Picture this: You’re a habitual user of the benzodiazepine Xanax (alprazolam), and you’ve just been offered a glass of wine. Is it safe for you to take that first sip? Or, can you have as many drinks as you’d like without worrying about the consequences?
You should know that thinking like this could be a sign of a substance abuse problem.
That’s especially true if you are hoping that alcohol will augment the impact of Xanax, so you can take fewer pills and feel just as good. If you have a substance abuse issue, treatment does work. With help, you can move past these kinds of thoughts and into a healthier future.
You should also know that there is no real safe amount of alcohol to take with Xanax. In fact, combining these two substances could lead to deadly side effects you just didn’t expect.
Alcohol is so dangerous, in terms of abuse, because it is so very common. As an addiction expert writing for Psychology Today explains, hostesses would rarely serve their dinner guests cocaine or heroin with dinner, but they might serve those guests alcohol without giving the issue a second thought. Because it is so easy to find, alcohol can seem completely harmless, and that means people might mix it with all sorts of other substances without realizing the dangers involved.
Alcohol can interact with almost every type of drug available, but the interactions involved can vary, depending on the drug. As the charity Drinkaware explains, alcohol tends to exaggerate the impact of drugs in some way.
For example, stimulant drugs (like cocaine) tend to speed up the heart and rev up electrical activity within the brain. Alcohol, as a sedative, tends to slow down heart rate and brain activity. When taken together, a stimulant and a sedative work against one another in a competition. That can lead to a heart that races one minute and then slows to a crawl the next. This puts the body in a precarious and unpredictable position.
Mixing alcohol with sedatives (such as benzodiazepines) tends to cause a doubling effect. Where a glass of alcohol might be mildly sedating, a glass of alcohol with a sedative can be extremely sedating, and in some cases, it might slow breathing down to such a degree that vital processes needed for life to stop altogether.
Despite these dangers, it is not uncommon for people to mix alcohol with substances of abuse. In research cited in an article published in Scientific American, researchers found that 60 percent of people who take medications known to interact with alcohol also drink from time to time. In addition, 5 percent have three drinks at a time when they imbibe alcohol.
This suggests that people are possibly not aware of how dangerous it can be to mix alcohol and drugs like Xanax. Unfortunately, the consequences of that ignorance can be severe.
As mentioned, alcohol is a sedative that tinkers with electrical activity within the brain and slows breathing and heart rates. Xanax is also a sedative, and when the two are combined, they can reinforce one another and deliver intense sedation. According to the National Institute on Alcohol Abuse and Alcoholism, combining alcohol and Xanax can also cause:
Side Effects of Combining Alcohol and Xanax
The two drugs work together to overwhelm delicate systems that keep people breathing normally and experiencing the world as they should. The combination can also cause people to feel so sedate and calm that they slip into a coma-like state that they cannot be awakened from. Death can follow.
In a study about Xanax overdose deaths, published in the journal Drug and Alcohol Dependence, researchers found that 34.5 percent of people who died due to Xanax also had alcohol in their bodies.
It might be easy to assume that people who died were taking illicit Xanax that was combined with some other illicit drug substance. Other studies suggest, however, that even pure Xanax can cause death when combined with alcohol.
In a separate study published in the American Journal on Addictions, researchers found that a prescription was present in 52.5 percent of Xanax overdose deaths. This means even people who take Xanax straight from a pharmacy face very real overdose risks. That risk is augmented when alcohol is also present.
When you’re given a prescription for Xanax, you’re also provided with guidelines that tell you how much of the substance to take and when to take it. You might think it’s reasonable to combine Xanax with alcohol as long as you don’t take more Xanax than your doctor prescribes. Unfortunately, research suggests that even sticking to a prescription won’t keep you safe.
In a study published in the journal Expert Opinion on Drug Metabolism and Toxicology, researchers looked at how quickly people’s bodies metabolized Xanax when alcohol was also present. The researchers found that after 120 minutes, Xanax concentrations increased by 642 percent when alcohol was also present. This is a huge increase, and it demonstrates just how dangerous it can be to combine alcohol and Xanax.
When the two are present at once, Xanax is just easier for the body to make use of, and the concentrations of the drug within the body rise accordingly. This just isn’t something that someone can overlook. It’s chemistry, and it can be remarkably dangerous.
Even a very small dose combined with alcohol can cause side effects you didn’t anticipate. For example, in a 1991 study published in the journal Human Psychopharmacology: Clinical and Experimental, researchers found that even a dose as small as 1 mg (milligram) when combined with a drink of alcohol resulted in sedation, dizziness, and impaired performance. When a dose that small causes such a big impact, it is safe to say that no dose is without risk.
(January 2016). Which is More Dangerous: Alcohol or Drugs? Psychology Today. from https://www.psychologytoday.com/us/blog/all-about-addiction/201601/which-is-more-dangerous-alcohol-or-drugs
Alcohol and Illegal Drugs. Drinkaware. from https://www.drinkaware.co.uk/alcohol-facts/health-effects-of-alcohol/effects-on-the-body/alcohol-and-illegal-drugs/
(February 2012). Deadly Duo: Mixing Alcohol and Prescription Drugs Can Result in Addiction or Accidental Death. Scientific American. from https://www.scientificamerican.com/article/mixing-alcohol-prescription-drugs-result-addiction-accidental-death/
(2014). Harmful Interactions: Mixing Alcohol with Medicines. National Institute on Alcohol Abuse and Alcoholism. from https://pubs.niaaa.nih.gov/publications/Medicine/medicine.htm
(2014). Circumstances and Toxicology of Sudden or Unnatural Deaths Involving Alprazolam. Drug and Alcohol Dependence. from https://ndarc.med.unsw.edu.au/project/circumstances-and-toxicology-sudden-or-unnatural-deaths-involving-alprazolam
(July 2015). Characteristics of Alprazolam-Related Deaths Compiled By a Centralized State Medical Examiner. The American Journal on Addictions. from https://onlinelibrary.wiley.com/doi/abs/10.1111/j.1521-0391.2012.00298.x
(May 2018). Influence of Ethanol on the Metabolism of Alprazolam. Expert Opinion on Drug Metabolism and Toxicology. from https://www.tandfonline.com/doi/abs/10.1080/17425255.2018.1483338?journalCode=iemt20
(September 1991). Effects of Single Doses of Alprazolam on Alcohol Alone and In Combination on Psychological Performance. Human Psychopharmacology: Clinical and Experimental. from https://onlinelibrary.wiley.com/doi/pdf/10.1002/hup.470060305