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Alcohol is a central nervous system (CNS) depressant. So is Xanax. Celebrities such as Judy Garland, Elvis Presley, Amy Winehouse, Heath Ledger, Anna Nicole Smith, and Whitney Houston died from overdosing on mixtures of alcohol and the class of medications known as benzodiazepines.

Xanax is also a Schedule IV drug, which means it has a low risk of dependence and abuse. However, when it is mixed with alcohol, it becomes much more dangerous. Alcoholics may take Xanax to ward off withdrawal symptoms.

What is Xanax?

This medication helps people to relax after suffering from a panic attack. If they experience social anxiety and find it hard to mix and mingle with others in social or work environments, Xanax can help them to relax to the point where they feel able to function. Xanax slows down your CNS activity, allowing you to feel calmer and function more easily.

The mixing of Xanax with any type of alcohol is what makes it unsafe. The US Drug Enforcement Administration (DEA) views the combination of alcohol and Xanax as increasing both drugs’ potential for abuse and the risk of physical dependence or addiction. Xanax has become one of the more popular medications for physicians to prescribe. However, for people suffering from alcohol use disorder, Xanax has become a way for them to soften the edges of withdrawal from alcohol, making dependence on both drugs a significant risk.

Common Side Effects of Xanax

This list covers the common side effects of this benzodiazepine:

  • Profuse sweating
  • Drowsy
  • Constipation
  • Dizzy
  • Diarrhea
  • Insomnia
  • Irritability
  • Memory issues
  • Problems with concentration
  • Inability to coordinate body or balance
  • Slurred speech
  • Loss of interest in sex
  • Headaches
  • Stuffy nose
  • Nausea
  • Vomiting
  • Muscle weakness
  • Swollen hands or feet
  • Changes in appetite or weight

Your doctor will likely prescribe around 0.25 to 0.5 mg of Xanax three times a day. Some patients with panic disorders have needed Xanax doses of more than 4 mg. every day. However, taking more than you are recommended is never a good idea. If you feel you need more than you’ve been prescribed, talk with your doctor first.

Xanax may interact poorly with other sedating medications such as narcotic pain medications, allergy or cold medications, sleeping pills, muscle relaxants, medications to treat depression, seizures or anxiety, cimetidine, birth control pills, ergotamine, cyclosporine, imatinib, dexamethasone, St. John’s wort, antifungals, antibiotics, seizure medications, and HIV/AIDS medications. Any benzodiazepine may cause fetal abnormalities and should not be taken in pregnancy or while the mother is nursing.

Interactions of Alcohol and Xanax

Both Xanax and alcohol act on your central nervous system in the same way; they are both depressants, slowing your system down. In fact, every container of Xanax comes with a warning label that reminds patients not to mix it with alcohol.

This benzodiazepine does not play well with alcohol including wine, beer, or hard liquor. Just as alcohol increases the inhibitory effects of Gamma Aminobutyric Acid, or GABA, Xanax does the same thing. In your brain, GABA quiets brain over-excitation, which helps you to feel relaxed or even mildly sedated.

If you add alcohol to Xanax, either when you are taking a prescribed dose or if you are abusing Xanax and alcohol, your brain and entire CNS may become too sedated, leading to overdose or even death.

Alcohol Poisoning and Xanax Overdose

It helps to understand what “addiction” really is. The psychiatric profession considers it to be a brain disease that presents with a need to use harmful substances even when someone knows what the consequences are. That is, addiction causes them to have a laser-sharp focus on obtaining and using certain drugs.

Alcohol poisoning symptoms:

  • Confusion
  • Slow breathing (fewer than eight breaths/minute)
  • Irregular breathing (10-second gap or more between some breaths)
  • Vomiting
  • Seizures
  • Low body temperature
  • Blue tinge to lips or skin
  • Unconscious and can’t be roused

Signs of Xanax overdose:

  • Poor coordination (stumbling)
  • Drowsy
  • Confusion
  • Blurry vision
  • Coma
  • Death

Using Xanax with alcohol may create a stronger high or buzz, along with other side effects. However, doing so forces your liver to work harder to break down both Xanax and alcohol.

Symptoms of a double overdose:

  • Sedation
  • Impaired muscle control and reflexes
  • Slurred speech
  • Confusion
  • Irritability
  • Aggression
  • Hostile behavior
  • Rage
  • Sadness
  • Impaired judgment
  • Blackout or impaired memory
  • Death

Withdrawal

When your body is experiencing a withdrawal from alcohol, you could experience many symptoms.

These will include:

  • Nausea
  • Anxiousness
  • Insomnia

Withdrawing from Xanax gives you a whole different set of symptoms:

  • Itchy skin, rashes
  • Numbness or tingling in face, hands, or feet
  • Sweating or flushing (red skin)
  • Anger and irritability
  • Becoming aggressive
  • Return of panic attacks and anxiety
  • Nightmares, disturbed sleep, insomnia
  • Bad memories return
  • Paranoia
  • Unable to concentrate, poor memory
  • Thinking obsessively
  • Hallucinations
  • Depressed
  • Headache
  • Cravings
  • Muscle and joint stiffness/pain
  • Weak limbs, particularly legs
  • Fatigue or exhaustion
  • Tremors
  • Dizzy
  • Flu-like or cold symptoms
  • Tinnitus (ringing in the ears)
  • Nausea/vomiting
  • Change in appetite (increased, with weight gain)
  • Hypersensitivity

Treatment

When someone you know experiences alcohol poisoning, they need immediate medical care. In the hospital, medical personnel may pump their stomach to keep more alcohol from being absorbed and give them activated charcoal to limit the absorption of alcohol already in their system. If they still don’t wake or respond, they may insert a breathing tube to prevent breathing problems. Doctors and nurses will monitor your friend’s vital signs and give oxygen therapy. They will also often receive intravenous fluids to keep from becoming dehydrated and be catheterized until they wake and can function on their own.

If your friend overdoses on Xanax, they also need immediate emergency medical treatment. Doctors and nurses will pump their stomach and give them IV fluids to help push the toxins out of their body. Some patients who have overdosed on Xanax receive flumazenil, which is an antidote to benzodiazepines that can reverse some of the worst effects of an overdose. They may also receive oxygen therapy.

Recovery from alcoholism requires more than a trip to the hospital. It needs the patient attend long-term rehab, whether in-patient or out-patient. Peer support and a structured environment help in recovery.

Long-term treatment of Xanax addiction involves the removal of this drug from your daily routine. Treatment may be part of a dual-diagnosis program, which addresses mental health issues along with addiction. Various therapies, such as cognitive behavioral therapy (CBT), cue exposure, self-control training, education, support groups, and individual, marital and family counseling, are provided to help the patient deal with their anxiety without the help of medications.

Sources:

  • https://lannarehab.com/blog/the-dangers-of-mixing-xanax-with-alcohol/

  • https://www.healthychildren.org/English/ages-stages/teen/substance-abuse/Pages/Controlled-Substances-Not-Just-Street-Drugs.aspx

  • https://www.rxlist.com/xanax-side-effects-drug-center.htm#overview

  • https://www.psychiatry.org/patients-families/addiction/what-is-addiction

  • https://www.mayoclinic.org/diseases-conditions/alcohol-poisoning/symptoms-causes/syc-20354386

  • https://www.medicalnewstoday.com/articles/326551.php

  • https://www.healthline.com/health/xanax-and-alcohol#xanax-and-alcohol-side-effects

  • https://clinicalservicesri.com/detox/xanax/

  • https://www.healthline.com/health/alcohol-intoxication#outlook

  • https://www.burningtree.com/alcoholism-long-term-treatment-2/

  • https://www.healthline.com/health/addiction/xanax-addiction#treatment