The Dangers of Mixing Xanax and Alcohol: Risks and Recovery

Alcohol and Xanax are two substances that ruin millions of Americans’ lives every year. Addiction to prescription drugs and alcohol is incredibly hard to leave behind. Without a structured approach to recovery, a person may never be free of the clutch these compounds have on their body, mind, and spirit.

That said, Xanax is an incredibly effective medication. Countless Americans use it, and in 2022, there were nearly 15 million prescriptions for the drug written by medical doctors. Alcohol is a similar double-edged sword to Xanax. It’s a great tool for unwinding after a long day—when used in moderation. When abused, alcohol is just as destructive as any misused or abused prescription medication, perhaps even more so.

Considering the risks of misusing and abusing these substances are pretty much well-known across American society, it’s surprising how many people have problems with them. Even more surprising is the fact that many American teens and adults choose to mix these two substances together, with no regard for the consequences of doing so.

Either they don’t understand the risk, or they don’t care—but whatever their motivation to do so—they’re gambling with their lives.

Polysubstance abuse of a Xanax and alcohol cocktail not only has disastrous consequences for your physical and mental health but overdosing on these compounds could easily end your life in a moment. Dropping a “xannie” with a glass of pinot noir might seem amazing at first, but there is not one single case of a person who didn’t eventually live to regret this choice.

Combining Xanax and alcohol deepens the sedentary effect of the medication on the body and brain. It impairs the users’ motor function and cognitive performance—and in the worst-case scenarios—significantly increases the risk of the user experiencing respiratory depression and fatal overdose.

This article doesn’t aim to judge anyone who’s currently lost in this behavior. If you’re using Xanax and alcohol, and you find you can’t stop—or maybe you’ve tried to stop and experienced bad side effects—this post aims to help you find a pathway to recovery.

If you’re reading this because you’re concerned about a loved one or friend, hopefully we can shine some light on the subject for you.

Xanax – Understanding How it Works in the Body

Xanax is the brand name for the prescription medication “Alprazolam.” It’s part of the “benzodiazepine” family and probably the most abused “benzo,” alongside the medications Clonazepam (Klonopin®) and Diazepam (Valium®), which are also part of the same sedative/hypnotic family of prescription drugs.

Doctors prescribe Xanax to patients to help them manage anxiety disorder. These drugs are highly effective at that task, and millions of Americans rely on Xanax and other benzo derivatives to help them avoid panic attacks and bouts of severe anxiousness.  

Benzodiazepines enhance the brain’s production and reuptake of a neurotransmitter called “gamma-aminobutyric acid” (GABA). GABA is the most abundant neurotransmitter in the body and plays a huge role in parasympathetic and sympathetic nervous system functions. Xanax manipulates GABA production and reuptake, which is why it initiates feelings of calm and relaxation in users.

Side Effects Associated with Xanax Use, Misuse, and Abuse

The side effects of Xanax use (not abuse) are pretty serious considering this is a widely prescribed medication. Overdose risk aside, there are a slew of adverse sides associated with its use, including the following.

• Decreased mental alertness and memory impairment.
• Drowsiness, fatigue, confusion, and concentration issues.
• Light-headedness and sensations of dizziness.
• Muscular system dysfunction and weakness.

When abused, the risk of experiencing these side effects increases, and when alcohol enters the mix, the side effects can turn deadly. Alcohol increases the sedative effect of the medication, and taking too much could lead to you passing out and entering respiratory depression where you stop breathing.

The problem with quitting Xanax is that sudden cessation of the drug has a profound adverse effect on the central nervous system and brain function. Depending on the extent of your use, suddenly stopping the medication could lead to you experiencing a seizure, which might land you in a coma.

Even light users are recommended to taper off the medication under medical supervision over a course of weeks or months.

Alcohol – Understanding How it Works in the Body

We officially classify alcohol as a “nervous system depressant.” It’s great for loosening our inhibitions at social events and makes it easier to unwind and relax when we’re feeling stressed. Like Xanax, it has its place in our lives, but when misused or abused, it has the potential to ruin us.

Alcohol affects the brain, but it also has a severely toxic effect on the body, especially when misused or abused. The stomach and small intestine digest alcoholic beverages and flood the alcohol into the bloodstream where it gets to work with suppressing the nervous system response.

Unlike Xanax, drinking too much in a single sitting won’t cause an overdose effect—you won’t perish—you’ll eventually just pass out and wake up with a raging hangover. Like Xanax, alcohol affects GABA production and reuptake in the brain and nervous system. Alcohol also affects the production and reuptake of many other neurotransmitters, such as glutamate, leading to similar effects as Xanax on motor skills, coordination, and the like. However, studies show that people with AUD often experience adverse changes to the brain’s function and structure.

The Consequences of Long-Term Alcohol Abuse

While Xanax has the potential to kill through overdose, alcohol takes a much longer time to destroy the body, and perhaps even take your life. The toxic effect of prolonged alcohol use affects many organs, most notably—the liver.

AUD can lead to the person developing advanced liver cirrhosis, leading to liver failure. It also increases the risk of developing heart disease and neurological impairment. Alcohol not only affects the addict dealing with AUD, it affects everyone around them.

Alcoholics usually find they endure relationship problems, experience rifts with their family who can’t handle their behavior and lose their job when their employer finds them drunk at work. The social and emotional impact of AUD and its impending fallout in the addict’s life can be just as devastating as the physiological effects it has on the body.

Combining Xanax and Alcohol – Understanding Physiological Interactions

While millions of Americans choose to abuse either Xanax or Alcohol, many decide to take things up a notch and combine the two. If that seems like a recipe for disaster—it is. These substances have a synergistic effect on the parasympathetic (PNS) and sympathetic (SNS) branches of the central nervous system (CNS).

Since alcohol and Xanax are CNS depressants they lower blood pressure and heart rate. Combining the two substances dramatically increases this effect while simultaneously amplifying the effect on the PNS where the user experiences the potential for the onset of respiratory depression.

Respiratory depression is a condition where breathing slows and becomes shallow, presenting a mortality risk as breathing slows and eventually stops. Users who have respiratory issues like asthma or impaired lung function are at higher risk of experiencing respiratory depression when using this killer cocktail.

If the user does enter respiratory depression, they need medical help immediately. EMTs will use a benzodiazepine receptor antagonist called “Flumazenil” to stop the reaction and restore GABA function in the nervous system. After stabilizing the patient, the EMS responders will transport the patient to hospital where they’re giving airway management and assisted ventilation where necessary.

If the patient doesn’t receive immediate medical assistance after entering respiratory depression, then there is a good chance they won’t make it.

Understanding Alcohol Metabolism and Liver Function

We’ve already discussed how prolonged use of alcohol can lead to severe liver disease. The reason for this is that the liver processes this toxin out of the body and prolonged inflammation of the liver leads to the onset of chronic conditions like cirrhosis.

The liver also takes up the responsibility of processing Xanax and removing it from the body. When a cocktail of Xanax and alcohol are consumed, the liver picks a side and decides that alcohol gets the priority treatment, choosing to metabolize it first over the Xanax.

As a result, the Xanax remains in the system for longer, experiencing higher levels of reuptake in the receptors, and a greater chance of initiating an overdose in the user. The damage to the liver caused by prolonged alcohol abuse will also make it harder for the liver to efficiently metabolize Xanax, increasing overdose risk.

Unpacking the Consequences and Danger of Combining Xanax and Alcohol

Immediate Risks

The immediate risks of using Xanax and alcohol together are real. While respiratory depression is always a possibility, it’s not always the worst outcome. The motor skill and balance impairment experienced by the user can cause bad falls.

The user could misstep, lose their balance, and hit their head on a hard surface, like the corner of a marble kitchen counter. Then there’s also the risk of blacking out from using the combo. The user may wake up unable to recall what happened to them in the hours they were passed out.

Long-Term Health Risks

The long-term use of this killer cocktail leaves lasting adverse health problems in the user. We’ve already discussed the liver damage caused by abusing these substances independently and in combination.

It goes without saying that combining these drugs can lead to severe addictions that are hard to break. As mentioned, it’s not possible to suddenly cease the use of either of these substances without enduring possibly life-threatening side effects.

Severe abuse of this combination has profound effects on the users mental health, leading to the development of mental health issues like depression and anxiety disorders. The user might return to abusing the drugs simply as a way to cope with their deteriorating mental health.

What are the Signs a Loved One is Abusing Xanax and Alcohol Together?

It’s hard to identify the signs of AUD and Xanax addiction in users, and even more challenging to identify the signs of polysubstance abuse concerning the two. For instance, unless you’re always around a person, you might think that them acting a little tipsy around the house when you’re over for a visit or running into them in a bar from time to time might be just normal behavior. It only becomes noticeable when they exhibit this behavior repeatedly, either at home or work, and their drunkenness starts to interfere with their ability to function properly.

Likewise, if your loved one has a Xanax prescription and they seem a zonked out, you might assume they’re just dealing with a heightened state of anxiety that they need to medicate themselves (according to their doctors’ instructions) through. But it’s far more challenging to realize a loved one has a deep addiction to Xanax because they’re usually well into it before anyone notices.

If your loved one has a prescription and they seem to drink frequently, they might be in the early stages of polysubstance abuse. If you notice your loved one displaying this behavior, speak to someone at a treatment center and arrange an intervention. The goal is to get them into an inpatient treatment program as soon as possible.

Wrapping Up – Treatment for AUD and Xanax Abuse

An inpatient program is the only way to break the cycle of polysubstance abuse with Xanax and Alcohol. Alone, these two addictions are almost impossible to break, but together, it’s a never-ending nightmare that is impossible to resolve, without tragedy.

An inpatient program starts with a medically managed detox when a qualified doctor prepares a detox protocol to limit the effects of alcohol and Xanax withdrawal. They’ll arrange a tapering structure for the Xanax and supporting drugs like Lorazepam for treating AUD.

The second treatment phase involves individual and group therapy sessions with a certified psychologist. The doctor uses a combination of evidence-based treatments like Dialectic Behavioral Therapy and Cognitive Behavioral Therapy to help the patient uncover the thoughts and behaviors driving their addiction.

The therapy sessions combined with a solid aftercare plan to manage triggers gives the patient the tools they need to experience breakthroughs. It helps them identify and change their behavior and thought patterns, essentially rewiring the neural pathways that feed their addiction. Over time, this rewiring of the brain makes it easier and easier for the addict to abstain and reduces the risk of relapse.