What Are the Dangers of Mixing Xanax and Alcohol?

Drinking even small amounts of alcohol with Xanax can lead to fatal overdoses and other side effects such as confusion and trouble breathing.

Xanax and alcohol can be a dangerous, even fatal, combination. Xanax, the brand name for alprazolam, is a benzodiazepine that may be prescribed for anxiety and panic disorders. It’s a central nervous system (CNS) depressant that works by slowing the activity in the brain. When mixed with other CNS depressants, like alcohol, the risk of side effects from each substance increases.

Can You Drink on Xanax?

Drinking alcohol with Xanax is risky, unsafe and should be avoided. Even small amounts of alcohol mixed with Xanax can lead to increased side effects and cause fatal overdoses.

Side Effects of Mixing Xanax and Alcohol

Since alcohol and Xanax are both CNS depressants, they have similar side effects, increasing the risk of side effects and overdose when mixed. Some harmful side effects that may increase by mixing Xanax and alcohol include:

• Drowsiness
• Confusion
• Loss of balance
• Unable to awaken
• Trouble breathing
• Slowed breathing
• Seizure

How Long After Taking Xanax Can I Drink?

Xanax reaches peak levels in the body one to two hours after a single dose. The average half-life of Xanax is 11.2 hours in healthy adults. This is the amount of time it takes the body to metabolize and get rid of half the Xanax in your system. It takes about four to five half-lives for a drug to be 94% to 97% eliminated from the body. A single dose of Xanax may remain detectable in healthy adults for as long as two days.

How quickly the body metabolizes a drug is affected by factors such as age, gender and health status. Older individuals may take longer to metabolize the same amount of a drug as younger individuals. Other medications may also affect the metabolism of Xanax. Certain drugs may extend how long Xanax lasts in the system, such as:

• Ketoconazole
• Itraconazole
• Clarithromycin
• Nefazodone
• Erythromycin
• Fluvoxamine
• Cimetidine

How Long After Drinking Can I Take Xanax?

The half-life of alcohol is four to five hours. It takes the body about five half-lives to get rid of most of the alcohol in your system, so alcohol may be detectable in your system for as long as 25 hours after the last drink. Several factors may affect how quickly the body clears alcohol, including:

• Medications
• Age
• Gender
• Body size
• Health conditions

Xanax and Alcohol Overdose

While overdose is possible with both Xanax and alcohol alone, the risk of overdose greatly increases when the two are taken together. Overdose in people taking Xanax can happen with smaller amounts of alcohol than typically seen with most fatal alcohol overdoses. Signs of Xanax overdose include:

• Extreme drowsiness
• Decreased alertness
• Confusion
• Lack of coordination
• Coma

Since both Xanax and alcohol are CNS depressants, the signs of overdose overlap for both. Signs of alcohol overdose include:

• Confusion
• Abdominal pain
• Lack of coordination
• Vomiting
• Slowed breathing
• Decreased alertness
• Coma

If an overdose from Xanax, alcohol or a combination of both is suspected, you should immediately call 9-1-1 for help and follow these steps.

• Stay with the person you suspect is overdosing.
• Keep the person on the ground sitting or partially upright.
• Help a vomiting person lean forward to prevent choking.
• Roll an unconscious person on their side to prevent choking.
• Prepare to provide information to responders on what the person drank and other substances they took.

How Concurrent Alcohol and Xanax Misuse Is Treated

Treating the combined misuse of alcohol and Xanax (alprazolam) typically requires a comprehensive approach that addresses both substances simultaneously. Because these substances can amplify each other’s adverse effects—and withdrawing from them can pose significant medical risks—professional guidance is crucial. Below is an overview of common strategies:

• Professional Assessment and Medical Stabilization
  • Medical Evaluation: A thorough evaluation helps determine the severity of misuse, overall health status, and any co-occurring mental health disorders.
  • Managed Detox: Stopping Xanax and alcohol abruptly can be dangerous; a medically supervised setting is often needed to manage withdrawal symptoms and stabilize vital signs. Detox protocols might include tapering off Xanax gradually and using supportive medications to alleviate alcohol withdrawal.
• Individualized Treatment Plans
  • Medication Management: Physicians may prescribe safer alternatives or tapering schedules to help individuals discontinue benzodiazepines. For alcohol dependence, certain medications (e.g., naltrexone, acamprosate) can reduce cravings and the risk of relapse.
  • Behavioral Therapy: Cognitive Behavioral Therapy (CBT), Dialectical Behavior Therapy (DBT), and other evidence-based approaches can help identify triggers, develop coping strategies, and reframe harmful thought patterns.
• Supportive Psychosocial Interventions
  • Inpatient or Residential Care: Intensive live-in programs provide structured environments free from everyday triggers. Continuous supervision also allows for immediate medical intervention if necessary.
  • Outpatient Programs: Intensive outpatient or partial hospitalization programs offer therapy, counseling, and support while allowing individuals to maintain certain daily responsibilities.
  • Group Therapy and Peer Support: Programs like 12-Step groups (e.g., Alcoholics Anonymous) or non-12-Step alternatives provide a sense of community and shared experiences. Group settings foster accountability and help individuals learn from each other’s challenges and successes.
• Aftercare and Relapse Prevention
  • Ongoing Counseling: Regular therapy sessions can address underlying issues—such as stress, trauma, or mental health concerns—that may have contributed to substance misuse.
  • Continued Medical Monitoring: Routine check-ins with healthcare providers ensure that any medication changes are safe and effective, and that new or re-emerging psychiatric symptoms are treated promptly.
  • Lifestyle Modifications and Support Systems: Long-term recovery often involves building healthy routines, stress-management techniques, and supportive relationships. Family therapy can also be valuable, helping loved ones understand the recovery process and provide effective support.
• Co-Occurring Mental Health Conditions
  • Integrated Treatment: Many people who struggle with alcohol and Xanax misuse also face depression, anxiety, or other mental health conditions. Treatment plans that address both substance misuse and mental health disorders concurrently (using therapy, medication, and psychosocial support) can improve outcomes.

Because the withdrawal process from both alcohol and benzodiazepines requires special care, seeking professional help is critical. Treatment typically involves gradual dose reductions, close supervision, and a combination of therapies to address the root causes of misuse. Recovery is often a long-term journey, and having ongoing medical and emotional support is a key factor in maintaining sobriety and overall well-being.

Get Help Today

If you or a loved one is struggling with Xanax addiction or alcohol use disorder, contact The Recovery Village Cherry Hill at Cooper today. Our team of licensed addiction experts can provide evidence-based, compassionate treatment that starts you on the road to long-term recovery.