Mixing Xanax & Cocaine | Effects & Risks

Polysubstance abuse occurs when you abuse two substances at once to achieve a more intense “high.”
For example, many people abuse Xanax alongside cocaine. This combination poses serious health risks, including addiction and overdose.
How Xanax Works
Xanax (also called alprazolam) is a prescription drug used to treat mental health disorders, particularly anxiety and panic disorders. It belongs to a class of drugs called benzodiazepines (or “benzos”).
As a central nervous system (CNS) depressant, Xanax enhances the activity of a neurotransmitter (brain chemical) called gamma-Aminobutyric acid, or GABA.
This effect slows down your brain activity, heart rate, and breathing. It also causes relaxation and, in some cases, euphoria (intense joy).
Potential side effects of Xanax include:
- drowsiness
- dizziness
- dry mouth
- slurred speech
- trouble concentrating
- irritability
How Cocaine Works
Cocaine is an illicit drug made from the leaves of the coca plant, which is native to South America. It’s a white powder that can be snorted, smoked, or injected.
As a central nervous system stimulant, cocaine boosts the amount of dopamine in your brain. Dopamine is a brain chemical associated with pleasure. When you use cocaine, the increased dopamine can make you feel euphoric, confident, and energized.
Potential side effects of cocaine may include:
- irritability
- agitation
- paranoia
- hypersensitivity to sight, sound, and touch
- trouble sleeping
- increased body temperature
- constricted blood vessels
- increased heart rate
Risks Of Mixing Xanax & Cocaine
Xanax and cocaine have opposite effects.
While Xanax acts as a depressant drug (or “downer”), cocaine acts as a stimulant drug (or “upper”). Some people combine downers and uppers to cancel out each drug’s negative effects. For example, they may hope that cocaine will decrease the drowsiness caused by Xanax.
Unfortunately, like other types of polydrug abuse, mixing Xanax and cocaine is dangerous. That’s because it’s difficult for your body to process two drugs with opposing effects.
In many cases, the drugs worsen each other’s negative side effects. They can also cause additional health problems, such as:
Depression
As a cocaine high wears off, many people experience symptoms of depression, which include:
- sadness
- hopelessness
- fatigue
- loss of interest in activities
- suicidal thoughts
Depression is also a potential side effect of Xanax. Thus, regular use of cocaine and Xanax can lead to depression.
Overdose
An overdose occurs when you use enough of a drug to cause life-threatening symptoms. When you mix cocaine and Xanax, you significantly increase your risk of overdose.
That’s because the drugs can lessen each other’s positive effects. For example, Xanax may limit the amount of energy one feels on cocaine. To remedy this effect, a person may use more cocaine than they normally would, causing an overdose.
To make matters worse, cocaine often contains dangerous additives, such as fentanyl. Fentanyl is an extremely powerful opioid that’s been involved in numerous overdose deaths.
Common signs of overdose include:
- nausea and vomiting
- sweating
- increased body temperature
- increased heart rate
- high blood pressure
- blurry vision or vision loss
- confusion
- anger
- seizures
- loss of consciousness
If you or someone you know experiences these symptoms, seek medical help immediately. When left untreated, an overdose can lead to brain damage or death.
Addiction
Both Xanax and cocaine pose a high risk of drug addiction (also called substance use disorder). If you develop this disease, you’ll feel unable to control your Xanax and cocaine use.
The most common signs of addiction are tolerance and physical dependency.
Tolerance means that you need increasingly larger or more frequent amounts of a drug to feel the desired effects. Physical dependency means your body requires drugs to function normally. If you don’t use drugs, you may experience withdrawal symptoms like anxiety, loss of appetite, and restlessness.
Other signs of addiction include:
- mood swings
- extreme cravings for drugs
- withdrawal from friends and family
- loss of interest in activities once enjoyed
- loss of motivation
Substance Abuse Treatment
In most cases, a person with an addiction will likely need to attend a substance abuse treatment program. When left untreated, an addiction to cocaine and Xanax can lead to other health problems, including:
- high blood pressure
- heart attack
- stroke
- memory loss
- nosebleeds and nasal damage from regularly snorting cocaine
- infections such as HIV and hepatitis C from sharing needles for injecting cocaine or having unprotected sex while high
- permanent brain damage
If you or a loved one struggles with Xanax and cocaine abuse, please contact an Ark Behavioral Health specialist. We offer comprehensive drug abuse and addiction treatment options, including medical detox, mental health counseling, and aftercare planning.
Written by Ark Behavioral Health Editorial Team
©2025 Ark National Holdings, LLC. | All Rights Reserved.
This page does not provide medical advice.
Centers for Disease Control and Prevention - Fentanyl
National Institute on Drug Abuse - Cocaine DrugFacts
United States National Library of Medicine - Alprazolam
United States National Library of Medicine - Cocaine withdrawal

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