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  • Mixing methadone and Xanax can be as dangerous as mixing any other opioid and benzodiazepine. Potential side effects include severe respiratory depression, sedation, poor concentration, and a higher risk of opioid overdose.

    Benzodiazepines have potentially dangerous drug interactions with opioids. Both are controlled substances. Labels and healthcare professionals warn against mixing the two, making concomitant use a form of substance abuse.

    Methadone is used to treat opioid use disorders (OUDs). Many patients who get treated for OUDs also have a history of benzodiazepine use. 

    Due to the serious side effects of methadone and benzos together, it is important that doctors and healthcare providers know about your drug use history when going into treatment.

    Effects Of Concomitant Methadone & Xanax Use

    Methadone and Xanax’s main ingredient, alprazolam, are both central nervous system depressants. Taking them together can lead to strong feelings of numbing, relaxation, and pain relief. Negative side effects can also be stronger, including:

    • drowsiness
    • constipation
    • sedation
    • hypotension (low blood pressure)

    Many of these effects also apply to other benzodiazepines. Brand name benzos like Xanax, Valium (diazepam), Ativan (lorazepam), and Klonopin (clonazepam) all come with warnings against mixing them with opioids and opiates.

    Dangers Of Mixing Xanax & Methadone

    Many prescription opioids are taken at home, but methadone treatment is likely a part of supervised addiction recovery programs. Methadone abuse under supervised conditions is supposed to be difficult, but it’s not impossible.

    Opioid Overdose

    Opioid overdose happens when opioid levels in the body become high, and the depressant effects of opioids make vital body functions slow down.

    Xanax and methadone have combined CNS depressant effects. When taken together, their effects are stronger than they would be taken alone. Signs of severe CNS depression and opioid overdose include: 

    • respiratory depression
    • slowed heart rate
    • coma

    Benzodiazepines had a 32% rate of involvement in methadone overdose deaths in 2017. This rate was high even compared to other opioids, including strong ones like codeine or fentanyl.

    Changes In Treatment Options

    Some patients who enter opioid addiction treatment may be taking Xanax as directed. Anxiety disorders and opioid abuse are commonly seen together, and patients may be taking Xanax to treat their anxiety or panic disorders. 

    These patients may still need to look at other treatment options for tapering off opioids. Xanax can make a safe dose of opioids a dangerous one. Xanax is also a short-term treatment for anxiety, and some patients may take the opportunity to look for other anxiety treatments. 

    Quitting Xanax after taking it for a long time can come with its own problems, such as withdrawal. Xanax withdrawal symptoms may include anxiety, weight loss, and changes in perception. Dealing with Xanax withdrawal can complicate your treatment program.

    Treatment Programs For Opioid & Benzodiazepine Abuse

    Prescription drug abuse is an ongoing problem in the United States. Historically, opioids and benzodiazepines are some of the most common targets for prescription drug abuse. Abusing these substances can come with temporary relief, but also life-threatening risks.

    Polydrug abuse can seem intimidating to treat at first. Being honest with your healthcare provider about substances you’re taking can help you get effective treatment and avoid dangerous interactions.

    To find an inpatient or outpatient addiction treatment program that works for you or your loved one, please contact our helpline today.

    Written by Ark Behavioral Health Editorial Team
    ©2022 Ark National Holdings, LLC. | All Rights Reserved.
    This page does not provide medical advice.

    Food and Drug Administration - XANAX Label
    National Institute on Drug Abuse - Benzodiazepines and Opioids
    National Library of Medicine: PubMed Central - Medicine Cabinet: Use of methadone
    National Library of Medicine: PubMed Central - Polydrug abuse: A review of opioid and benzodiazepine combination use

    Medically Reviewed by
    Kimberly Langdon M.D.
    on April 29, 2022
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