Can You Overdose on Xanax?


For those not familiar with Xanax, also known by its generic name alprazolam, it is a benzodiazepine drug commonly prescribed to treat anxiety disorders and anxiety caused by depression.  According to a study published by Statista, an online portal that provides market and consumer data, the annual number of prescriptions written for this specific benzodiazepine has been on a steady climb since being prescribed by physicians more than 18 million and 21 million times in 2004 and 2018, respectively.  By the way, physicians are now prescribing it a jaw-dropping 44 million times per year.    

The number of times physicians have prescribed Xanax to patients speaks to how effective the drug is at combating anxiety disorders and anxiety caused by depression.  After all, most physicians are not in the business of prescribing medications to their patients that do not work.  That said, one could argue that Xanax works a little too well insofar as the addictive nature of the drug has turned the lives of countless people upside down.

What Makes Xanax So Addictive?

While Xanax and generic alprazolam can be godsends to those struggling with anxiety and depression, they can be an utter nightmare to those who have become addicted to them.  Ironically, the very things that make Xanax and other benzodiazepines effective at subjugating anxiety and depression are also the ones that make them highly addictive.  To put this into perspective, we should probably get a better understanding of what happens in the brain and body when someone takes these drugs. 

Once someone takes Xanax, alprazolam, or another benzodiazepine pill or tablet, and it has time to navigate through their digestive tract, it begins working in their brain.  In the brain, these drugs trigger an uptick in the production of gamma-Aminobutyric acid (GABA), a naturally occurring amino acid responsible for regulating mood.  When the brain produces more GABA, it promotes a sense of calmness that alleviates feelings of anxiety and depression.  But things can quickly go awry if individuals do not take Xanax, alprazolam, and other benzodiazepines as prescribed by their physician or if they pair them with illicit drugs, such as heroin, for example, or take them while consuming alcohol.

Can You Overdose on Xanax if You Combine It With Heroin or Alcohol?

If you’re taking Xanax or any other benzodiazepine to combat anxiety, depression, or both, you certainly do not want to take it with alcohol or pair it with heroin.  Doing so makes benzodiazepines, in general, more addictive and significantly increases the risk of overdose, according to a study published by the Centers for Disease Control and Prevention (CDC).  Starting with heroin, researchers and scientists with the CDC noted that while heroin is a street drug and Xanax is a prescription-based drug, they are both central nervous system depressants.  How exactly does that answer the question of can you overdose on Xanax, you ask?  According to CDC researchers and scientists, heroin drastically intensifies the effects of Xanax to the extent that it contributes to the following:

  • Labored breathing
  • A weakened pulse
  • Compromised cardiac function

All three of these things can contribute to an overdose that requires hospitalization, and in many cases, such an overdose can even prove fatal.  To put into perspectively how likely it is for individuals to overdose on heroin and Xanax or another benzodiazepine, we need only look at a study published in the Journal of Drug and Alcohol Dependence. According to the study data, 50 to 80 percent of individuals who combine heroin and benzodiazepines die from a fatal overdose.  As we are already on the topic, common signs of a benzodiazepine overdose involving heroin include the following:

  • Bluish-colored lips
  • Confusion
  • Nausea and vomiting
  • Weak pulse
  • Arrhythmia
  • Hypotension
  • Dilated pupils
  • Feeling disoriented
  • Poor motor coordination
  • Drowsiness
  • Delirium
  • Loss of consciousness or coma

The Truth About Combining Xanax and Alcohol

Much like heroin, you would do best to avoid consuming alcohol while taking Xanax or any other benzodiazepine for that matter.  Because alcohol is a central nervous system depressant that affects GABA and dopamine levels in the brain, it can also intensify the effects of Xanax and other benzodiazepines.  Of course, the amount of alcohol one consumes influence the direction in which things ultimately play out. 


For example, when individuals consume small amounts of alcohol while taking benzodiazepines, they generally feel stimulated and invigorated.  Meanwhile, they tend to feel exceptionally sedated and relaxed whenever they take benzodiazepines and consume a moderate amount of alcohol.  Things, however, can significantly spiral out of control when they start to consume copious amounts of alcohol while on Xanax or another benzodiazepine.  Several studies show that consuming exceedingly large amounts of alcohol while taking Xanax and similar drugs can make overdosing more likely. 

And this is because the liver prioritizes metabolizing alcohol over all other substances, which means these drugs remain in their system that much longer.  As far as the signs of a Xanax-alcohol overdose, they are not too dissimilar from those associated with a Xanax-heroin overdose.  In other words, they, too, can be quite severe and life-threatening if individuals do not receive prompt medical care.

Bottom Line

In summary, overdosing on Xanax and other benzodiazepines is entirely possible, especially when taken with alcohol and other drugs.  Since 2016, there have been more than 10,000 overdose-related deaths stemming from the misuse or outright abuse of benzodiazepines in the U.S., according to the National Institute on Drug Abuse (NIDA).  While this article has focused primarily on the dangers of combining Xanax with alcohol or heroin, there are also dangers associated with pairing it with other drugs, including some over-the-counter and prescription-based ones.  Bearing that in mind, individuals should speak with their doctor if they have any questions or concerns regarding drug-to-drug interactions and contraindications.

Reviewed for Medical & Clinical Accuracy by Long Island Treatment Center

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