Xanax Overdose: Symptoms, Treatment and Prevention

Last Updated: February 26, 2024

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Article at a Glance:

  • Xanax is a benzodiazepine drug prescribed for conditions including anxiety and panic disorders.
  • Mixing Xanax with other depressants like opioids or alcohol can significantly increase your risk of a Xanax overdose.
  • A Xanax overdose can be deadly, especially when Xanax is mixed with other depressants.
  • Xanax recovery is possible with the right support.

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A Xanax overdose can be fatal, especially when Xanax is taken with another drug. Seek emergency help immediately if you suspect a Xanax overdose.

In 2020, over half of fatal benzodiazepine overdoses were due to Xanax (alprazolam). As the most commonly prescribed benzodiazepine in the U.S., Xanax is taken by millions of Americans every year. Nonetheless, it is a controlled substance that carries a risk of abuse, addiction and overdose. As such, it is important to know the risk factors for a Xanax overdose and what to do if you suspect an overdose.

What Does Xanax Do?

Xanax is a benzodiazepine commonly known as a “benzo.” The drug works by enhancing the effect of the neurotransmitter gamma-aminobutyric acid (GABA) in the brain. GABA is the brain’s main inhibitory neurotransmitter, meaning it helps reduce brain activity. Because Xanax helps calm down the brain and body, it is often prescribed to treat conditions like:

  • Anxiety disorders
  • Panic disorder
  • Nausea and vomiting due to chemotherapy

Is Xanax Safe?

As an FDA-approved medication, Xanax is safe and effective when taken exactly as prescribed by a doctor. However, as a Schedule IV controlled substance, it can increase the risk of abuse, addiction and dependence, especially if not taken as prescribed. Taking more Xanax than prescribed or taking it more often than prescribed can increase your risk of Xanax addiction and overdose.

Some safety issues can also arise if someone takes Xanax for an extended period. These include an increased risk of:

  • Cognitive impairment
  • Motor vehicle crashes
  • Hip fractures

Related Topic: Xanax Side Effects

Can You Overdose on Xanax?

It is common to overdose on Xanax if you take it with other substances, such as opioids, or take more Xanax than prescribed. A Xanax overdose can be deadly. In 2020, there were more than 1,200 fatal Xanax overdoses. In 2021, about 14% of opioid overdose deaths also included the presence of a benzo like Xanax.

What Happens When You Overdose on Xanax?

When you overdose on Xanax, an excessive impact on neurotransmitters, specifically GABA, affects your brain. Xanax causes GABA to work more effectively in your brain. Since GABA slows down brain activity, taking too much Xanax slows your brain excessively.

Most people who seek help for a Xanax overdose will be very sedated but have near-normal breathing, heart rate and blood pressure unless they have taken Xanax with another substance. Unfortunately, most Xanax overdoses involve taking multiple substances, which makes a Xanax overdose very dangerous.

Xanax Overdose Symptoms

If you or someone you love takes Xanax, knowing how to identify overdose symptoms quickly is important. When someone overdoses on Xanax alone, overdose symptoms are generally limited but include:

Physical Symptoms

  • Slow or shallow breathing, which is more likely to occur if Xanax is taken with another substance, such as an opioid
  • Balance problems, which can lead to trouble walking
  • Physical coordination problems, which can lead to difficulties completing motor tasks

Cognitive and Emotional Symptoms

  • Mental status changes, which can include confusion
  • Drowsiness, which may lead to excessive sleepiness
  • Slurred speech, even when the person tries to enunciate their words

A Xanax overdose can be fatal, especially if someone takes Xanax with another drug. If someone is experiencing signs of a Xanax overdose, seek help immediately by calling 911 or contacting the National Capital Poison Center.

Xanax Overdose Risk Factors

A Xanax overdose can be deadly, especially when Xanax is combined with other depressants like opioids or alcohol. Fortunately, many risk factors can help identify who is most at risk for a Xanax overdose. Knowing that you or someone you love has risk factors can help you remain vigilant against taking too much Xanax. In addition, risk factors can signal that it may be time to seek help for Xanax use.

Some risk factors include:

Xanax Addiction

As a Schedule IV controlled substance, Xanax carries a risk of abuse, addiction and dependence. For this reason, doctors and pharmacies must closely monitor benzodiazepine prescriptions and ensure people are not taking too much Xanax or taking it more often than prescribed.

A common reason people take more Xanax than they should is to try to self-treat sleep or anxiety problems. However, other medications that are less addictive can treat these conditions, so it is important to talk to your doctor if you are tempted to take more Xanax than instructed.

Xanax Addiction Rate

Xanax is the most commonly prescribed benzo, with almost 17 million prescriptions dispensed in the U.S. in 2020. Although little data is available specifically on Xanax addiction rates, experts know that about 2% of people prescribed benzos have benzodiazepine use disorders. This means that around 340,000 Americans likely have an addiction to Xanax.

Xanax and Alcohol

You should avoid drinking while taking Xanax. This is because both Xanax and alcohol are central nervous system depressants that can slow activity in your brain and may have an additive effect. Mixing the two substances can increase the risk of overdose and side effects like:

  • Dizziness
  • Drowsiness
  • Problems concentrating
  • Impaired thinking and judgment

How Long After Taking Xanax Can I Drink?

It is important to avoid alcohol until your body has metabolized Xanax. Although short-acting Xanax only lasts a few hours in most people, it can last much longer in others, especially those who have liver problems or are on medications that interact with Xanax. As such, you should talk to your doctor before drinking if you take Xanax. Based on your medical history and medications, your doctor can give you the safest time frame for when to have a drink.

Other Drug Interactions

Taking Xanax with other central nervous system depressants can increase the risk of overdose. This is especially true of opioids, which is why the FDA has a boxed warning on benzodiazepines like Xanax that warns against combining it with opioids. More than 93% of fatal benzo overdoses in 2020 involved people who had also taken an opioid.

Interactions with Xanax are not limited to opioids. For example, certain antidepressants, especially fluvoxamine, have a drug interaction with Xanax that may increase the risk of an overdose. If you take Xanax and start taking fluvoxamine, you may need a Xanax dose decrease.

Co-Occurring Disorders

Mental health concerns like depression can increase the risk of a Xanax overdose. Unfortunately, some people may intentionally overdose on Xanax by taking a large amount of the drug or combining it with other drugs.

Pre-Existing Conditions

Some medical conditions, such as liver or breathing problems, can increase the risk of an accidental Xanax overdose. For this reason, it’s very important only to take Xanax prescribed to you by a doctor.

Age/Race/Gender

Age, race and gender are additional risk factors for Xanax overdose. More than 51% of Xanax overdoses in 2020 were in women, and 81% of fatal benzo overdose victims were white. Although overdose can occur in anyone at any age, benzo overdose rates are highest among those aged 25–34 as of 2020.

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Xanax Overdose Prevention

Because of the dangers involved with a Xanax overdose, avoiding an overdose in the first place is key. Fortunately, steps can help minimize your risk of a Xanax overdose. These include proper prescription use, avoiding self-medication and recognizing signs of a Xanax dependency.

Proper Prescription Use

One of the most important things you can do to avoid a Xanax overdose is only to take Xanax that has been prescribed to you and to take it exactly as instructed by your doctor. You should avoid taking more Xanax than prescribed or taking it more often than prescribed. Further, do not mix it with other drugs or alcohol without first clearing it with your doctor.

Xanax Dosage

Brand-name Xanax and its generic version, alprazolam, both come in different forms and doses:

  • Oral concentrate: As 1 mg of alprazolam inside every 1 mL of liquid
  • Orally disintegrating tablets: In strengths of 0.25 mg, 0.5 mg, 1 mg, 2 mg
  • Short-acting tablets: In strengths of 0.25 mg, 0.5 mg, 1 mg, 2 mg
  • Long-acting tablets: In strengths of 0.5 mg, 1 mg, 2 mg, 3 mg

How Often Can You Take Xanax?

You should only take Xanax as often as prescribed by your doctor. Short-acting Xanax can be taken up to three times daily, while long-acting Xanax is usually taken once daily. Taking Xanax more often than prescribed can increase your risk of overdose.

What Is the Highest Dose of Xanax?

Short-acting Xanax comes in strengths as high as 2 mg, and long-acting Xanax can be as high as 3 mg. However, the highest recommended dose of Xanax depends on why you take it. For example, the highest recommended total daily dose for anxiety is 4 mg; for panic disorder, it is 10 mg.

Avoiding Self-Medication

Avoiding self-medication is an important step in avoiding a Xanax overdose. Sometimes, a person will think they need a higher drug dose, so they will take more of it than prescribed or more often than instructed. However, doing so can increase the risk of having too much Xanax in your body, especially if you are older, overweight, have liver or kidney disease or take other medications that interact with Xanax. For this reason, it is important not to adjust your Xanax dose without first getting permission from your doctor.

Recognizing Signs of Dependency

Sometimes, despite a person’s best efforts, they may develop a dependency on Xanax. Signs of an emerging dependence can include cravings or taking the drug at times when it’s not medically necessary. Dependency can be physical and psychological and develop over time. If you notice you are starting to rely more on Xanax than you did when you were first prescribed the medication, talk to your doctor about your risk of Xanax addiction.

Xanax Overdose Treatment

A Xanax overdose is a medical emergency. Due to its life-threatening risks when combined with other substances, a Xanax overdose should only be treated in a medical setting. Doctors can monitor your vital signs and mental status while Xanax works its way out of your body.

Emergency Response

A Xanax overdose can cause slurred speech, movement problems and altered mental status. Because of this, doctors will often provide supportive care and monitor the person closely, ensuring they are safe while waiting for Xanax to wear off. 

In cases where Xanax was mixed with another substance like an opioid, emergency personnel may give an opioid reversal agent like naloxone and closely monitor the person for opioid overdose symptoms like slowed breathing and heart rate.

Medical Intervention

Medical interventions are rarely needed if the person has overdosed on Xanax alone with no other substances involved. In rare cases, doctors may prescribe flumazenil, a benzodiazepine reversal drug. However, flumazenil can carry health risks like seizures and heart rhythm abnormalities, so it is not widely used.

Ongoing Support and Recovery

A Xanax overdose can be a red flag that the person has become addicted to or dependent on the drug. This is often a sign that the person needs help. Your doctor can refer you to a Xanax recovery center like The Recovery Village Cherry Hill at Cooper, where you can be gently weaned off Xanax and begin a Xanax-free life.

How Much Xanax Is Too Much?

How much Xanax it takes to overdose can vary, especially when you mix the drug with other substances. Most Xanax overdoses occur when Xanax is taken with other depressants, including alcohol or opioids. Illicit Xanax may be counterfeit and is sometimes cut with opioids like fentanyl, further increasing your overdose risk.

How Much Xanax Does It Take To Overdose?

There is no one set amount of Xanax that can cause an overdose. Multiple factors can influence how much Xanax it takes to overdose, including whether your body is used to (or tolerant of) Xanax and whether you have taken other substances. To avoid a Xanax overdose, never take Xanax in higher or more frequent amounts than prescribed.

How Much Xanax Can Kill You?

Different amounts of Xanax can be fatal in different people. Factors that can affect this include taking other substances besides Xanax, especially opioids. The amount can also depend on whether your body is used to the presence of Xanax.

Xanax Addiction Treatment

Fortunately, help is available for Xanax abuse and addiction. A medical detox program can wean you off Xanax in a safe environment to help you avoid withdrawal symptoms. This is followed by a rehab program that helps ensure you stay off Xanax for good.

At The Recovery Village Cherry Hill at Cooper, we offer an evidence-based medical detox program and a comprehensive list of rehab options to suit your needs. Our rehab options include:

Our 90-bed, nationally accredited treatment facility also has amenities to help keep your body and mind healthy while you recover from Xanax. These include:

  • Fully-equipped gym
  • Indoor basketball half-court
  • Outdoor volleyball court
  • Yoga room
  • Game room
  • Entertainment lounges
  • Outdoor bocce ball
  • Outdoor shuffleboard

If you or someone you love is struggling with Xanax, our addiction experts can help. Contact us today to learn more about Xanax addiction treatment programs that can work well for your situation.

Sources

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National Institute on Drug Abuse. “Benzodiazepines and Opioids.” November 7, 2022. Accessed July 30, 2023.

Maust, Donovan T., Lin, Lewei A., Blow, Frederic C. “Benzodiazepine Use and Misuse Among Adults in the United States.” Psychiatric Services, December 17, 2018. Accessed July 30, 2023.

National Institute on Drug Abuse. “Research suggests benzodiazepine use is high while use disorder rates are low.” October 18, 2018. Accessed July 30, 2023.

Drugs.com. “Drug Interaction Report: alprazolam, ethanol.” Accessed July 30, 2023.

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Isbister, Geoffrey K.; O’Regan, Luke; Sibbritt, David; Whyte, Ian M. “Alprazolam is relatively more toxic than other benzodiazepines in overdose.” British Journal of Clinical Pharmacology, July 2004. Accessed July 30, 2023.

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