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The Effects of Mixing Xanax and Alcohol

Mixing Xanax and alcohol can carry a variety of risks, as the drugs could produce unpredictable interactions. As a benzodiazepine, Xanax can cause sedative effects, which can amplify the effects of other depressant drugs, like alcohol. This can increase the risk of negative health outcomes, like overdose. Understanding the risks of mixing Xanax and alcohol can be vital in achieving recovery.

What is Xanax? What is Xanax Used For?

Xanax (a brand name for alprazolam) belongs to a class of drugs known as benzodiazepines.1,2 Xanax is approved for use in treating anxiety disorders, including generalized anxiety disorder, anxiety with depression, as well as panic disorder, with or without agoraphobia.1, 2 Xanax is a central nervous system, or CNS depressant and works to increase the inhibitory signaling of a neurotransmitter called GABA for the short-term relief of symptoms of anxiety.2, 3, 4

A survey conducted in 2018 showed that, among Americans:

  • More than 30.7 million people aged 12 or older used benzodiazepines in the last year.5
  • More than 5.4 million people aged 12 or older misused benzodiazepines in the last year.5
  • Nearly 17.7 million people aged 12 or older used Xanax in the last year.5
  • 1 million people aged 12 or older misused Xanax in the last year.

Alprazolam is one of the most commonly prescribed benzodiazepines for the management of anxiety; in the U.S., it is the most commonly prescribed psychotropic medication.6 It accounted for more than 48 million prescriptions dispensed in 2013 even though many prescribers recognize its pronounced potential for misuse.6

Along with diazepam, alprazolam is one of the most frequently diverted benzodiazepines encountered on the illicit market. 7 In the last decade, it has also been one of the most-common benzodiazepines involved in drug-related emergency department visits.6 Commonly abused for its pleasantly sedating effects, many people who misuse Xanax continue doing so as a result of the reinforcing dopamine activity associated with its use.18

If you’re concerned that you or a loved one might be misusing Xanax and alcohol, you’re right to worry. Please don’t hesitate to take the first step today and call us for a confidential conversation at .


What Are The Dangers of Mixing Xanax and Alcohol?

Xanax and alcohol both depress certain central nervous system functions, such as breathing; using them together can increase the risk of severe side effects and a potentially fatal overdose.3, 8 Combining these substances can increase the likelihood of certain symptoms such as dizziness, excessive drowsiness, difficulty concentrating, reduced motor control, falls and other injuries, erratic behavior, memory impairment, trouble breathing, respiratory arrest, and even death.2, 11, 7, 12 

Alcohol overdoses may occur when areas of the brain controlling basic life-support functions—such as heart rate, breathing, and temperature control—become overwhelmed with the amount of alcohol in the bloodstream and begin to shut down.13 Adding Xanax, another CNS depressant, to the mix further increases the risk of such an overdose.13

Side Effects of Xanax

Even when taken as prescribed for therapeutic purposes, Xanax is associated with some side effects. Potential side effects include: 2

  • Sleepiness.
  • Difficulty concentrating.
  • Decreased coordination.
  • Headaches.
  • Dizziness or light-headedness.
  • Fatigue.
  • Irritability.
  • Joint pain.
  • Dry mouth.
  • Constipation.
  • Changes in sex drive.

Some side effects, especially in the context of concurrent alcohol or other substance use, can be significant. Seek immediate medical attention for anyone exhibiting severe symptoms such as seizures or difficulty breathing.

Long-Term Effects of Xanax Abuse

In addition to its notoriously high abuse liability, relative to some other benzodiazepines, Xanax is associated with more severe withdrawal symptoms developing after a shorter period of use.6 Beyond an increased risk of significant dependence and the likelihood of a troublesome withdrawal syndrome, there are several other potential long-term effects to consider in cases of chronic use. Such effects include:8 

Physical: Cumulative risks of trauma from falls or accidents in association with altered level of consciousness, decreased motor skills, and incoordination. Increased risk of significant physiological dependence and associated withdrawal, which can include symptoms of anxiety, agitation, insomnia, muscle cramps, sensory distortion, nausea, vomiting, hallucinations, tremors, and seizures. 

Mental: Depression, problems with memory, increased risk of suicidality, hallucinations, over-reliance on Xanax to get through the day, difficulty focusing on tasks, trouble with visual and spatial abilities, loss of self-confidence. Increased risk of developing patterns of polysubstance use (e.g., drinking while taking Xanax) to augment the desired effects of the drug.

Legal/Financial: Buying illicit Xanax can be expensive and place you at risk of legal ramifications. Visiting more than one doctor for prescriptions, going to multiple pharmacies, buying Xanax from other people, stealing medication, and driving under the influence can result in arrest and incarceration. Driving while on Xanax increases the risk of car accidents. 

Vocational/educational: Reduced ability to focus on tasks can cause people to be less productive.

Social: Addiction can increase feelings of isolation, and may strain relationships with family and friends. 

Signs and Symptoms of Xanax Addiction

According to the American Society of Addiction Medicine (ASAM), addiction is a treatable yet chronic disease involving the use of drugs and/or alcohol that or becomes compulsive and often continued despite negative or harmful consequences.9

Individuals diagnosed with a substance use disorder (SUD) involving Xanax (i.e., a sedative, hypnotic, or anxiolytic use disorder)  must meet at least two of the below criteria within the same 12-month period:10

  • Experiencing difficulties in functioning at work, school, or home because of use.
  • Having strong cravings or urges for Xanax.
  • Persistently wanting to take less or being unable to control use.
  • Quitting or cutting back on hobbies, socializing, or important work activities because of use.
  • Spending a lot of time getting, using, or recovering from Xanax.
  • Using after it has caused or worsened problems in relationships with others.
  • Using after knowing that it has caused or worsened a chronic physical or psychiatric issue.
  • Using for a longer time or in a larger amount than planned.
  • Ongoing use in settings where it is dangerous, like while driving.
  • Developing tolerance, meaning that a larger amount is needed to achieve the desired effect, or there is less of an effect if the same amount is used.
  • Experiencing withdrawal symptoms if you stop or cut back or needing to continue taking the drug to prevent the onset of such symptoms.

Read More Effects From Mixing Alcohol:

How to Safely Detox from Xanax and Alcohol

The symptoms of alcohol withdrawal can range in intensity. Severe withdrawal symptoms can quickly become life-threatening for individuals who’ve developed a significant level of physical dependence and, for this reason, alcohol detox efforts commonly involve close medical supervision.14 Such symptoms can include anxiety, agitation, insomnia, increased body temperature, elevated heart rate, increased blood pressure, increased sensitivity to light and sound, delirium, hallucinations, delusions, tremors, and seizures.14

Withdrawal from Xanax shares many of the same symptoms as that of alcohol withdrawal, and may similarly benefit from close monitoring.3, 14 Xanax withdrawal may include anxiety, confusion, elevated heart rate and blood pressure, distorted sensory perception, hallucinations, delirium, and seizures.1, 3, 10, 14

mixing xanax and alcohol

Since both Xanax and alcohol withdrawal carry many of the same risks and are managed similarly, detox commonly takes place in a medical setting, which facilitates round-the-clock monitoring of symptom progression as well as the administration of pharmacologic or other medical interventions when necessary to keep people safe and comfortable.14 Tapered doses of benzodiazepine sedatives (e.g., chlordiazepoxide) or, in rarer cases, anticonvulsant medications may be utilized to help you detox safely by minimizing the risk of seizures, agitation, delirium, etc.14,15

Medical detox is often the starting point on the road to recovery from addiction. It is a process that combines medical supervision and medication to keep you as safe and comfortable as possible while dealing with the symptoms of withdrawal.16

How to Get Help For Xanax and Alcohol Addiction

Medical detox is only the first element of a more comprehensive course of addiction treatment. Once withdrawal has been successfully managed, rehab is the next phase of your recovery journey.17 Treatment may be provided in a variety of settings which include individual and group therapy sessions designed to help participants maintain sobriety, improve relationships with family and friends, learn vocational skills and manage legal issues if applicable.17 Certain medications (e.g., naltrexone, acamprosate, disulfiram) may be used to discourage continued drinking behavior, while others may be started or continued to manage any underlying anxiety or other mental health issues as needed.17

There are two main types of rehab settings, inpatient and outpatient. Inpatient or residential treatment involves a stay at a facility for the duration of treatment, where a treatment team is able to provide supervision and support throughout the day.17 Along with focusing on recovery from addiction, some facilities may treat co-occurring mental health disorders as a part of a comprehensive treatment plan.17

In certain instances, such as when the magnitude of physical dependence and subsequent risk of withdrawal is relatively low, as well as when personal support systems are strong, outpatient detox and, later rehabilitation efforts may be a good fit for someone in recovery. Outpatient programs often provide similar types of programming as inpatient facilities but may be relatively less time-intensive. Individuals are able to return home or to other living situations outside of treatment hours. Individual and group therapy is still provided along with mental health treatment, and participation in self-help is encouraged.17

Find Polysubstance Misuse Rehab

If you or a loved one is struggling with polysubstance misuse or addiction, it’s important to remember that there is help available. Evidence-based addiction treatment can lead to positive results for those struggling with alcohol and Xanx misuse and addiction. If you’re ready to seek help, a good first step would be to reach out to your doctor. They may be able to help determine a diagnosis or refer you to appropriate treatment facilities.

Additionally, that treatment directory can connect you with thousands of rehabs across the country. This powerful online tool allows you to search by zip code, helping you find local or out-of-state rehabs that suit your needs. You may also consider calling the American Addiction Centers (AAC) addiction helpline. This 24/7 resource connects you with compassionate staff who can help you find suitable rehabs and verify your insurance benefits.

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