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The Dangers of Mixing Xanax and Alcohol

Many people mix Xanax with alcohol to amplify the effects of both substances. However, those who combine these drugs are often unaware of how dangerous this practice can be. This article explores the properties of Xanax and alcohol, the short-term and long-term effects of combining these drugs, and where to get help if you believe that you or your loved one has a problem abusing substances.

About the Substances

Xanax is the brand name for alprazolam, a Schedule IV drug that’s part of a class of drugs known as benzodiazepines. Benzodiazepines are central nervous system (CNS) depressants, which means that they slow brain activity. They are typically prescribed to treat anxiety and panic attacks, although they are also used to manage the symptoms of alcohol withdrawal. When prescribed for a short period of time and taken exactly as prescribed, Xanax can be a safe and therapeutic medication. However, it is a federally controlled substance, which means that it has potential for abuse, dependence, and addiction.1 

Alcohol, on the other hand, is legal for people over the age of 21 to purchase and consume, but this does not necessarily make it safer than other substances. Moderate drinking, defined as 1 drink a day for women or 2 for men, is relatively safe. However, many people, especially young people, engage in binge drinking, described as consuming 4 drinks in a fairly short period of time for women and 5 for men.2 Nearly 27% of people aged 18 or older had engaged in past-month binge drinking.3 Consuming large amounts of alcohol in any manner can lead to overdose and death.

Since Xanax and alcohol are both CNS depressants, each of them alone can lead to coma, suppressed breathing, and death. Therefore, combining them is extremely risky, mainly due to the risk of extreme respiratory depression. 

Short-term Effects of Concurrent Use

In the short-term, a person who mixes Xanax and alcohol can experience a range of side effects, which can place people in dangerous situations and increase their risk of injury or death. These effects include:2,4,6

  • Dizziness.
  • Extreme drowsiness.
  • Slurred speech.
  • Increased risk of aggression.
  • Impaired judgment.
  • Loss of coordination.
  • Memory loss.
  • Vomiting.
  • Coma.
  • Death.

Even if someone mixes Xanax and alcohol and does not experience a serious overdose or die, they are putting themselves in significant danger each time they engage in this practice. Chronic Xanax and alcohol abuse may result in a series of physical and mental long-term effects.

Long-term Effects of Mixing Xanax and Alcohol

Long-term abuse of these two drugs has not been extensively studies. However, there are known, long-term effects for abusing either substance alone. The long-term effects of alcohol abuse can include:5

  • Liver disease, including fatty liver, alcoholic hepatitis, and cirrhosis.High blood pressure.
  • Stroke.
  • Irregular heartbeat.
  • Cardiomyopathy, characterized by stretching and weakening of the heart muscle.
  • Changes to the brain, including memory loss and diminished cognitive abilities.
  • Problems with the pancreas, including potentially deadly issues such as pancreatitis.
  • Increased risk of cancer of the mouth, esophagus, liver, breast, and throat.
  • Weakened immune system, which can cause relatively minor diseases to become serious.

The long-term abuse of Xanax can also lead to serious long-term consequences, including:6,7,8

  • Cognitive impairment.
  • Increased risk of falls.
  • Increased risk of aggression.
  • Decreased resting heart rate.

Both substances can lead to tolerance, which means that increased amounts are necessary for users to feel the desired effects. In attempts to overcome this tolerance, people may use more and more Xanax and alcohol, which can hasten the development of physical dependence. When someone is physically dependent on Xanax and alcohol, they have to continue using the substances to avoid the emergence of unpleasant and potentially fatal withdrawal symptoms, such as agitation and seizures.6 Physical dependence is the body’s natural adaptation to the presence of the substances, but with continued concurrent abuse, a person who is dependent could develop an addiction, which is characterized by a set of maladaptive, drug-seeking behaviors. Someone who is addicted to alcohol and/or Xanax is likely to experience the following ramifications of chronic use:6

  • Interpersonal and relational problems.
  • Expulsion from school.
  • Termination from work.
  • Child custody issues.
  • Legal problems, such as DUI.
  • Financial hardship.
  • Exacerbation of psychological or physical conditions.
  • Strong drug cravings.

It is not advisable for someone to try to stop using Xanax or alcohol alone. Instead, they should seek professional help to do so. No one sets out to become addicted, and it’s hard to ask for help, but it’s the only way to stay safe while detoxing.

How to Get Help

Detox is the process of getting drugs such as Xanax and alcohol out of a person’s body and helping them to withdraw safely after they have become physically dependent. There are a variety of options for this process, including:

  • Inpatient detox: Inpatient programs can provide 24-hour support and medical monitoring for detox from Xanax and alcohol. Detox is especially important if a person has been abusing alcohol or Xanax, because stopping the use of these substances can result in seizures, delirium, and hallucinations. Withdrawal from alcohol or Xanax often requires inpatient treatment in order to monitor a person for serious medical complications. Inpatient detox can take place in a dedicated detox facility or be part of a longer-term rehab program.
  • Hospital programs: This is the most intensely monitored detox setting. People may wind up detoxing here after being admitted for adverse consequences resulting from Xanax and alcohol abuse. Once stabilized, the hospital staff members will refer patients to a substance abuse treatment program.
  • Outpatient treatment: Outpatient detox treatment, which allows the patient to attend scheduled meetings and then return home, is sometimes an option but it should only be done after a comprehensive evaluation by a doctor who has deemed little to no risk of complicated withdrawal.

After a person completes Xanax and alcohol detox, it is imperative to transition into an addiction treatment program that can rectify negative behaviors and replace unhealthy coping skills with healthy ones. These programs can occur in a number of settings, just as detox can. The important thing is that you get the help you need to change your patterns of drug abuse and lead a healthy and happy life.


  1. U.S. National Library of Medicine. (2017). Xanax-Alprazolam Tablet.
  2. National Institute on Alcohol Abuse and Alcoholism. (2015). Alcohol Overdose: The Dangers of Drinking Too Much.
  3. National Institute on Alcohol Abuse and Alcoholism. (2017). Alcohol Facts and Statistics.
  4. University of Michigan. (2017). The Effects of Combining Alcohol with Other Drugs.
  5. National Institute on Alcohol Abuse and Alcoholism. (N.D.). Alcohol’s Effect on the Body.
  6. American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (DSM-5®). Washington, DC: American Psychiatric Publishing.
  7. Johnson, B., Streltzer, J. (2013). Risks Associated with Long-Term Benzodiazepine UseAmerican Family Physician, 88 (4), 224-225.
  8. Center for Substance Abuse Research. (2004). Benzodiazepines.
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