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Xanax is a famous brand label for alprazolam, a type of benzodiazepine used to keep anxiety and depression under control. While the drug has been highly effective in keeping these psychiatric issues under control, experts have warned the users time and again not to combine it with other substances due to the fear of drug interactions and side effects. One such combination that people frequently talk about is Xanax and alcohol. Numerous warnings have been issued regarding drinking with Xanax as the combination leads to several side effects. It is essential to know what interactions to expect and how they affect the body.
What Happens When You Mix Xanax and Alcohol? Short-Term Effects
Multiple sources have documented the risks of mixing alcohol with benzodiazepines like Xanax. Some of these short-term dangers include:
Relaxation and Euphoria
The use of both drugs at once can immediately lead to euphoria and relaxation, along with a marked reduction in stress and anxiety. These effects typically occur in lower doses; as an individual increases the amount, sedation takes over very soon.
Lethargy, Fatigue, and Lightheadedness
People combining alcohol with Xanax also experience lightheadedness. This effect results from decreased blood pressure and can be particularly dangerous upon consuming both substances in higher doses. Lightheadedness is likely to continue in some individuals even after they have recovered from substance use. Some people also report developing fatigue, tiredness, and a lack of energy.
Irritability and Aggression
Several studies have suggested that people who use alcohol with Xanax together are at higher risk of becoming irritable, aggressive, and angrier than those who use either of these drugs alone. Even though both alcohol and benzodiazepines cause relaxation and reduce stress in the short term, they also inhibit their ability to keep an eye on their behaviors and feelings. These short-term side effects are more prevalent in people who consume both substances at higher doses. Moreover, they are also more pronounced in people with a history of anger issues, impulse control issues, anger outbursts, and more.
People taking Xanax and alcohol together are likely to develop certain cognitive issues. These effects are generally dose-dependent, meaning people who use them in lower doses feel spaced out and fuzzy. Those who use it in higher doses may experience it more intensely.
What Happens When You Mix Xanax and Alcohol? Long-Term Effects
Due to the synergistic effects of both drugs, their combination can decrease the blood flow to the brain and increase the inhibitory neurotransmitters. As a result, users are likely to experience significant issues with problem-solving, thinking, judgment, planning, and self-control. Additionally, as the use of Xanax and alcohol becomes chronic, the following long-term side effects may occur:
Cardiovascular and Respiratory Effects
The combination of Xanax and alcohol will likely suppress how the autonomic nervous system functions. One of the significant dangers of using them together is the shutting down of the brain stem, which controls many automatic life-sustaining functions, such as respiration and heart rate. Even people who do not use these substances at significantly high levels but consume them for a long time are vulnerable to depressed respiratory and cardiovascular effects. Due to these effects, the oxygen flow to the brain can chronically reduce, leading to widespread damage in different body parts.
Increased Risk of Unconsciousness
Continuing to use alcohol while someone is using Xanax can increase the risk of becoming unconscious or acquiring a comatose state.
Kidney and Liver Damage
Chronically mixing Xanax with alcohol burdens the body and the liver, which has to metabolize it all the time. Similarly, the kidneys also come under stress as they must keep removing these drugs from the system. With time, both organs sustain significant damage, which deteriorates the overall state of health.
Increased Risk of Overdose
Using central nervous system depressants with each other can increase the risk of an overdose. This is because both of these substances have similar effects, and if taken together, they can severely depress the central nervous system.
Many people without issues with using Xanax or alcohol alone may develop an allergic reaction when combined.
Increased Potential for Psychosis and Neurological Effects
Mixing Xanax with drinking increases the potential to experience delusions and hallucinations. Sometimes, the combination can even trigger seizures which are uncommon when either of them is used alone. Both alcohol and Xanax can also lead to physical dependence if a person keeps using them for a long time. Such polysubstance reliance is much more complicated than single-drug dependence and may require much more effort to overcome it.
Development of Substance Use Disorder
Using more substances together increases the risk of developing an addiction much more quickly. Addiction to Xanax and alcohol together is highly complex and much more difficult to overcome. Fortunately, there are many addiction treatments available that may help such users overcome these addictions safely and effectively.
Withdrawals From Xanax and Alcohol: What it Looks Like
If you have been using alprazolam and alcohol, you may go through withdrawal as soon as you stop using them. Even people who have been using it as prescribed for a long time period may need to taper it slowly to avoid experiencing withdrawal symptoms. Some common withdrawal symptoms that may occur when you stop using this combination may depend on the following:
- How much Xanax are you using?
- How much alcohol are you using?
- How frequently do you combine both substances
- Your current physical health
- Any co-occurring mental health disorders
- Any co-occurring medical conditions
- Past medical and addiction history
Alcohol and Xanax withdrawal is comparable to detoxing from other depressant substances. The only difference is that you may experience more intense symptoms than usual, as both substances are depressants and exert similar side effects. Some examples of these withdrawal symptoms include the following:
- Erratic breathing
- Fast or fluttering heartbeat
- Loss of consciousness
- Tingling in extremities
- Chills and sweating
- High blood pressure
- Delirium tremens
The time it takes for an individual to detox from Xanax and alcohol depends on individual factors, such as how severe an addiction is. In general, these symptoms begin on the very first day following the stoppage of these substances and peak in about two days. The most uncomfortable of these symptoms are over within the first five to seven days; however, many continue to experience psychological symptoms for weeks or even months. Known as post-acute withdrawal syndrome, these symptoms include:
- Low mood
These symptoms tend to occur as the chemicals in the brain attempt to rebalance themselves without substances. An addicted brain is used to very high levels of certain neurotransmitters due to the presence of substances like Xanax and alcohol. However, as these chemicals exit the body, these chemicals come back to normal levels, and the body responds to these changes in the form of withdrawal symptoms.
Do You Need Medical Detox for Xanax and Alcohol?
Alcohol is one of the most dangerous substances to detox from. Do not attempt to quit cold turkey, as it may lead to withdrawals that can be highly debilitating. Though rare, some people have died due to delirium tremens, a side effect of alcohol withdrawal. Xanax withdrawal, on the other hand, may not be as severe as alcohol withdrawal. However, mixing the two substances can worsen the process and require professional intervention.
Medically-assisted detox is the best way to stop yourself from using Xanax and alcohol without putting your life at risk. A typical program for detox may include the following:
- Physical exam and assessment
- Regular monitoring of vital signs
- 24/7 medical supervision
- Immediate attention to medical emergencies
- Regular comfort-level checks
- Prescription medications to ease withdrawal symptoms
- Drug taper schedules, as clinically appropriate
- Holistic approaches to ease the process
A good detox center helps clients get through the process in a comfortable and luxurious environment. Each client receives a comfortable bed with a television and furnishings. Nurses check on them regularly to ensure they don’t develop any side effects.
Why do people mix Xanax and Alcohol?
A lot of people mix Xanax and alcohol to enhance the effects of either of them. Both these agents are depressants that slow down the central nervous system. These medicines improve the levels of gamma-aminobutyric acid (GABA) in the brain, which trigger feelings of relaxation by blocking certain activity in the CNS. The same neurotransmitter also helps users sleep. Combining Xanax and alcohol can make a user less inhibited and calm, and people often do so to intensify the desirable effects. However, these users are unaware that mixing these agents can be dangerous and potentially fatal.
Is it dangerous to combine Xanax and alcohol?
When taken in therapeutic doses, Xanax is a safe drug. The potential for severe interactions is also minimal when people combine small doses of alcohol and Xanax. This is because the body is able to metabolize both of them in smaller doses. However, when you increase the quantity of either or both of them, this puts a significant strain on the system. It obviously may not be so problematic if you combine one tablet of Xanax with one beer as combining a 12-pack of beer with up to seven tablets of Xanax. That said, remember that you cannot predict how these substances affect your body regardless of the doses, so be careful while combining them.
Is it ok to have one or two drinks with Xanax?
No, it is always best to altogether avoid taking alcohol with Xanax. Depending on the individual tolerance level, some people can easily tolerate one or two drinks. Still, when you combine them with benzodiazepines, like Xanax, you may not expect how your body responds to it. Because of the heightened risk of side effects from combining both, doctors do not usually recommend drinking as long as you take Xanax. Complete avoidance is the best way to ensure you don’t suffer any side effects.
When can I start having alcohol once I have stopped using Xanax?
Xanax and other benzodiazepines can stay in the system for some time, even after you have stopped taking them. Drinking alcohol before the drug gets out of the system can lead to Xanax and alcohol interactions similar to the ones that occur when you combine them. Hence, it is better to wait for a few days after your last dose before you start drinking again. Experts do not advise stopping Xanax just to drink alcohol. Moreover, if someone has been taking it for a long time, stopping it suddenly may cause withdrawals, so be careful.
1 University of Michigan. (2020). The effects of combining alcohol with other drugs.
2 Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of addiction medicine, 12(1), 4–10.