What Happens When You Mix Alcohol and Xanax?

The Risks and Side Effects of Combining Xanax with Alcohol

Have you ever wondered what happens when you mix alcohol and Xanax? You may know people who use Xanax while also engaging in unhealthy alcohol use. But what appears to be a way to relax or take the edge off after a long day can actually shut down critical systems in the body and increase the risk of overdose more than you think.

The Purpose Healing Center clinical team has seen this dangerous combination many times.

One or both drugs can lead to addictive behaviors and mental and physical dependence alone; combined, Xanax and alcohol interactions can be perilous in the near term and lead to a complex drug and alcohol addiction in the long term.

Understanding how Xanax and alcohol abuse pose a severe risk can and should be a consideration when considering treatment options and avoiding the risks of regular consumption.

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What Xanax Is and How It Affects the Body

Xanax is the brand name for alprazolam, a prescription drug in the benzodiazepine class. Used under proper medical supervision, it’s an effective treatment for generalized anxiety disorder and panic disorder.

It calms the central nervous system and provides sedative and muscle-relaxing effects that can come from fear or agitation. The relief is quick, which is why it also carries a heightened risk of dependence and misuse when used beyond the therapeutic dosage range.

Xanax facilitates the release of the inhibitory neurotransmitter gamma-aminobutyric acid (GABA) indirectly and increases the concentration of dopamine in the central nervous system.

Why Mixing Xanax With Alcohol Is More Dangerous Than It Seems

Xanax and alcohol both impact the central nervous system as depressants. The complications that can arise from mixing alcohol with other drugs cannot be overstated. Benzodiazepine-related visits to emergency rooms are frequent, with some being overdoses from a Xanax-alcohol combination.

The National Institute on Alcohol Abuse and Alcoholism (NIAAA) reports that 1 out of 5 benzodiazepine prescription overdose deaths also involve alcohol.

1) Increased Risk of Respiratory Depression

The combination of Xanax and alcohol can result in respiratory depression, which can be fatal. Respiratory failure happens when inappropriate alcohol and alprazolam use suppresses respiratory function to the point of shutting it down completely.

2) Sedative Effects Lead to Functional Impairment

Alone, both Xanax and alcohol can impair cognition and coordination. But mixing Xanax and alcohol can lead to increased sedation and impaired cognitive and motor functions. The results can be devastating, as evidenced in a 2024 Arizona Department of Transportation (DOT) report.

In 2024, Arizona had 121,107 auto crashes; alcohol abuse was involved in 5,520 accidents, 347 fatalities, and 3,574 injuries. Alcohol made up almost 28% of all fatal crashes.

3) Increased Overdose Risk

Taking Xanax and alcohol together increases the risk of overdose. It’s important to understand that both Xanax and alcohol are central nervous system depressants that can produce sedative effects.

That can lead to respiratory depression, a situation where breathing becomes shallow or stops. It’s a medical emergency that requires an immediate call to 911.

4) Endangering Personal Well-Being

Individuals who mix Xanax and alcohol may experience blackouts, where they have no memory of events that occurred while under the influence.

Taking alcohol with Xanax increases exposure to sexual assault or other dangers, especially in tandem with binge drinking.

5) Long-term Use Can Mean Severe Liver Damage

Chronic use of both Xanax and alcohol can lead to long-term health issues, including liver damage. It’s also important to know that the liver prioritizes metabolizing alcohol over Xanax, which can lead to increased levels of Xanax in the body after the alcohol is no longer a threat.

6) Mental Health Risks Associated With Alcohol and Xanax Use

When the short-lasting effects of Xanax and alcohol abuse wear off, underlying mental health conditions quickly reappear. The person still has not addressed how to manage anxiety or panic attacks, so their mental illness continues to have a negative impact on everyday life.

Additionally, taking two substances together contributes to developing polysubstance addiction, a term referring to disordered use of one or both substances. When this happens, therapists must address both addictions and any underlying causes of substance abuse at the same time.

How Much Alcohol Is Too Much When Xanax Is Involved?

The Centers for Disease Control (CDC) provides clear guidance on what amount of alcohol constitutes too much when taking Xanax.

They explain that alcohol interacts with other drugs in ways that can be unpredictable; therefore, no amount of alcoholic drinks is safe with any other drug.

Tolerance, Physical Dependence, Addiction, and Risk of Overdose

With repeated use, the body starts adapting to the presence of your Xanax prescription and alcohol. That leads to tolerance and the need for higher doses to achieve the same calming effects. Over time, tolerance grows into physical dependence and addiction.

By this phase, Xanax and alcohol’s effects have become pronounced, and stopping suddenly triggers uncomfortable withdrawal symptoms. These can include anxiety, tremors, insomnia, and severe mood swings.

As tolerance increases, the risk of a fatal overdose also rises, especially when someone takes Xanax and alcohol together. The combined substances can shut down the body’s ability to regulate breathing and consciousness, making it a life-threatening event.

How Can Mixing Xanax With Alcohol Mask Warning Signs of Overdose?

One of the most insidious things about mixing alcohol and Xanax is how they can mask the warning signs of the other. Xanax dulls awareness of alcohol’s effects; alcohol intensifies sedative effects without triggering any mental alarms.

Because of this interconnectedness, people don’t notice the slower breathing, confusion, extreme drowsiness, or loss of coordination until it’s too late. This masking raises the danger of alcohol poisoning or a Xanax overdose.

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How Xanax Use and Alcohol Interact

Xanax is a common anxiety and panic attack prescription medication, but misuse often starts when people use it with alcohol to manage their stress of feel more confident in social situations. In time, the alcohol and Xanax become paired coping tools and reinforce each other’s use.

The pattern increases the chances of developing an addiction, as people continue using increasingly more to offset their anxiety or discomfort.

When Social Drinking Alcohol Turns Into a Pattern of Alcohol Abuse

A polysubstance addiction to alcohol can start as occasional social drinking. It can gradually become a harmful pattern that involves the addition of benzodiazepines or other substances.

Because Xanax reduces inhibition and anxiety, people become more socially confident and want to continue to duplicate that feeling. But over time, that requires increasingly larger amounts of substances, growing the addiction incrementally.

What are Signs Someone May Be Abusing Alcohol and Xanax?

Early signs of combining Xanax and alcohol can be behavioral:

Taking Xanax outside the prescribed methods (either taking doses too soon or increasing the amount they take)
Drinking alcohol more often
Using substances instead of relying on any other coping tools
Lying about or minimizing their use
Planning their day around using
Stealing or scamming for money for substances

If you or a loved one is engaging in these behaviors, it’s time to reach out for help.

The Typical Physical Symptoms of Alcohol-Xanax Addiction

The physical symptoms of a combined addiction reflect the depressant nature of each of these substances. Some of the physical signs of Xanax-alcohol abuse are:

Slowed reflexes
Frequent drowsiness
Poor coordination
Impaired memory
Slow reflexes or response
Headaches
Nausea
Sleep disruptions

It’s crucial to remember that labored breathing and loss of consciousness are severe physical signs that require immediate help.

Emotional and Mental Health Signs of Mixing Alcohol and Xanax

The ups and downs of using substances take an emotional and mental toll on the user. Some mental health symptoms that point to polysubstance abuse are the following:

Increased irritability
Depression
Emotional numbness
Loss of emotional control (lashing out)
Self-isolation
Making poor decisions

Because the primary effects of both substances involve calming or numbing the emotions, some people may struggle to manage their stress or anxiety without them. That can reinforce their dependence.

What are Considered Evidence-Based Treatments for Substance Use Disorders?

At Purpose Healing Center, we care for co-occurring Xanax addiction and alcohol misuse with evidence-based modalities, tailored to meet each client’s needs. Some of the most effective therapies we offer include:

Behavioral therapies help clients learn to replace inappropriate coping tools, like drug or alcohol use, with positive strategies. We use Cognitive Behavioral Therapies (CBT), Dialectical Behavior Therapy (DBT), and others, along with holistic treatments like music or art therapies to help each client find new ways to manage stress.
Medication management or exploring alternative medications is another tool. They’re especially helpful for those who have anxiety but have become addicted to benzodiazepines. We’ll find a better solution that won’t keep retriggering the addiction.
We use a therapy personalized matching process to align our treatments with each person’s needs, incorporating both individual treatment and group therapy to address the substance use.
Dual diagnosis treatment determines the underlying cause of addiction (if unknown), allowing our clinical team to treat both the reason behind the drug and alcohol addiction at the same time they treat the substance abuse.
We also help each client come up with a personalized aftercare strategy, a road map to help them stay on track after they graduate from their program.

These are a general overview of just a few treatments our clients experience. Call us to learn about other therapies or if you have any questions about how these strategies could help you overcome an addiction.

When to Seek Addiction Treatment for Xanax and Alcohol Use

Download Am I Addicted to Xanax and Alcohol Checklist Quiz

It’s time to seek professional help if you are drinking alcohol, mixing Xanax, and still lacking healthy coping mechanisms to manage your anxiety, stress, or trauma. Our quick checklist quiz can guide you in self-reflection to determine if you need to reach out to the Purpose Healing Center team for treatment.

Print it out, answer the questions honestly, and grab your phone to call for a confidential discussion about your needs.

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Get Professional Help for Alcohol and Xanax at Purpose Today

If your Xanax and alcohol misuse has become unmanageable, it’s time to get help. Our treatment center staff has the experience it takes to help you recover from any addiction – Xanax, alcohol, or other drugs. We’ll also use evidence-based tools to treat anxiety, depression, trauma, or other underlying causes that caused you to abuse benzodiazepines in the first place.

If you want to explore treatment options but worry about the costs, we encourage you to call our admissions number for advice. We accept nearly all AHCCCS plans and most commercial insurance plans in-network as well.

Call us today – your call to our staff will help set that stage for overcoming the adverse effects of substances and moving into a healthier life, so please reach out confidentially now.