Some people carelessly mix benzodiazepines like Xanax and alcohol, often to self-medicate for anxiety. But this common combination can be very hazardous, at best causing increased intoxication, disorientation, short-term memory loss, and clumsiness, and at worst leading to respiratory depression, coma, and death.
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What is Xanax?
Xanax is the brand name of the benzodiazepine alprazolam. Alprazolam is a tranquilizer and sedative prescribed for anxiety disorders, particularly panic disorder and generalized anxiety disorder (GAD). Its use is usually short-term, given concerns about tolerance, dependence, addiction, and dangerous withdrawal symptoms.[1]
Like other benzodiazepines, Xanax slows down the central nervous system, producing a feeling of relaxation, calmness, and well-being. Xanax can help people with acute anxiety feel more normal and break the cycle of panic.
However, Xanax has also become a popular drug of abuse, known by the slang terms Xannies, Bars, and Z-bars. Some people chase its feeling of calmness and disconnection, using it recreationally, while others self-medicate for undiagnosed or untreated anxiety.
Related: Types of Xanax
The 2015–2016 National Surveys on Drug Use and Health estimated that 10.4% of Americans had used benzodiazepines as prescribed in the previous year while an additional 2.2% had misused the drugs.[2] Xanax/benzo abuse is connected to addiction, overdoses, and adverse interactions with other drugs and substances, including alcohol.
How does Xanax work?
Xanax, like other benzodiazepines, works by enhancing the brain’s release of the inhibitory neurotransmitter GABA, which slows down the central nervous system (CNS). This can make you calm, relaxed, and drowsy but also cause amnesia, confusion, and impaired coordination.
Too high of a dose of Xanax can overly depress the CNS, causing extreme sedation, respiratory depression, coma, and death.
What happens if you mix Xanax and alcohol?
Xanax and other benzodiazepines should never be mixed with alcohol or any other depressants at the risk of excessively depressing the central nervous system. This is known as polysubstance abuse and greatly increases the risk of health complications and overdose.
The combination is so risky because Xanax and alcohol have similar mechanisms of action: both stimulate the release of GABA in the brain and depress the central nervous system. They magnify each other’s effects. Chase a glass of wine with a Xanax and you’ll feel even more relaxed—and drowsy and intoxicated—than you usually do after one drink.
Some people who have mixed benzos and alcohol describe feeling euphoric and joyful. But others report feeling disoriented, dizzy, and clumsy. They say they’ve blacked out and lost memories or fallen asleep in public.[3]
Additionally, alcohol and Xanax each interfere with the liver’s ability to break down the other. Higher concentrations of both alcohol and Xanax will remain in the bloodstream for longer, increasing the effects and the duration.[3]
At very high doses, the CNS depressant effects of both Xanax and alcohol can compound, possibly leading to respiratory depression and arrest, cardiac arrest, coma, and death.
Benzodiazepines including Xanax were involved in more than 118,000 overdose deaths between 2000 and 2019 in the U.S. Alcohol was co-involved in 16.3% of those deaths, second only to opioids as the most common secondary substance.[4]
Despite the risk, many people, especially those with anxiety disorders, combine alcohol and Xanax. Alcohol itself is a powerful anxiolytic (a drug that reduces anxiety), and around one-fifth of people with anxiety disorders report self-medicating with it.[5]
Similarly, you should never mix benzos like Xanax with opioid pain pills such as OxyContin or Vicodin; opiates such as codeine or heroin; or sleeping pills such as Ambien and Lunesta.
How long after taking Xanax can you drink alcohol?
While it’s best to avoid concurrently using Xanax and alcohol, some people will continue to do so and should know how to minimize their risks.
Fortunately, Xanax is a relatively short-acting benzodiazepine. Immediate-release tablets have a half-life of approximately 11 to 12.5 hours. That means after half a day, half the original amount of Xanax remains in your bloodstream. [6] Therefore doctors recommend waiting at least 11 hours after taking immediate-release Xanax before consuming alcohol.[3] You should wait longer if you’ve taken a high dose or used an extended-release preparation.
You should also wait at least 8 hours after drinking alcohol to take Xanax, or longer if you’ve had a lot to drink. This allows enough time for your blood alcohol content to fall.
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