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Why You Shouldn't Mix Xanax and Alcohol

As dangerous as improper drug use is, the danger increases exponentially when drugs are mixed together. One particularly deadly combination is Xanax and alcohol. When taking prescribed drugs at the prescribed dose, we are always warned that interactions between certain drugs can be harmful or even fatal. It should come as no surprise, then, that combining drugs when they are being abused is extremely dangerous.

Unfortunately, many individuals that abuse drugs regularly do just that – combine two or multiple drugs at a time. They may start using this way, consciously add the second substance to their original drug of choice, or attempt to replace their prescription addiction with alcohol, which they deem 'less dangerous,' inevitably becoming addicted to both.

Xanax and alcohol is a combination of drugs that we seem to hear about disturbingly often as the risk of a fatality is so high. While there are many drugs that are considered ‘more deadly’ in terms of their likelihood to kill on their own, this combination seems to result in a shocking number of deaths. But why is the mixture so deadly?

Alcohol and Xanax

The Dangers of Alcohol

The dangers of alcohol are extremely well established. The world’s deadliest drug, poisoning by alcohol kills six people a day in the U.S. alone. This does not include deaths due to liver, heart, pancreas, stomach and other diseases caused by alcohol, drunk driving accidents, and a host of other alcohol-related deaths. While in the worst cases alcohol abuse can be fatal, its short term effects such as drowsiness, emotional instability, risky behaviors, ‘blackouts’, and even comas are of course extremely dangerous and can have lasting consequences. It is a well-known fact that alcohol is a central nervous system (CNS) depressant.

Its legality and non-controlled status continue to lull the public into a false sense of it being ‘safer’ than other drugs, which unfortunately increases abuse of alcohol. This may also factor into individuals’ willingness to mix alcohol with other drugs. While some consciously mix alcohol with other drugs in order to experience a more intense ‘high’, others simply do not consider the added danger posed by the alcohol in their system when they take another drug. Perhaps one of the most dangerous of these combinations is alcohol with the drug Xanax.

The Dangers of Xanax

Xanax is actually not the name of the drug. It is a brand name that has become a generic trademark (like ‘Thermos’ or ‘Kleenex’). The name of the drug itself is alprazolam – but regardless of brand, any alprazolam is likely to be referred to by anyone other than a medical professional as ‘Xanax.’ It is a benzodiazepine – a class of psychoactive drugs known for their ‘calming effect’ and considered to be minor tranquilizers. These drugs were embraced as a much safer alternative to barbiturates, and by the end of the 1970s were the most prescribed drug in the world. Valium was at one time the most popular of these, but Xanax was introduced in 1981 as a safer, less abuse-prone alternative. By 2010, Xanax was the twelfth most prescribed drug in the country. It is largely used in the treatment of panic and anxiety disorders as well as chemotherapy-induced nausea (combined with other drugs). Like alcohol, it is a CNS inhibitor – in this case, it facilitates the release of the inhibitory neurotransmitter GABA, causing the anti-anxiety/sedative effect desired.

However, it would soon come to light that the likelihood of Xanax dependence and abuse was far more complicated than initially thought. While it is true that relatively few prescribed users increase their dosage or engage in other drug-seeking behavior, its high potency, rapid onset, mild euphoric effect and physical dependence/withdrawal syndrome in long-term users create a highly addictive situation for those who do engage in abusive behavior with Xanax.

In short, while it is relatively rare for ‘responsible’ users to find themselves unwittingly hooked on Xanax, its massive prescription numbers and easy availability mean it is one of the most misused pharmaceuticals in the United States. Xanax figures heavily in the 35% of urgent care and emergency room hospital visits attributed to benzodiazepines and has been classified as a Schedule IV controlled substance by the DEA.

Even when used as prescribed, Xanax can cause a number of concerning side effects, including:

  • Anterograde amnesia
  • Concentration issues
  • Slurred speech
  • Disinhibition
  • Drowsiness, dizziness, lightheadedness, fatigue, unsteadiness, and impaired coordination, vertigo
  • Skin rash, respiratory depression, constipation
  • Suicidal ideation

Long-term abuse, meanwhile, can have more serious effects, including:

  • Stomach bleeding (this can sometimes occur in the short term)
  • Liver damage
  • Withdrawal
  • Dementia
  • Amnesia
  • Chronic respiratory issues
  • Severe depression
  • Delirium
  • Psychosis

Still, the likelihood of an overdose due to Xanax is relatively low due to the very high dose that would be necessary. Where it becomes one of the more dangerous drugs in the world is when combined with other drugs. And sadly, in combination with other drugs is how Xanax is often abused.

xanax and alcohol

Why Xanax and Alcohol Are So Dangerous When Combined

As mentioned previously, the risk of misuse or a developed addiction by those using it solely as prescribed for their particular ailment is relatively low. However, its risk for misuse and dependence is particularly high amongst those most likely to engage in the dangerous behavior of drug mixing: those with a history of drug and/or alcohol dependence, and those suffering from borderline personality disorder. In addition, Xanax is often used in conjunction with other drugs either to counteract their effects or enhance them. It is used to combat a ‘bad trip’ while on psychedelics and to relieve agitation and insomnia when coming down from stimulants. Conversely, it is used to enhance the effect of other depressants including heroin, opioids – and alcohol.

It is exactly this combined effect that makes the simultaneous use of alcohol and Xanax so incredibly dangerous. The euphoric effects experienced when ingesting each drug individually are intensified when the two are combined. For an individual desiring a high, this, of course, results in increased usage as his or her tolerance increases. Increasing the danger is the fact that users are often even more unaware of the high volumes they are consuming than they would be when taking one or the other.

Along with the desired effect, the adverse effects are also increased when using both drugs together. Extreme fatigue and lightheadedness can occur surprisingly quickly. These feelings can continue after the other effects of the drug have worn off. Increased dizziness, loss of concentration and lack of coordination put users in great danger to themselves – and others, should they operate a vehicle or blackout and become violent or irrational. Paradoxical reactions, or effects that are the opposite of what you would expect, become far more likely when the two are combined. Extremely rare when Xanax is used on its own, aggression, irritability and anger become far more likely when it is combined with alcohol. In fact, the likelihood is considerably more than when alcohol is used alone as well – a drug known to cause such reactions. Individuals for whom such behavior is unheard of may exhibit such, while those with a history of impulse control issues can find themselves ‘flying off the handle’ frighteningly quickly.

Long term abuse of this combination can result in some truly horrifying conditions including anoxic brain damage, liver cancer, mouth cancer, throat cancer, breast cancer, heart conditions like cardiomyopathy and arrhythmia, stroke and pancreatitis. The potential for liver and kidney damage is far higher when the drugs are used in combination than when either is used in isolation. This increased potential holds true for physical dependence, substance use disorder, psychosis or neurological effects, and even the development of unusual side effects and resultant conditions. Withdrawal associated with abruptly ceasing the use of alcohol and Xanax use is not only miserable, but it can also be life-threatening and requires an established (and preferably in house) detox program

Alcohol and Xanax and Central Nervous System Depression

As disturbing as all these effects may be, they are not the main reason why the combination of Xanax and alcohol is such a dangerous one. The primary danger is the fact that both alcohol and Xanax are central nervous system (CNS) depressants. Though both these drugs can result in feelings of depression, this is not what CNS depression refers to. The depression of the nervous system refers to a physiological state where brain activity is inhibited or suppressed to such a level that the rate of automatic processes such as breathing and heart rate are considerably decreased. If this depression occurs long enough and to a great enough extent, loss of consciousness can occur, followed by a comatose state and eventually death.

Combining two or more depressant drugs is a common cause of drug overdose, and the CNS depression caused by the combination of alcohol and Xanax is, along with opioids, one of the most dangerous. Acting on the hypothalamus, this deadly combination slows an individual's breathing and heart rate while causing a precipitous drop in body temperature and blood pressure. The implications of this are obvious – these are processes that are vital to our survival. However, our central nervous system or any one of these processes does not even need to completely shut down to have disastrous, and still possibly fatal effects.

Most often with CNS depression, the slowing of breathing is the lynchpin in the chain reaction that leads to death. However, one does not have to stop breathing completely to find oneself in deathly trouble. When our breathing becomes sufficiently shallow, we no longer exhale the correct amount of carbon dioxide. This results in a build-up of carbon dioxide called hypercapnia – a condition that can lead to convulsions, unconsciousness, and in severe cases, death.

Even when overdose does not occur, a little known fact is that this continued CNS depression can have long term effects as well. Chronic use of the Xanax and alcohol combination means that your brain and other organs will regularly be receiving severely decreased levels of oxygen – far less than required. This chronically decreased oxygen flow is known as hypoxia, and can result in significant brain damage and damage to other vital organs.

Extremely important to note is, using these drugs in combination, even at levels too low to present a risk of overdose, still can result in serious health issues. While hypoxia and significant damage to organs are less likely, the chronic slowing down of vital functions can see users suffer various cardiac and respiratory issues, making them in turn more vulnerable to heart and respiratory disorders and infections.

Deaths Attributed to Mixing Xanax with Other Drugs

A number of celebrities and high profile individuals have succumbed to the mix of Xanax (or similar benzodiazepines) and alcohol or other drugs, including:

  • Heath Ledger
  • Tom Petty
  • Philip Seymour Hoffman
  • Lil Peep
  • Leslie Carter (sister of Backstreet Boys’ Nick Carter)
  • Wayne Static (singer of rock band Static-X)
  • John Odom (baseball player)
  • Adam ‘DJ AM’ Goldstein
  • Andy Irons (surfer)
  • Marek Svatoš (former NHL player)

One of these deaths that resulted in a vigorous discussion about Xanax abuse was that of Lil Peep. Just 21 at the time of his death, Lil Peep (born Gustav Elijah Åhr) was a rising rapper and singer. Like a number of younger rappers, Lil Peep was very open about his drug use. However, rather than specifically glorifying it, he was also open about the fact he was using the drugs to self medicate a host of mental issues including depression, anxiety and bi-polar disorder. He regularly referenced his usage of Xanax in songs as well as in interviews and on social media. Shortly before his death, he was filmed attempting to swallow a Xanax pill in a disoriented state then posting that it was his sixth. While alcohol was not found in his system during an autopsy, the presence of a host of CNS depressing opioids including hydrocodone and oxycodone along with Xanax and other drugs illustrates the deadly effect this combination can have and how quickly it can occur.

Treatment for Xanax and Alcohol Addiction

Addiction to a combination of drugs is often far more powerful and harder to treat than an addiction to any single drug. Because of the desired effects, and the fact that abusers are often self-medicating persistent mental issues, this difficulty is intensified, and many users are unlikely to seek help on their own. The knowledge of the horrible and potentially fatal withdrawals associated with suddenly stopping the use of these two drugs can also be a deterrent to quitting. An established and well-designed intervention and detox program like that provided by Clean and Sober Recovery Services can, therefore, be the best first step in treating this particular type of addiction. With both residential and outpatient treatment programs, treatment can be tailored to recovering individuals' needs. If you or a loved one is suffering from a Xanax and alcohol addiction, please contact us today to begin the road to recovery.

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