Mixing Xanax And Codeine | Interactions & Effects

Xanax, a brand-name benzodiazepine, and codeine, an opioid narcotic commonly used in combination medications, are two prescription drugs that address anxiety and pain. 

However, these substances are commonly abused by people to get high, often with dangerous side effects. 

Mixing these medications increases the risks involved, and may lead to a dangerous interaction even at therapeutic doses.

Drug Interactions Between Alprazolam & Codeine

According to the black box labels included with both alprazolam (Xanax) and codeine medications, these prescription medications should not be taken in combination because of an increased risk of sedation, respiratory depression, and death.

This means that these two drugs, when used together, may act as powerful central nervous system depressants, slowing down your thinking, heart rate, blood pressure, body temperature, and (most dangerously) breathing. 

This interaction can be deadly, especially at high doses.

How Benzodiazepines & Opioids Work

Benzodiazepines work to control symptoms of anxiety, panic disorders, and seizures by increasing the effect of the gamma-aminobutyric acid (GABA) neurotransmitter, pushing activity down across your entire central nervous system. 

Alprazolam (Xanax) is one of the most commonly prescribed benzos and has an intermediate onset of action and a duration of action of between 10 and 20 hours. 

It is similar to lorazepam (Ativan). Diazepam (Valium) and clonazepam (Klonopin) are longer-acting with a duration of action of between 1-3 days, though diazepam has a much faster onset.

Opioid medications work by stimulating opioid receptors in the central nervous system, changing how the body senses and reacts to pain at lower doses, and triggering the release of dopamine and an intense, euphoric high at high doses. 

Compared to stronger opioid drugs like fentanyl, heroin, oxycodone (OxyContin), hydrocodone, and others, codeine is quite weak and is used for mild to moderate pain and cough suppression. 

Short-Term Side Effects Of Mixing Xanax & Codeine

Despite being a weak opioid, codeine can still have a profound effect on your body and nervous system. Taken with Xanax, this effect is greatly increased, and vice versa. 

This interaction can cause serious side effects including:

• profound drowsiness or fatigue
• impaired thinking
• mood swings
• dizziness
• confusion
• stomach pain
• nausea

Overdose

If the effects of either drug are too much for your body, you may experience drug overdose symptoms including:

• blurred vision
• slurred speech
• confusion
• blue-tinted nails or lips
• difficulty moving
• nausea and vomiting
• pinpoint pupils
• slow or irregular pulse
• coma

Immediately contact your local emergency department and administer naloxone if you ever suspect that you or someone around you is experiencing an opioid overdose. Fatal overdoses can occur.

Long-Term Effects & Dangers Of Mixing Xanax & Codeine

Chronically abusing drugs in combination exposes you to the long-term danger associated with abusing each substance, including the risk for substance use disorder. 

Abusing both substances can lead to more intense and prolonged withdrawal symptoms if you choose to stop taking one or both substances. Accordingly, tapering and medical supervision in a detox program are likely advised in cases of polysubstance withdrawal. 

Health Effects Of Chronic Prescription Opioid Abuse

Long-term side effects of codeine abuse may include:

• kidney and liver damage, largely due to presence of acetaminophen in combination codeine products
• immune system dysfunction
• memory problems
• mental health issues like depression or anxiety
• fatigue
• muscle spasms
• impotence and reproductive dysfunction

Health Effects Of Chronic Benzodiazepine Use

Long-term side effects of benzodiazepine abuse may include:

• changes in appetite and weight
• changes to sex drive
• brain damage and cognitive impairment
• memory dysfunction
• increased risk of birth defects (in cases of pregnancy)
• seizures

Substance Abuse Treatment

Substance abuse is a challenging pattern to break, especially when it involves multiple drugs and repeated attempts to get clean. 

If you or a loved one struggles with problematic use of benzodiazepines, opioids, or any other substance or combination of substances, it may be time to consider working with health care professionals who can help. 

Contact us today for information on our professional treatment options.