Effects & Dangers of Mixing Alcohol and Xanax
Polysubstance use occurs when a person uses more than one substance simultaneously or sequentially.1 Mixing substances is never safe, as it can lead to dangerous and unpredictable effects.1 If you or a loved one use alcohol and Xanax (alprazolam), you may not realize how risky this combination can be for your health. This page will help you understand the dangers of mixing alcohol and Xanax, why using multiple substances increases your risk of addiction, and how to get help if you or a loved one is struggling.1
Combining Alcohol and Xanax
Alcohol and Xanax are both depressants.2 Xanax is the brand name for the generic alprazolam, a benzodiazepine.3 The benzodiazepine category of drugs, which also includes prescription medications like Ativan (lorazepam), Klonopin (clonazepam), and Valium (diazepam), works by enhancing the effect of neurotransmitters in the brain that inhibits nerve activity.2 This leads to its intended function of decreasing anxiety and inducing sleep when taken as directed.2 Alcohol also has depressant properties, which can lead to various effects depending on different factors, such as how much a person drinks and how often.4
The combined effects of alcohol and Xanax are intensified, increasing the risk of severe consequences.5 Despite this risk, mixing alcohol and Xanax is relatively common. One study found that 88% of individuals who take benzodiazepines also drink alcohol, and 25% intentionally use them together.6
People engage in polysubstance use for various reasons, such as to:2
- Enhance or prolong a substance’s effects.
- Counteract the effects of a substance.
- Feel a new effect.
- Lessen or prevent withdrawal symptoms.
- Escape from the stressors of daily life, health issues, or trauma.
What Is Xanax Misuse?
Xanax can be a safe and effective medication when taken as prescribed by a doctor. However, even when used appropriately, dependence can develop, leading to withdrawal symptoms if the medication is stopped abruptly.3 Misuse, also known as non-medical use, refers to taking medication in any way other than prescribed.7 This includes:7
- Taking someone else’s medication (even if for a seemingly similar complaint)
- Taking a higher dose than prescribed.
- Taking the medication more frequently than prescribed.
- Taking the medication for reasons other than those for which it was prescribed (e.g., to feel its euphoric effects or experience a “high”).
Misusing Xanax, especially in combination with other substances like alcohol, significantly increases the risk of serious health consequences, including addiction, overdose, and even death. It’s important to understand that even if Xanax is initially taken as prescribed, misuse can develop over time, leading to a dangerous cycle of dependence and increasing risk.8
Dangers of Mixing Alcohol and Xanax
Combining depressants like alcohol and Xanax is inherently dangerous as each substance amplifies the effects of the other, leading to serious adverse outcomes.2,3 Alcohol and Xanax mixed can cause severe drowsiness and respiratory depression, which can lead to coma and death.3
The combined effects of alcohol and Xanax may also include:3,9
- Dizziness.
- Impaired motor control.
- Unusual behavior.
- Memory problems.
Alcohol mixed with Xanax also significantly increases the risk of overdose, which is a medical emergency. While some of the symptoms of mixing these substances, such as drowsiness, can be present even without an overdose, an overdose can manifest in more severe forms of these symptoms, including:3
- Confusion.
- Difficulty speaking (i.e., dysarthria).
- Lethargy.
- Hypnotic state.
- Diminished reflexes.
- Poor muscle control (i.e., ataxia).
- Decreased muscle tone (i.e., hypotonia).
- Lowered or elevated blood pressure, heart rate, or respiratory rate.
Alcohol and Xanax Addiction
Both alcohol and Xanax carry a risk of developing an addiction, clinically referred to as a substance use disorder (SUD).3,10 Alcohol addiction is diagnosed as an alcohol use disorder (AUD) and Xanax addiction is diagnosed as a sedative, hypnotic, or anxiolytic use disorder.10,11 An SUD is a medical condition characterized by an impaired ability to control one’s substance use despite the negative mental, physical, and social consequences.10,11
If you have an SUD, you may be more likely to develop a dependence on other substances.1 You may also be more susceptible to developing more than one SUD. When this occurs, it is referred to as having concurrent or co-occurring SUDs, or polysubstance use disorder.5 Concurrent SUDs are relatively common. In 2023, 48.5 million people aged 12 or older (or 17.1%) had an SUD in the past year, including 28.9 million who had an AUD.12
Polysubstance use has consistently been linked to poorer treatment outcomes, which include lower treatment retention, increased relapse rates, and a mortality rate that is three times higher than that associated with the use of just one substance.1
Alcohol and Xanax Addiction Treatment
If you or a loved one are struggling with alcohol and Xanax addiction, you are not alone, and help is available. Evidence-based, personalized treatment can help people stop using substances and improve their quality of life.5
Treatment looks different for everyone but may include pharmacotherapy combined with behavioral therapies, such as:5
- Motivational interviewing (MI), which is designed to address a person’s ambivalence about changing their alcohol and Xanax use.5 Therapists use reflective listening and open-ended questions to help clients identify their reasons for change, address conflicting motivations (e.g., wanting to reduce anxiety vs. fearing withdrawal), and build self-efficacy for managing cravings and triggers specific to substance use.5
- Contingency management (CM), which is a behavioral therapy based on principles of operant conditioning, where people learn new behaviors through positive reinforcement.5 People typically receive vouchers or prizes to reward specific measurable behaviors, such as negative drug or alcohol tests, attending therapy sessions, or engaging in alternative coping activities to replace substance use.5
- Cognitive-behavioral therapy (CBT), helps people identify and challenge negative thought patterns and behaviors that contribute to their substance use and instead develop behavioral self-control and other coping skills so they can achieve and maintain abstinence.13
- 12-step facilitation therapy, which is designed for use in individual, outpatient settings.5 It can help people become familiar with and engage in mutual help support groups, such as Alcoholics Anonymous (AA) or Narcotics Anonymous, which can provide peer support and accountability for managing substance use.5
Because people who struggle with polysubstance use often have more complex needs, they may require treatment and support services from different settings and providers across settings.5 This may include:
- Medical detox, which provides medically supervised withdrawal management to help people become medically stable and, ideally, continue to formal treatment.14 People who engage in polysubstance use can have more complex withdrawal symptoms. Medical detox can help manage these symptoms, provide support, and help people remain as comfortable and safe as possible.5
- Inpatient drug and alcohol rehab, where people live at a treatment facility, receive 24/7 care and support, and participate in different types of therapies and treatments.14
- Outpatient addiction treatment programs, where people can keep living at home but attend treatment at a treatment facility on a regular schedule.14
- Intensive outpatient addiction treatment programs, which are more supportive types of outpatient programs offering 9-20 hours of weekly treatment.14
- Partial hospitalization rehab programs, which are highly supportive outpatient programs offering 4-8 hours of daily treatment.14
- Sober living, which are substance-free, supportive residences that assist people in recovery as they transition back to their daily lives after completing formal rehab.14
- Rehab aftercare, which can include various forms of ongoing support, such as 12-step groups, recovery check-ins, or individual counseling, to help people maintain recovery and prevent relapse.14
Getting Help for Alcohol and Xanax Addiction
No matter how things might seem right now, there is always hope. If you are struggling with alcohol and Xanax addiction, or know someone who is, we can help.
Please call American Addiction Centers (AAC) at any time of day or night to connect with a compassionate, knowledgeable admissions navigator. We can help you find the right treatment program for your needs, answer your questions, help you understand how to use health insurance coverage for rehab, and easily verify your insurance.