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  • Xanax, a brand-name prescription medication containing the drug alprazolam, rarely causes life-threatening complications when taken as directed. Mixing medicines, however, can be a dangerous or even deadly mistake.

    A high-potency benzodiazepine, alprazolam works by greatly increasing the body’s sensitivity to the gamma-aminobutyric acid, or GABA, neurotransmitter for a short period of time. 

    This depresses or slows down the body’s central nervous system (CNS) and relieves muscle spasms as well as feelings of intense fear, anxiety, or panic until the drug is processed by the body. 

    However, benzodiazepines are best when used only as a short-term treatment option for panic attacks or anxiety disorders, as longer use will rapidly lead to physical dependence. 

    Xanax & Polysubstance Abuse

    Some people seek out Xanax to self-medicate against daily stress or other mental health challenges. Others will take larger doses to get high, triggering euphoria and inebriation.

    Some also abuse Xanax with other legal or illegal drugs, which is known as polysubstance abuse

    This is defined as using a combination of substances to change or heighten euphoria or moderate some of the less-desirable side effects that come with some forms of substance abuse, despite the severe short and long-term risks.

    Effects Of Mixing Xanax With Alcohol

    Alcohol is the most widely abused drug in the world and another central nervous system depressant like Xanax. Concurrent Xanax and alcohol abuse increase the effects of alcohol, and vice versa, which can cause severe CNS sedation.

    Severe Respiratory Depression & Overdose

    Short-term symptoms of combining alcohol and Xanax overdose may include:

    • extreme relaxation, fatigue, or drowsiness
    • impaired attention, judgement, and inhibition
    • loss of muscle control and coordination
    • slurred speech
    • mood and behavioral changes
    • memory issues and blackouts
    • loss of consciousness
    • slow heart rate
    • low blood pressure
    • slow or shallow breathing (respiratory depression)
    • blue-tinted fingernails and lips

    In some cases, respiratory depression causes permanent brain damage or death. This is why the FDA requires prescription drug labels on Xanax bottles warning that the drug should never be taken with alcohol or a number of other drugs. 

    Additionally, the liver uses many of the same enzymes to process both alcohol and Xanax, meaning that if a person takes both the negative effects of Xanax and alcohol will continue much longer than with either substance alone. 

    Effects Of Mixing Xanax With Opioids

    Opioids are a family of widely-abused narcotic painkillers that work by stimulating opioid receptors in the brain. These include methadone, heroin, morphine, oxycodone, hydrocodone, and fentanyl.

    In high doses, opioids cause euphoria and build patterns of habit and desire that feed compulsive drug use, while also depressing CNS activity.

    Risk Of Deadly Overdose 

    This greatly increases the risk of dangerous or deadly overdose when benzos and opioids are used together, marked by the same symptoms listed above, along with pinpoint pupils which are a classic sign of opioid overdose. 

    Effects Of Mixing Xanax With Other Tranquilizers

    Combining Xanax with other benzos drugs (including Klonopin/clonazepam, Valium/diazepam, Librium/chlordiazepoxide, and many others), barbiturates, or other sedative-hypnotics will increase the sedative effects of both drugs, with overdose symptoms similar to those listed above.

    Tolerance, Dependence, & Withdrawal

    Mixing tranquilizers also greatly increases the rate at which the body develops tolerance to their effects and becomes dependent on the medications, leading to potentially severe withdrawal symptoms if you begin to cut back, or end your substance use cold turkey.

    Effects Of Mixing Xanax With Stimulant Drugs

    What happens when you mix stimulants like cocaine, methamphetamine, amphetamine, and even high-dose caffeine with a powerful sedative like Xanax? It depends. 

    While some effects of each drug may more-or-less balance out for an uncertain period of time, each drug also has its own side effects, especially at high doses. 

    And the push-pull between the drugs can create unpredictable, upsetting, and deceptive sensations and physical or mental effects.

    Severe Side Effects

    Serious potential side effects include:

    • paranoia
    • psychosis
    • heart attack
    • stroke
    • rapid development of addiction and dependence
    • delayed overdose
    • death

    Mixing stimulants and Xanax may also cause a profoundly uncomfortable comedown or withdrawal symptoms after the high has passed. 

    Effects Of Mixing Xanax With Marijuana

    Xanax and cannabis are not considered to be a life-threatening or seriously dangerous combination when taken together. However, mixing the two can still cause unpredictable and uncomfortable mental and physical effects, including:

    • dizziness
    • drowsiness
    • poor concentration
    • slurred speech
    • confusion
    • impaired judgement
    • impaired coordination

    Polysubstance Abuse Treatment

    If you or a loved one struggle with polydrug abuse or Xanax addiction, medical detox and professional addiction treatment may be your best option for achieving lasting recovery.

    To learn more, please contact us today.

    Related Topics

    What Happens When You Mix Xanax & Adderall?

    Combining Xanax (a depressant) and Adderall (a stimulant) may worsen your side effects and decrease the potential positive aspects of each medication. 

    Abusing Xanax and Adderall can also increase the risk of addiction, respiratory depression, and severe withdrawal symptoms when you stop using.

    Learn more about Mixing Xanax & Adderall

    Can You Take Ativan & Xanax On The Same Day?

    Taking Ativan and Xanax at the same time may increase the severity of side effects, including drowsiness, dizziness, and memory impairment. Elderly people have an increased risk of experiencing falls, fractures, and car accidents. 

    In addition, taking high doses of benzodiazepines can cause a potentially life-threatening overdose. Signs of an overdose include slowed breathing and loss of consciousness.  

    Learn more about Mixing Xanax & Ativan

    What Happens When You Mix Xanax & Klonopin? 

    Mixing Xanax & Klonopin can make common side effects like sedation, headache, and dizziness more intense. It can also increase your risk of serious side effects, like physical dependence and drug overdose.

    Learn more about Mixing Xanax & Klonopin

    What Happens When You Mix Xanax & Cocaine?

    Xanax slows down your central nervous system, making you feel calm and sleepy. On the other hand, cocaine speeds up your central nervous system, making you feel happy and energized. 

    These opposing effects can wreak havoc on your body. You may experience a variety of unpleasant side effects, including irritability, agitation, depression, and suicidal thoughts. 

    In addition, mixing cocaine and Xanax significantly increases your risk of overdose and addiction.

    Learn more about Mixing Xanax & Cocaine

    Is It Dangerous To Mix Xanax & Oxycodone?

    Yes, it is dangerous to mix Xanax and oxycodone. Doctors likely avoid prescribing them together unless they are out of other treatment options. Mixing Xanax and oxycodone can lead to overdose, respiratory depression, and other serious side effects.

    Learn more about Mixing Xanax & Oxycodone

    Can You Take Xanax & Methadone At The Same Time? 

    No, taking Xanax and methadone at the same time is not recommended. Mixing benzodiazepines and opioids can cause respiratory depression, sedation, coma, and death.

    Learn more about Mixing Methadone & Xanax

    What Happens When You Mix Xanax & Codeine?

    Mixing benzodiazepines like Xanax with opioids (even a relatively weak opioid like codeine) exposes you to severe potential harm due to central nervous system depression. 

    Long-term effects, including dependence and addiction to both substances, are also intensified with concurrent use.

    Learn more about Mixing Xanax & Codeine

    What Happens When You Mix Xanax & Trazodone?

    Although Xanax and trazodone work on different parts of the brain, adverse drug interactions, and side effects may occur when you mix them, including drowsiness, impaired judgment, and nausea.

    Learn more about Mixing Xanax With Trazodone

    What Happens If You Take Xanax With Lexapro?

    If you take Xanax with Lexapro under doctor supervision, you should be fine. However, if you’re abusing the drugs together, you may experience extreme sedation, memory issues, and dizziness.

    Learn more about Taking Xanax With Lexapro

    Written by Ark Behavioral Health Editorial Team
    ©2024 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Alcohol Research & Health - Alcohol and Medication Interactions
    Centers for Disease Control and Prevention (CDC) - Polysubstance Use Facts
    Centers for Disease Control and Prevention (CDC) - Prescription Opioid and Benzodiazepine Medications and Occupational Safety and Health: Information for Employers and Healthcare Providers
    National Institute on Drug Abuse (NIDA) - Commonly Used Drugs Charts

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 27, 2022
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