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Healthcare providers sometimes prescribe Xanax (alprazolam) as a short-term treatment for anxiety disorders, and a question they often encounter is whether or not you can mix Xanax and alcohol.
Let’s say, for example, that someone took a prescribed amount of Xanax in the morning. Now, it’s later that evening, and they are feeling much better. They’re out at a restaurant with a friend who is ordering a beer. Knowing they took Xanax earlier, they’re wondering if it’s safe to join their friend in having an alcoholic beverage. In this situation, it’s best to avoid drinking any alcohol.
Read on to learn more about why mixing Xanax and alcohol can be dangerous.
What is Xanax?
Xanax (alprazolam) is an anxiolytic (anti-anxiety) medication that’s available with a prescription from a healthcare provider. It is usually prescribed to adults as a short-term or as-needed treatment for mental health disorders like generalized anxiety disorder (GAD) and panic disorder (Pfizer, 2021).
It is a benzodiazepine or “benzo.” Benzodiazepines work by boosting the activity of a brain chemical called gamma-aminobutyric acid (GABA). GABA blocks certain brain signals, which slows down the activity of your brain and nervous system, producing calming and sedative effects (Bounds, 2020).
Here’s a quick summary of information about Xanax (alprazolam) (Pfizer, 2021):
- Drug class: benzodiazepine
- Brand name: Xanax
- Generic name: alprazolam
- Form: oral tablet
- Strengths: 0.25 mg, 0.5 mg, 1 mg, and 2 mg
Alprazolam is classified as a schedule IV controlled substance. This means that while it has several legitimate medical purposes, its use carries several risks, including possible addiction, substance abuse, and harmful effects when combined with certain substances, including alcohol (DEA, n.d.; FDA, 2020).
Your guide to anxiety medications
What are the risks of mixing Xanax with alcohol?
Mixing Xanax (alprazolam) with alcohol can have life-threatening effects. The combination can intensify certain side effects of Xanax, such as problems with coordination, unsteadiness, slurred speech, sedation or drowsiness, memory loss, and dizziness.
The effects of alcohol also alter the way your body metabolizes or breaks down Xanax, making the drug more toxic. The combination may also increase the risk of aggression and irritability (Huang, 2018; Iranpour, 2019).
Because of these risks, the Food and Drug Administration (FDA) requires all benzodiazepine prescription drugs to carry updated boxed warnings on their labels. These warnings alert healthcare providers and patients about the potential dangers of drug abuse, addiction, and harmful interactions (FDA, 2020).
Mixing alcohol with Xanax may also increase the risk of taking too much of the drug and possibly leading to a Xanax overdose. Xanax is known to cause disinhibition (defined as a lack of self-restraint) and euphoria (feeling “high”). These effects can sometimes lead people to take more than prescribed. It’s possible to develop the feeling that you “need” to take the drug (George, 2020).
Additionally, Xanax (alprazolam) and alcohol are both central nervous system depressants (also called CNS depressants or “downers”). Other types of CNS depressants include opioids (such as hydrocodone, oxycodone, or tramadol) and sleep aids (such as Ambien).
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Taking too much of one or more CNS depressants can increase the risk of respiratory depression. Respiratory depression is caused by your brain slowing down the vital signals to your body and may lead to trouble breathing, low blood pressure, loss of consciousness, and, in some cases, death. Unfortunately, alprazolam was one of the top ten drugs most frequently involved in fatal overdoses in the United States between 2011 and 2016 (Pfizer, 2021; George, 2020; Warner, 2018).
FAQs about Xanax and alcohol use
Learn answers to some frequently asked questions about the dangers of mixing Xanax with alcohol.
How long does Xanax stay in your system?
After you take a dose of Xanax (alprazolam), the drug’s effects usually last for about six hours. However, it takes longer than six hours for the drug to completely get out of your system (George, 2020; Pfizer, 2021).
Xanax has a half-life of 11.2 hours. “Half-life” is the length of time required for the body to eliminate half of a drug’s dose. Every drug’s half-life is an average, but several factors can lengthen it, including older age and drug interactions (Pfizer, 2021; Hallare, 2020).
On average, it takes about four to five half-lives for a drug to completely clear from your body. So, even after you no longer feel it working, Xanax can stay in your system for more than two days after your last dose (Hallare, 2020).
Is it safe to have just one alcoholic drink with Xanax?
No. There’s no amount of alcohol that’s safe to consume with Xanax. It’s best not to drink any alcohol with alprazolam, not even one serving. There’s no recommended or safe dose when it comes to drinking alcohol while taking Xanax.
I forgot that I took Xanax earlier today. What should I do if I just drank an alcoholic beverage?
It’s best to stop drinking alcohol and call your healthcare provider to get personalized medical advice. But if you’re having trouble breathing or having other severe symptoms, don’t wait to get help. Call 9-1-1 or have someone drive you to the nearest emergency medical facility right away. You should not drive yourself.
Alprazolam (Xanax): dosage, uses, side effects
The dangers of mixing Xanax and alcohol
The dangers of drinking alcohol with Xanax are real. Before taking any benzodiazepine, it’s important to be open with your healthcare provider about any alcohol abuse or substance use problems. You should also tell them about all of the drugs or prescription medications that you’ve been taking.
If you feel like you struggle with alcohol addiction or drug addiction, talk with a healthcare professional. They can recommend treatment options and offer additional medical advice.
- Bounds, C. G. & Nelson, V. L. (2020). Benzodiazepines. [Updated Nov 22, 2020]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK470159/
- Drug Enforcement Agency (DEA). (n.d.). Drug scheduling. Retrieved Aug. 17, 2021 from https://www.dea.gov/drug-information/drug-scheduling
- Food and Drug Administration (FDA). (2020). FDA requiring boxed warning updated to improve safe use of benzodiazepine drug class. Retrieved Aug. 17, 2021 from https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class
- George, T. & Tripp, J. (2020). Alprazolam. [Updated Jul 19, 2021]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK538165/
- Hallare, J. & Gerriets, V. (2020). Half life. [Updated Oct 6, 2020]. In: StatPearls [Internet]. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK554498/
- Huang, Z., Xu, Z., Wang, H., Zhao, Z. Q., & Rao, Y. (2018). Influence of ethanol on the metabolism of alprazolam. Expert Opinion on Drug Metabolism & Toxicology, 14(6), 551–559. doi: 10.1080/17425255.2018.1483338. Retrieved from https://pubmed.ncbi.nlm.nih.gov/29848078/
- Iranpour, A. & Nakhaee, N. (2019). A review of alcohol-related harms: a recent update. Addiction & Health, 11(2), 129–137. doi: 0.22122/ahj.v11i2.225. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6633071/
- Pfizer. (2021). Xanax (alprazolam) tablets, for oral use, CIV. Retrieved from https://www.accessdata.fda.gov/drugsatfda_docs/label/2021/018276s055lbl.pdf
- Warner, M., Trinidad, J. P., Bastian, B. A., Minino, A. M., & Hedegaard, H. (2016). Drugs most frequently involved in drug overdose deaths: united states, 2010-2014. National Vital Statistics Reports from the Centers for Disease Control and Prevention, 65(10), 1–15. Retrieved from https://www.cdc.gov/nchs/data/nvsr/nvsr67/nvsr67_09-508.pdf
Felix Gussone is a physician, health journalist and a Manager, Medical Content & Education at Ro.