Taking Xanax with Alcohol

It’s easy to assume that a prescription medication is safe, especially if it was given to you by your doctor. However, this is not necessarily the case. Every substance has risks and possible side effects that tend to become worse when the drug is misused or abused.

Using Xanax with alcohol is a particularly dangerous way of misusing this drug—with potentially deadly consequences.1

Xanax and the Body

woman feeling effects of Xanax

Xanax, the brand name for alprazolam, is a benzodiazepine, a central nervous system depressant that works by enhancing the activity of GABA, an inhibitory neurotransmitter that effectively slows nerve impulses throughout the body. Benzodiazepines produce sedating and relaxing effects and are primarily used in the short-term management of anxiety and panic disorders.2,3

While it can be extremely useful for people with these disorders, Xanax does have some potential adverse side effects, which may include:2,4

  • Drowsiness.
  • Lethargy.
  • Irritable mood.
  • Problems concentrating.
  • Lightheadedness and dizziness.
  • Slurred speech.
  • Nausea and vomiting.
  • Changes in sex drive.
  • Appetite and weight changes.
  • Memory problems.
  • Unusual mood changes.
  • Suicidal thoughts and behaviors.

Alcohol Side Effects and Risks

Alcohol is a depressant substance and can produce effects similar to those of Xanax in many cases, such as:5

  • Increased feelings of relaxation.
  • Impaired judgment.
  • Impaired muscle coordination.
  • Slurred speech.
  • Slowed reaction time.
  • Memory and concentration problems.
  • Slowed breathing and increased heart rate.
  • Loss of consciousness.

Why Mixing Xanax and Alcohol Is Dangerous

Alcohol and Xanax both depress the central nervous system and have many similar effects on the body—and when these drugs are taken together, the effects intensify.

People taking benzodiazepines such as Xanax are cautioned to avoid alcohol while taking the drug due to the risk of fatal overdose and accidents.3

Overdose Is More Likely

Using these drugs in combination may result in profound depression of the central nervous system (CNS), placing the individual in greater danger than if they had used Xanax or alcohol alone.1

Signs of an overdose on Xanax and alcohol may include:3,6

  • Profound confusion/stupor.
  • Loss of coordination and slowed reflexes.
  • Loss of consciousness with inability to wake up.
  • Clammy skin and low body temperature.
  • Irregular, very slow, or stopped pulse.
  • Very slow or stopped breathing.
  • Bluish tint to skin around the fingernails and lips.

Severe respiratory depression, coma, or death may result from an overdose of this drug combination.7,8

Accidents and Injuries

Xanax and alcohol may result in car accidents from cognitive effects and blurred vision

As both alcohol and Xanax can cause impaired motor coordination, drowsiness, and dizziness, the risk for accidents may be much higher among those who use these drugs together. Driving is especially dangerous, as the person may be unable to react quickly enough to changes on the road, may have blurry vision, may be confused, or may even fall asleep at the wheel. Driving while under the influence of either substance is risky, and your ability to operate a car safely under the influence of both may be significantly reduced.3

Falls and other injuries may also be more likely among individuals who use these drugs in combination. The risk is increased among elderly individuals.9

Signs Someone Is Using Xanax and Drinking

People may take Xanax together with alcohol to enhance their euphoric, sedating effects, and they may not anticipate the compounding negative effects or recognize that the combination may be life-threatening.

If you suspect someone is regularly using these drugs together, watch for the following signs:3,5,10,11

  • Appearing drowsy very often or to an unusual degree.
  • Stumbling/falling down.
  • Slurring their words regularly.
  • Making bad decisions/showing signs of impaired judgment.
  • Not remembering events or forgetting details about them.
  • Doctor-shopping, or visiting multiple doctors for Xanax prescriptions.
  • Smelling of alcohol.

Your loved one may also begin to feel shaky and sick when unable to drink and/or use Xanax. This is withdrawal and indicates physical dependence has developed to one or both substances.9

Withdrawal from Xanax and Alcohol

Withdrawal symptoms are similar for both substances and may include:9

  • Sweating.
  • Rapid pulse.
  • Hand tremors.
  • Insomnia.
  • Nausea and vomiting.
  • Inability to stay still (e.g., pacing, tapping fingers, fidgeting, etc.).
  • Hallucinations.
  • Seizures.

Withdrawal from both Xanax and alcohol can be life-threatening in some cases, and those attempting to detox off of either substance need to do so under medical supervision.

The Desert Hope medical detox program is staff with doctors and nurses who provide 24/7 monitoring to ensure patient safety. In this inpatient medical detox environment, you or your loved one will receive the medical care you need to safely withdraw from these drugs. Staff can also help you move forward into the next phase of treatment, since detox is rarely enough treatment for an individual to maintain their sobriety over the long term.

Treatment for Polydrug Addiction

The extreme dangers of combining Xanax and alcohol highlight the importance of treatment. After medical detox, professional treatment for addiction to Xanax and alcohol may occur in one or more of the following:

  • Residential treatment
  • Partial hospitalization program
  • Intensive outpatient program
  • Outpatient program

Someone seeking treatment for addiction may attend more than of these levels of care. For example, they may start out in residential treatment and then move into an IOP as they progress and then eventually into a standard outpatient program that is much less intensive.

Treatment may involve the following elements:

  • Individual and group therapy
  • Family therapy
  • Medication-assisted treatment (e.g., acamprosate for alcohol addiction)
  • 12-step meetings
  • Drug education
  • Holistic or experiential therapies
  • Recreational activities/outings
  • Aftercare planning to help you transition out of treatment

At Desert Hope, we offer the full continuum of care so that you or your loved one may continue your recovery efforts without disruption as you progress without having to change locations or treatment providers.

Desert Hope also provides treatment for co-occurring disorders, which may be particularly important for those with anxiety or panic disorders who began using Xanax with a prescription. Without treatment of the underlying mental health issues a person faces, sobriety may be especially difficult to maintain.

Desert Hope staff also work with all patients from the start to develop an aftercare plan so that they have concrete steps to take once they leave the program. This may include steps such as moving into a sober living home or enrolling in an alumni program.

With research-based therapy and a supportive, substance-free environment, someone struggling with Xanax and alcohol abuse has a better chance of safely ending their use of both substances and learning new ways to cope with reaching for either drug. Recovery is possible with the right treatment.


  1. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of addiction medicine12(1), 4–10.
  2. U.S. Drug Enforcement Administraion. (n.d.). Benzodiazepines. 
  3. Pfizer. (2011). XANAX® alprazolam tablets, USP.
  4. U.S. National Library of Medicine. (2019). Alprazolam.
  5. Virginia Center for Integrated Healthcare. (2013). Alcohol Effects & Safer Drinking Habits.
  6. National Institute on Alcohol and Alcohol Abuse. (2018). Understanding the Dangers of Alcohol Overdose.
  7. Ogbu, U. C., Lotfipour, S., & Chakravarthy, B. (2015). Polysubstance abuse: alcohol, opioids and benzodiazepines require coordinated engagement by society, patients, and physicians. The western journal of emergency medicine16(1), 76–79.
  8. Isbister, G. K., O’Regan, L., Sibbritt, D., & Whyte, I. M. (2004). Alprazolam is relatively more toxic than other benzodiazepines in overdose. British journal of clinical pharmacology58(1), 88–95.
  9. American Psychiatric Association: Diagnostic and Statistical Manual of Mental Disorders: Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition. Arlington, VA: American Psychiatric Association, 2013.
  10. National Institute on Drug Abuse. (2011). Research Report Series: Prescription Drug Abuse.
  11. Office of Personnel Management. (n.d.). Alcoholism in the Workplace: A Handbook for Supervisors.
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