Why Xanax and Alcohol Interact (And Why It Matters to You)

Get Help. Talk To Someone Now!

Call toll free to:

Find treatment near you
Discover online or in person rehabs
Get 24 hour information on addiction

800-934-9518

Why Do Xanax and Alcohol Interact?

Xanax and Alcohol are both central nervous system depressants, and when used together, can be a dangerous combination.

What is Xanax?

Xanax or alprazolam is a prescription medication classified as a benzodiazepine. Benzodiazepines are mild tranquilizers and are commonly prescribed to relieve symptoms of anxiety, seizures and sleep disorders.¹Using Xanax in any way not prescribed by your doctor—such as taking more than prescribed or taking someone else’s prescription—is inherently risky and potentially dangerous. ¹

Xanax works by enhancing the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that slows brain activity. GABA helps regulate communication between the brain and the nervous system, promoting a calming effect. By increasing GABA activity, Xanax suppresses the CNS and reduces excessive neural activity.

Xanax is a fast -acting medication; most people feel its effects within an hour, with peak levels in the bloodstream occurring between one and two hours after ingestion. This rapid onset can help decrease the intensity of anxiety and panic attacks, reduce seizure activity and improve certain sleep disturbances

Even when taken as prescribed, Xanax can produce unwanted side effects, including:³

Sedation or drowsiness
Slurred speech
Dizziness
Trouble concentrating
Depression
Impaired coordination
Impaired memory
Disorientation
Irritability
Decreased libido

Xanax is recommended as a short-term solution for medical and behavioral health issues due to the high risk of developing a tolerance, dependence or addiction to the substance. Within a few weeks of taking Xanax, you may start to develop a tolerance to your current dose. When you develop a tolerance to Xanax, your current dose will no longer produce the same desired effect. Your doctor may talk to you about increasing your dose or may suggest transitioning to another medication with a lower risk of physical dependence and addiction.

You have likely developed a physical dependence when you feel withdrawal symptoms if you decrease your dose, take it less frequently or miss a dose. Benzodiazepines can take a significant amount of time to be fully eliminated from the body, and withdrawal symptoms may not begin until Xanax levels drop low enough that they no longer suppress them.

The average half-life of Xanax, or the time it takes for the body to metabolize half of a single dose, is approximately 11 hours in healthy adults. However, the total time Xanax remains in your system can vary depending on factors such as age, liver function, dosage, frequency of use, metabolism and whether other substances are involved. It is also important to remember that the noticeable sedative effects of Xanax usually wear off before the drug reaches its half-life, even though measurable amounts may still be present in the body.

Continual use of a benzodiazepine like Xanax, especially over a long period, changes your brain chemistry. Therefore, taking a dose of Xanax may no longer produce that sudden increase in GABA neurotransmitters, which can lead to challenging physical and psychological effects, including: ³

Irritability that increases to angry outbursts, sometimes escalating to violent reactions
Cognitive decline
Respiratory depression
More severe memory problems
Major depression
Increased risk for Alzheimer’s disease and dementia
Increased risk of suicidal thoughts
Seizures
Liver damage

The long-term effects may actually increase some of the symptoms you were trying to treat, such as anxiety and panic attacks. Because Xanax is metabolized by the body quickly, you can experience increased anxiety and nervousness between doses.³

As well, long-term use of Xanax can increase the risk of addiction, overdose, coma, and death.³

What is Alcohol?

Like Xanax, alcohol is a central nervous system depressant. How alcohol affects you depends on many factors, including the number of drinks consumed, the type of alcohol, the health of your liver, age, gender, and even how much food you eat before you drink. For many, it takes about one hour to metabolize a standard drink, which is considered to be one of the following: 12 ounces of beer, 5 ounces of wine, 8 ounces of malt liquor or 1.5 ounces of spirits.

Drinking more than one drink per hour can lead to intoxication and the following short-term effects:⁵

Happy mood, elation
Lowered inhibitions
Loss of coordination
Slurred speech
Loss of decision-making skills and judgment
Trouble concentrating
Blurred vision
Mood swings
Raised blood pressure

Chronic misuse of alcohol can lead to tolerance, physical dependence/addiction, and affect both your physical and mental health. Long-term use of alcohol can lead to severe side effects, including:

Changes in brain chemistry and functioning
Learning problems
Memory loss
Hepatitis
Liver damage and failure
Acid reflux caused by erosion of the stomach lining
Increased risk of ulcers
Cancer in the throat, liver, stomach, mouth, colon and breast
High blood pressure
Stroke
Irregular heartbeat
Depression
Anxiety
Mood swings

What Are the Risks of Mixing Xanax and Alcohol?

Xanax and alcohol affect the body in similar ways, particularly in their ability to depress the central nervous system. When taken together, their effects are not just amplified but addictive. Because both substances signal the central nervous system to slow down, combining them can intensify their action. This significantly raises the risk of dangerous outcomes, including:

Slowed heart rate
Slowed breathing
Oxygen deprivation
Neurological malfunction
Changes in mood
Overdose

The more you mix Xanax with alcohol, their short-term effects will increase and become severe. For example, a slowed heart rate can turn into severe cardiac depression or cardiac arrest. Other long-term effects include:⁶

No longer feeling the Xanax and alcohol “high”
Severe respiratory depression or stopped breathing
Oxygen deprivation that causes brain damage, which may be irreversible
Severe depression, anxiety, or other mental illness
Cirrhosis of the liver
Cardiomyopathy
Stroke
Pancreatitis
Increased risk for accidents, injuries and suicidal thoughts
Seizures
Coma
Addiction

Call 800-839-1686 Toll Free. Privacy Guaranteed. No Commitment.

Help is standing by 24 hours a day, 7 days a week.

Risk factors that can increase your risk of adverse short- and long-term effects when mixing Xanax and alcohol.

Certain factors can increase your risk of short- and long-term effects of mixing Xanax and alcohol. You may be at increased risk:⁷

If you are using Xanax in a way that has not been prescribed by your doctor
If you are misusing alcohol, such as by binge drinking, drinking to excess daily, or drinking against a medical recommendation
If you have an underlying medical issue
If you are taking other prescribed medications that could interact with Xanax and alcohol
If you are taking other illicit drugs in addition to Xanax and alcohol
If you have a mental health condition

Your risk for serious side effects also depends on the amount of Xanax and alcohol you consume and for how long.⁷

Can I Become Addicted to Xanax and Alcohol?

Xanax and alcohol are both addictive substances. Certain factors make you more likely to become dependent on mixing Xanax and alcohol and lead to addiction. The top two risk factors are:⁸

Genetics—Just like all other hereditary traits, a predisposition to addictive behavior can be inherited.
Environment—The environment in which you live contributes to the development of an addiction. For example, if you live with a person who uses alcohol daily, you may be influenced to do the same, even if you know alcohol interacts with your Xanax prescription.

Other risk factors include your metabolism, stress level, route of consumption and how old you were when you first mixed the two substances.⁹

Someone addicted to mixing Xanax and alcohol may experience:⁸

Changes in eating habits
Changes in weight
Decreased focus on personal hygiene
Skin problems
Bruising or injuries from falls or accidents

In addition to the physical symptoms, misusing Xanax and alcohol can lead to:

Defensiveness
Becoming easily agitated and angered
Feeling unable to cope with stress
Rationalizing your use of Xanax and alcohol
Losing interest in people and activities you once enjoyed
Denying that you have a substance use disorder to others or yourself
Experiencing rapid changes in mood
Experiencing increased anxiety or rebound anxiety
Experiencing intense cravings for either or both substances

What do I do if I have an addiction to Xanax and Alcohol?

Admitting you have a problem with your substance use is the first and most important step toward recovery. Because withdrawal from Xanax and alcohol can be extremely uncomfortable and potentially life-threatening, a supervised medical detox is the safest way to clear the substances from your body. During a medically supervised detox, a highly trained care team closely monitors your vital signs, assesses for changes and administers supportive medication, if needed. Should you need medication. Beginning your recovery this way decreases the time you spend in withdrawal and enables you to focus on your recovery.

After detox stabilization, a comprehensive treatment program that includes inpatient or residential care, outpatient services like intensive outpatient (IOP), partial hospitalization (PCP) or a standard outpatient program is the next best step toward long-term recovery.

Polysubstance use disorder can affect anyone, regardless of age, background or circumstances. No one is immune to addiction. However, understanding your personal risk factors, such as family history, mental health conditions, trauma or ongoing substance use, can help you to recognize warning signs early. With that awareness, you can take steps to seek support or make informed choices that reduce the likelihood of developing an alcohol or substance use disorder.

No matter what stage of addiction you are in, you can get help. Call 800-948-8417 Sponsored to speak with a treatment specialist at any time.

Resources

S. National Library of Medicine. (2021). Alprazolam. MedlinePlus.
Substance Abuse and Mental Health Services Administration. (2014). The DAWN Report. Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes.
Griffin, C. E., 3rd, Kaye, A. M., Bueno, F. R., & Kaye, A. D. (2013). Benzodiazepine pharmacology and central nervous system-mediated effects. The Ochsner Journal, 13(2), 214–223.
US Food and Drug Administration. (2011). Xanax.
National Institutes of Health. (2007). NIH Curriculum Supplement Series [Internet] – Information About Alcohol. Bethesda (MD): National Institutes of Health.
Votaw, V. R., Geyer, R., Rieselbach, M. M., & McHugh, R. K. (2019). The epidemiology of benzodiazepine misuse: A systematic review. Drug and alcohol dependence, 200, 95–114.
Krawczyk, N., Eisenberg, M., Schneider, K. E., Richards, T. M., Lyons, B. C., Jackson, K., Ferris, L., Weiner, J. P., & Saloner, B. (2020). Predictors of Overdose Death Among High-Risk Emergency Department Patients With Substance-Related Encounters: A Data Linkage Cohort Study. Annals of emergency medicine, 75(1), 1–12.
Lerner, A., & Klein, M. (2019). Dependence, withdrawal, and rebound of CNS drugs: an update and regulatory considerations for new drug development. Brain communications, 1(1), fcz025.
gov. (2019). Mental Health and Substance Use Disorders.