Xanax and Alcohol: 5 Critical Risks of Mixing These Substances

Mixing Xanax and alcohol is more common than you might think—and that’s concerning because this combination carries some serious risks. Both substances affect your brain in similar ways, and when they’re taken together, they can amplify each other’s effects to a potentially life-threatening degree. 

Most people don’t realize that having “just a few drinks” while taking Xanax can harm their health.

Some people mix these substances on purpose; others don’t fully understand their risks. Either way, the combination can cause lasting damage to your physical and mental health.

We’ll help you understand how Xanax and alcohol affect your body, why the combination is so risky, and how to get help if you’re concerned that you or your loved one is becoming dependent.

What Happens When You Mix Alcohol and Xanax?

When you mix Xanax (the brand name for alprazolam) and alcohol, you’re combining two substances that both slow down your central nervous system. Xanax works by boosting the effects of GABA¹ (Gamma-aminobutyric Acid), a natural neurotransmitter that reduces brain activity. Alcohol affects many of the same brain systems, also increasing GABA’s effects while blocking other brain chemicals.

This creates what behavioral health experts call a synergistic effect. This means that when combined, Xanax and alcohol don’t just add their effects together—they multiply them. This is why the combination is especially dangerous.

Why do people mix Xanax and alcohol?

People mix Xanax (alprazolam) and alcohol primarily for enhanced sedative effects, as both substances depress the central nervous system which can lead to increased relaxation, euphoria, or intoxication. Some individuals may do this intentionally to heighten the effects, while others may mix them unintentionally, not realizing how dangerous the combination can be.  It is important to ask what intention the person had when mixing the substances or if it was consumed unintentionally.

Andrew J. Schreier, ICS, CSAC, LPC, ICGC-II, BACC

1. Enhanced Sedation

Both Xanax and alcohol are central nervous system depressants² that cause sedation on their own. When combined, this sedative effect becomes much stronger.

You might feel extremely drowsy, dizzy, or uncoordinated. Tasks that require alertness, like driving or using machinery, become highly dangerous. Even just walking around normally is more dangerous, as you’re more likely to fall and hurt yourself.

2. Life-Threatening Breathing Problems

One of the most life-threatening side effects of mixing Xanax and alcohol is respiratory depression—when your breathing becomes dangerously slow or shallow. Both substances suppress the part of your brain that controls breathing.

Together, they can slow your breathing to the point where your body doesn’t get enough oxygen, potentially leading to brain damage, coma, or death.

When combined, Xanax and alcohol suppress your autonomic respiratory drive.³ That means they interfere with the brain stem’s ability to detect carbon dioxide in your blood—the primary trigger that tells your body to breathe. Without this signal functioning properly, your breathing can slow or even stop completely without even feeling like you’re having trouble breathing.

3. Increased Overdose Risk

This combination increases your risk of overdose. Even amounts of each substance that would be safe individually can become deadly when combined. In fact, one report finds Alprazolam (Xanax) is even more toxic than other benzodiazepines in overdose,⁴ warning that “severe toxicity is often related to co-ingestants, especially alcohol.”

This is particularly dangerous because the effects of alcohol and Xanax can be unpredictable—what might seem like a small amount of alcohol can dramatically increase the effects of Xanax in your system.

Maybe you’ve taken your normal prescribed dose of Xanax with a moderate amount of alcohol before without serious consequences. But taking higher doses, changes in your physical condition, timing between doses, or even what you’ve eaten that day can suddenly make the same amounts deadly.

4. Memory Impairment and Blackouts

Both Xanax and alcohol affect your memory. Used together, they can cause severe memory problems. You might find yourself having more blackouts or periods of time you can’t remember at all.

One participant in a study on benzo use by young people in the UK⁵ reflects on his experience with frequent blackouts: 

I don’t know how many memories or experiences I have lost due to my benzo use back then, but they are parts of my life that I will never be able to get back.

These memory gaps can be frightening—and potentially dangerous—if you made decisions or took actions you can’t recall.

What are the risks of combining alcohol and Xanax?

In your brain, alcohol increases the release of the neurotransmitter GABA, which produces slower brain activity that you perceive initially as relaxation. But both alcohol and Xanax also enhance the effect of the GABA-A receptor, making the increased GABA levels much more potent. This creates a particularly dangerous situation since a dose of either Xanax or alcohol that might be “safe” on its own can combine in the brain in dramatically more powerful and unpredictable ways. They also have synergistic effects on muscle control, short-term memory, judgment, and breathing- meaning that alcohol and Xanax are incredibly dangerous and potentially fatal when combined.

W. Lee Warren, MD

5. Behavioral Changes

Over time, the combination of substances can cause noticeable changes in how you feel and act. You might become more aggressive, emotional, or take risks you normally wouldn’t. Severely impaired judgment can lead you to make poor decisions with lasting consequences. While most people start taking Xanax for anxiety or panic disorders, abusing Xanax can make you feel more anxious or agitated rather than calmer.

Why Do People Mix Xanax and Alcohol?

People mix Xanax and alcohol for several reasons, often without realizing how serious the risks are.

• Seeking Stronger Effects: Some people combine these substances intentionally to feel a stronger effect. Since both Xanax and alcohol reduce anxiety and make you feel relaxed, some people think taking them together will increase these pleasant feelings. They might be seeking deeper relaxation or trying to escape stress, anxiety, or other emotional discomfort.
• Self-Medication: Someone whose prescribed Xanax isn’t fully controlling their anxiety disorder might drink alcohol for additional relief. This often happens when anxiety breaks through between doses⁶ or when someone has developed tolerance to their medication.

For more information on how substances can interact with each other and affect your body’s response to medication, see our article on cross-tolerance. Understanding this concept is especially important if you take Xanax or other prescription drugs.

• Unintentional Mixing: Many people mix these substances unintentionally. Someone might take their prescribed Xanax and later attend a social event where they have a drink, not realizing the interaction they’re creating. Others might simply not know about the risks or might think that “just one drink” won’t cause problems.
• Social Pressure: Social pressure can play a role too. In settings where drinking is expected, someone who takes Xanax might feel awkward explaining why they can’t drink, especially if they don’t want to discuss their mental health.

Regardless of the reason, mixing Xanax and alcohol is never safe, even in small amounts—the risks far outweigh any perceived benefits.