Alcohol is the most commonly misused psychoactive substance in the United States. In 2019, more than 25% of people binge drank, and 14.1 million met the criteria for an alcohol use disorder. Because alcohol is so common, it’s sometimes mixed with other drugs, both by mistake and intentionally. Intentional drug mixing for recreational purposes can be potentially dangerous, increasing your risk of overdose and other consequences. Xanax is a prescription medication that’s also used illegally as a recreational drug.
But how does Xanax interact with alcohol, and how can mixing the two substances affect your body? Learn more about Xanax and alcohol interactions and their side effects.
Xanax is the brand name for a central nervous system depressant called alprazolam. The drug is used to treat anxiety and panic disorders. Xanax is in a class of drugs called benzodiazepines, which are popular for a variety of issues from anxiety to insomnia. Benzodiazepines work by interacting with a chemical in the brain called gamma-aminobutyric acid (GABA), which helps to facilitate calmness, relaxation, and sleep. Xanax binds to GABA receptors and increases the efficacy of the chemical. People who have trouble calming down, resting, or sleeping may experience relief when Xanax enhances their chemical ability to slow down their nervous system.
Xanax may also be misused or used recreationally. As the drug works to slow down your nervous system, it can also have other effects and side effects. The drug can cause a relaxing euphoric that’s similar to alcohol intoxication. It may also cause unwanted side effects like fatigue, depressed mood, and impaired judgment.
But what happens if Xanax and alcohol are taken at the same time?
There are many medications that are dangerous to mix with alcohol. They may interact with one another poorly, increasing your risk of experiencing unpleasant or dangerous side effects. Some may interact by putting your body through extra strain, like your liver, which processes anything you swallow from pills to alcohol. Since alcohol and some medications can create toxic chemicals when they’re broken down in the liver, taking them at the same time could lead to liver damage or inflammation.
Alcohol and Xanax can interact in the body in a different way. Alcohol is also a central nervous system depressant, and it works in a very similar way to Xanax. They both influence GABA and increase feelings of relaxation. Both slow down your nervous system in order to achieve their effects.
This causes a phenomenon called potentiating, which is when two or more drugs combine to cause more intense effects than they would separately. When alcohol and Xanax potentiate, it can lead to intoxication with relatively moderate doses. Symptoms may include severe drowsiness, slurred speech, memory blackouts, impaired motor function, and other issues.
When the drugs combine the sedative effects, it can cause you to feel extremely sleepy or lose consciousness. You may feel physical weakness, relaxed muscles, and heaviness in your extremities. This can also affect your coordination and lead to accidents or injuries. Both alcohol and Xanax can cause these effects in high doses, but the combination can cause them in otherwise small amounts.
Both Xanax and alcohol can have an effect on your mood. Alcohol can act as a temporary mood booster in some people and cause depression in others. Some experience both at different times. Xanax can sometimes cause depression as a negative side effect, and some people experience thoughts of suicide. Other rare side effects include rage, aggressive behavior, and irritability. Alcohol also increases risk-taking behavior and impairs your judgment and decision making. Mood and behavior symptoms may increase when the substances are combined.
Alcohol and Xanax are both associated with memory impairment. High doses can inhibit the process of short term memories making into long-term memory storage. This can cause memory gaps, also called blackouts.
Combining alcohol and Xanax may also cause physical side effects like nausea, headaches, blurred vision, and low blood pressure. Low blood pressure can cause lightheadedness, particularly when you stand up from sitting. You may also experience gastrointestinal distress with symptoms like nausea, vomiting, stomach aches, and diarrhea.
Misusing alcohol and Xanax together recreationally increases your risk of long-term consequences. Alcohol and Xanax misuse can lead to chemical dependence and addiction. Using the drugs together may cause you to develop these issues more quickly. Long-term depressant misuse can cause psychological and physical health issues. Both may lead to depression, personality changes, and cognitive impairments.
Alcohol and Xanax misuse can also contribute to changes in your sex drive, appetite, and weight. It can also increase your risk of some serious physical problems, including cancer, stroke, heart disease, liver disease, and other diseases.
Xanax can cause an overdose, which may involve intense, unpleasant side effects. However, like most benzodiazepines, an accidental overdose doesn’t usually lead to fatal symptoms. Overdose deaths without any other substance involved are uncommon and often involve suicidal intentions. However, the majority of overdose deaths involve another substance, especially opioids. In 2018, there were 10,724 overdose deaths that involved benzodiazepines, and only around 1,000 didn’t also involve an opioid. In some cases, powerful opioids like fentanyl are pressed into fake Xanax pills, leading to an overdose before they even realize that they took something in addition to a benzodiazepine.
While Xanax is not likely to cause a deadly overdose on its own, it certainly can lead to dangerous overdose symptoms when it’s combined with other drugs. Since alcohol is so common, it may be used alongside a prescription by accident. But it’s also used in the same settings that drugs may be misused.
Alcohol and Xanax are two very common depressants that see recreational use and misuse. But both substances may be dangerous when mixed with other drugs as well.
Alcohol can be dangerous when it’s mixed with other benzodiazepines, too, including the popular drug Valium. Like Xanax, these other benzodiazepines work in a similar way in the brain and can potentiate with alcohol. But this isn’t the only class of drugs that can be dangerous with alcohol. Other depressants like barbiturates and opioids like heroin can have depressing effects that intensify alcohol. Mixing any of these drugs with alcohol or each other can lead to a fatal overdose. Whenever you take a prescription, recreational, or over-the-counter drug, it’s important to check its interaction with alcohol before drinking.
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National Institute on Drug Abuse. (2020, October 19). Overdose Death Rates. from https://www.drugabuse.gov/drug-topics/trends-statistics/overdose-death-rates
National Institute on Drug Abuse. (n.d.). Opioids. from https://www.drugabuse.gov/drugs-abuse/opioids
RxList. (2018, February 6). Benzodiazepines Drug Class: Side Effects, Types & Uses. from https://www.rxlist.com/benzodiazepines/drug-class.htm
RxList. (2019, September 17). Gamma-aminobutyric Acid: Health Benefits, Uses, Side Effects, Dosage & Interactions. from https://www.rxlist.com/gamma-aminobutyric_acid/supplements.htm