Can I mix alcohol and xanax (benzodiazepines)?

Dear Reader, 

It’s good that you're considering the safety of mixing these drugs before potentially experiencing it yourself! Mixing benzodiazepines (sometimes called benzos) like Xanax with even small amounts of alcohol can lead to severe side effects, including coma and overdose. This is because both produce depressive effects in the body and brain. Continue reading to learn more about what benzodiazepines are, the side effects of mixing these drugs, and how you can safely consume benzodiazepines. 

What are benzodiazepines and what effect do they have on the body?  

Benzodiazepines are depressants that delay the speed of signals sent in areas of the brain where emotions and decision-making are regulated. They’re often used for short-term treatment of anxiety, panic attacks, and insomnia.  

They’re highly addictive, and if used long-term, can have serious side effects like liver and kidney damage and low blood pressure. These drugs aren’t intended to be used every day for long periods of time and must be prescribed by a health care provider.  

The immediate effects of benzodiazepines in the body include:  

• Lower blood pressure  
• Lower heart rate 
• Slower breathing 
• Muscle relaxation  
• Calmness and relaxation  

List adapted from Addiction Center 

Different benzos may have varying effects, person-to-person.  

What happens if you mix benzodiazepines and alcohol? 

Both alcohol and benzodiazepines are central nervous system depressants, causing effects like relaxation and calmness. Taking both together at any level can increase these effects to be much greater than just one drug would have on its own. 

Effects of mixing benzodiazepines and alcohol in the body include: 

• Dizziness 
• Drowsiness 
• Slurring speech  
• Difficulty breathing 
• Loss of coordination 
• Problems in memory  
• Behavioral changes  

List adapted from American Addiction Centers 

That said, the effects of mixing benzodiazepines and alcohol together can vary based on factors like the amount of each substance consumed, age, weight, and genetics of the person consuming these drugs. 

Is there a risk of overdose when mixing benzodiazepines and alcohol? 

There’s a strong risk of overdose if someone consumes benzodiazepines and alcohol, even if it’s only a small amount of alcohol. This is because both drugs impact breathing and lung quality, which can lead to dangerously slow and shallow breathing.  

Signs of overdose when benzodiazepines and alcohol are taken together can include:  

• Slow or shallow breathing  
• Slow heart rate or pulse  
• Confusion  

List adapted from Oxford Treatment Center 

How can you use benzodiazepines safely?  

Although taking benzodiazepines and alcohol together can be dangerous, there are some harm reduction practices that can help reduce some of the risks that you may be exposed to. These practices include:  

• Consulting with a health care provider. A health care provider can prescribe you medication as well as discuss the side effects and interactions of said medications with you.  
• Starting low and going slow. In some instances, pills can take up to an hour before they start to have an effect. Consider starting with a smaller dose so you can better monitor the effects you’re feeling.  
• Tracking overall consumption. If you want to avoid the side effects of mixing alcohol and benzodiazepines completely, wait at least five days after your last benzo dose to resume any level of drinking.  
• Keeping track of how much you take. Take medications as prescribed to you. This can help you avoid experiencing heightened side effects, as well as under- or overdosing.  
• Getting pills from an approved source. Stick only to benzodiazepines and other prescription drugs that are prescribed by a health care provider. Doing so can lower your risk of running into products contaminated or mixed with harmful ingredients like fentanyl. You can also consider buying test strips to check unprescribed pills for fentanyl. 
• Reducing mixing with various substances. Combining benzodiazepines with opioids or stimulants can increase risks of drowsiness, poor coordination, memory problems, or dangerous breathing issues. This can lead to overdoses and even death.  
• Carrying naloxone. Naloxone can reverse opioid overdoses when used in time and can be lifesaving to have in the right moment. It can keep someone alive and stable before further medical attention; it also can’t hurt someone if they're given it when they may not need it.  

Overall, benzodiazepines and alcohol can lead to harmful effects when they’re mixed, but you can take steps to reduce them.