiturates, these medications also carry a significant risk of abuse and carry the potential to cause various side effects.

The risk of side effects secondary to benzos use can further exacerbate in people who intentionally or unintentionally mix it with other substances, such as alcohol. The combination of benzos and alcohol is becoming extremely common due to various reasons. Some like to mix them because of the heightened sedation, while others believe the combination can help them manage their anxiety symptoms more effectively. Regardless of the causative factor, the combination carries very serious risks for overall health and can potentially lead to life-threatening issues if not managed in time. If you or a loved one has been routinely combining benzodiazepine with alcohol, seeking information about benzos and alcoholism is crucial.

Benzos and Alcoholism: Unwinding the Underlying Relationship

Professional drug regulatory bodies report that benzodiazepines are rarely the primary drug of abuse in polysubstance abuse. Most people mix them with other substances, such as opioids and alcohol. Such combinations are particularly dangerous for health and lead to frequent emergency department admissions. Following are some common reasons why people may choose to mix benzodiazepines with other substances, including alcohol:

  • The practice of mixing two drugs together, such as benzos and alcohol, enhances the effects of at least one of them.
  • Alcohol is easily available and legal to obtain for adults. Its easy availability at parties or other social situations makes it a perfect companion to use with other drugs, such as benzodiazepines.
  • Individuals misusing benzos often think mixing prescription medications with alcohol is safer than combining the beverage with illegal drugs.
  • Expert bodies confirm that people suffering from an underlying alcohol use disorder experience stronger effects due to benzodiazepines. This enhancement is likely due to the neurobiological mechanisms linked with alcohol addiction.

Why are Benzos and Alcohol Really Dangerous?

Can you drink alcohol with benzodiazepines? Experts strictly say no. The risks associated with combining the two substances are very high. Every warning label printed on a benzodiazepine box contains warnings against mixing it with alcohol, and healthcare professionals also explicitly advise their patients to avoid any alcoholic beverage as long as they are on these medications. The risks of using them together are much higher than the ones brought on by either of their use alone. Some of these side effects and risks include the following:

Heightened Effects

Mixing both substances can lead to enhanced effects due to a similar mechanism of action. What this means is a simultaneous increase in the intensity of side effects associated with both.


Mixing two substances with a similar mechanism of action and overall effects, such as alcohol and benzodiazepines, can significantly heighten the risk of an overdose. Such types of overdoses can have serious and potentially life-threatening ramifications due to extensive brain and organ damage secondary to a lack of oxygen. While it normally takes a very high level of alcohol consumption to experience an overdose, using it with a benzodiazepine considerably reduces the threshold, making it easier to cross the line.

Both alcohol and benzodiazepines are broken down in the body by the liver. However, the liver always prefers to metabolize alcohol first, making benzodiazepines last much longer in the body and exert more intensified effects. If a user constantly keeps consuming these substances, their blood levels can reach a critically high level, suppressing the breathing mechanisms, triggering seizures, and inducing a coma or even death.

Reduced Cognition

Due to the heightened effects of combining alcohol and benzodiazepines, users may experience a significant decrease in their cognitive performance leading to serious situations. For example, a loss of sensation due to this substance combination can lead to accidents, whereas impaired judgment may land a user in risky situations. Moreover, the combination may cause them to lose control over their emotions and engage in aggressive or hostile activities.

Reduced Physical Reactions

Because using benzos and alcohol together enhances the overall effects of both substances, a user experiences impaired response times and motor coordination and struggles with performing complex or routine actions. These side effects can put them in various potentially life-threatening situations.

More Intense Side Effects

Using two depressants of the central nervous system, such as alcohol and benzodiazepines, at once can enhance a person’s overall potential to experience side effects. These common side effects include vomiting, nausea, allergic reactions, and excessive fatigue, and lethargy.

Unpredictable Side Effects

Every individual is different and may experience different side effects due to mixing alcohol with benzos. For many, these side effects can be unpredictable and sometimes become difficult to diagnose, even by experienced healthcare professionals.

Increased Likelihood of Acute Conditions

Combining two substances, such as benzos and alcohol, can increase the risk of developing acute conditions, such as stroke, heart attacks, seizures, suicidal tendencies, and psychosis.

Long-Term Physical Issues

Continued use of alcohol and benzodiazepines can put a person at a heightened risk of experiencing long-term physical problems. These risks may include problems with gastrointestinal or cardiovascular issues, potential liver damage, and neurological problems like dementia.

Mental Health Disorders

Long-term use of alcohol and benzos simultaneously can make a person more vulnerable to acquiring a serious psychological condition. These conditions may include problems like trauma, depression, anxiety disorders, stress-related disorders, bipolar disorder, and psychotic disorder. These mental health issues are much higher in people with a history of polysubstance abuse.

Physical Dependence & Addiction

Prolonged use of a benzodiazepine or alcohol alone can put a person at risk of acquiring physical dependence. This risk multiplies tremendously in people who use them together, especially for longer periods. A withdrawal process in such circumstances can also become potentially fatal due to life-threatening symptoms like seizures. If left unchecked, this dependence can quickly progress to take the shape of a proper substance use disorder. Such cases of polysubstance use disorder can easily become complicated, making a recovery very difficult.

Deterioration of Life Quality

Continued use of benzos and alcohol together can increase the risk of impairment in one or more aspects of life. For example, such people may have issues maintaining healthy relationships, struggle to keep employment, and perform poorly at school.

Remember that any level of abuse for one or both of these substances must be taken seriously. Most cases where a person is mixing a Benzo drug with alcohol require professional intervention for a full recovery.

Treatment for Benzo and Alcohol Use Disorder

A person who routinely uses benzodiazepines with alcohol is at a very high risk of experiencing addiction to both substances simultaneously. In such circumstances, seeking help becomes compulsory, and the treatment process often begins with identifying the problem and asking for the right place for support. A professional addiction treatment center is the best place to get the support and help you need to overcome these complicated, co-existing issues. These institutes have specialized medical teams with vast experience in handling addiction cases that can analyze each case individually and develop a personalized treatment plan.

For most people, recovery from co-existing benzo and alcohol addiction begins with a detoxification process where the body slowly weans off these addictive substances. Following are the three goals of addiction that the rehab may follow:

  • To help a patient withdraw from polysubstance abuse safely and effectively
  • To make the withdrawal process gentle while protecting a patient’s dignity
  • To prepare them for long-term rehabilitative therapy to overcome alcohol and benzodiazepine dependence

A detoxification process may differ from one person to another depending on how intensive their withdrawals are. Some people may benefit from a slow-tapering regimen in which a professional slowly reduces their benzodiazepine dose over a certain period. Others recover well through a medication-assisted program where they get access to controlled medication to overcome withdrawal symptoms. Following the detox step, most people require long-term therapy to ensure recovery and sobriety while minimizing the risk of relapses. The goal of rehabilitation is to help people address the psychological aspect of their addiction by passing patients through multiple levels of care, such as inpatient, outpatient, intensive outpatient, and partial hospitalization programs. These programs may incorporate a combination of counseling, behavioral therapies, and medication to encourage patients to make positive changes in their behaviors and thoughts.


What are the indications of using benzos?

Benzos or benzodiazepines are medications commonly used to manage anxiety. Anxiety is a mental disorder triggered by excessive activity in brain nerves, and benzos help calm them down by balancing certain neurotransmitters. Moreover, these medications work well for the management of insomnia, seizures, nausea, vomiting, and depression. Following are some examples of benzodiazepines:

Do alcohol and benzodiazepines work in the same way?

Benzos and alcohol work similarly by targeting and impacting GABA neurotransmitters in the brain. However, because of their different chemical structures, their mechanism of action is not identical.

How long after taking a benzodiazepine can you drink alcohol?

The amount of time after which you can safely drink alcohol varies according to the benzo you are consuming. This is because different types of benzodiazepine drugs persist in the body for different lengths of time, and it is safe to allow the medication to completely get out of the system before drinking. For example:

  • Alprazolam, temazepam, estazolam, and lorazepam may last in the body for eleven to twenty hours
  • Clonazepam, flurazepam, diazepam, quazepam, and chlordiazepoxide may last in the body between one to three days

Additionally, other medical factors, such as a pre-existing liver or kidney dysfunction, may also interrupt these durations and cause the benzo medication to last even longer.

Can taking a benzodiazepine make anxiety worse?

While those who use benzos often do so to help treat some form of anxiety, in some cases, they can make anxiety worse. When a person is prescribed benzodiazepines and uses them for an extended period of time, they will gain a tolerance. Then, they start to require more to achieve the same effect.

This can lead to increased anxiety, and benzos can even become a source of anxiety. When used in the short term, they can be an effective treatment for anxiety, the most common mental health disorder globally. However, if benzos are used for longer than two months, anxiety can begin to worsen. 

If this is the case for you, consider developing a plan to discontinue benzo use. Withdrawal symptoms can be severe and lead to seizures. Therefore, speak with a doctor if you are experiencing any of these issues

Can mixing benzos and alcohol lead to an overdose?

It is possible to experience an overdose by mixing benzodiazepines with alcohol. Remember that overdose is a medical emergency and may lead to permanent brain damage, coma, and death. Some of its symptoms include confusion, weak pulse, slowed breathing and altered mental status.

How can I reduce the harm of mixing benzos with alcohol?

Keep the following tips in mind if you are on benzodiazepines but enjoy having a drink now and then:

  • Use either of drugs somewhere safe around loved ones you trust
  • Avoid operating heavy machinery or driving if you are taking benzos, alcohol, or both
  • Avoid mixing benzos with any other substance
  • Do not exceed the daily amount more than that recommended by the doctor
  • Remember that Benzo are short-term medication and must not be used for prolonged periods to minimize dependence

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