What this article is about
Mixing alcohol and benzodiazepines (like Xanax, Valium, Klonopin, or Ativan) is one of the most dangerous drug combinations, since both substances depress breathing, leading to overdose or death. This article explains why combining alcohol and “benzos” is so risky, how they interact, and how to treat alcohol and benzo use.
What are benzodiazepines?
Benzodiazepines are known as prescription tranquilizers. When used as prescribed, tranquilizers can help treat anxiety, tension, muscle spasms, stress reactions, panic attacks and sleep disorders.[1] They are also often prescribed or used in hospitals to treat epilepsy.[2]
Common types and brand names include:
- Xanax (alprazolam)
- Valium (diazepam)
- Klonopin (clonazepam)
- Ativan (lorazepam)
Long-term benzodiazepine use is not common. Most patients stop using them within days or weeks.[3] For example, they may be prescribed for a few days when a person has suffered the loss of a loved one and is having trouble sleeping. They are also used to help people who are waiting for an antidepressant to work.
Can benzodiazepines treat alcohol withdrawal symptoms?
In many cases, benzodiazepines are used to reduce alcohol withdrawal symptoms during treatment.[4] Alcohol withdrawal can be very painful and even deadly. Benzodiazepines can help gradually taper off these symptoms.[5] It is generally considered to be a safe treatment for withdrawal, but should be used under a provider’s care.
What are the risks of benzodiazepine use?
Benzodiazepines cause the brain to function more slowly. When they are not used correctly or misused, they can have serious side effects.
Some examples of benzodiazepine misuse include:
- Taking a prescription medication more often, in higher quantities, and for significantly longer than instructed.
- Going to multiple doctors to receive multiple prescriptions.
- Using benzodiazepines that aren’t prescribed to you.
Symptoms include:
- Slurred speech
- Shallow breathing
- Sluggishness
- Fatigue
- Disorientation
- Slowed reflexes and poor coordination
- Memory loss
- Poor judgement
- Irritability
- Paranoia
- Thoughts of suicide.
Benzodiazepine overdose doesn’t usually happen on its own, but they have been found in overdoses that involve multiple substances.[6] The Drug Enforcement Administration (DEA) has also warned about fake prescription pills, like Xanax, that are sold illegally and can contain fentanyl. This can lead to an accidental overdose.
Can you become addicted to benzodiazepines?
Yes. Research suggests that using benzodiazepines for even a few weeks can increase the risk of developing an addiction to them.[7]
People can develop painful withdrawal symptoms if they stop using them, including: [8]
- Sweating
- Shivering
- Anxiety and panic
- Restlessness
- Mood swings
- Insomnia
- Muscle spasms or tremors.
Can benzodiazepine use disorder be treated?
Yes. Benzodiazepine dependence is usually treated by gradually weaning off of the medication over a period of a few weeks.[9] This can happen in outpatient treatment, when you go back and forth between home and treatment. More severe cases may need to be treated in a hospital.
This is what might happen during treatment:
- Usually, 5-7 days (or longer) are needed to slowly tapered off the medication.
- Other kinds of benzodiazepines (like Ativan) are often used in the process.
- Anti-seizure, anti-anxiety, and sleep medications may be needed.
- If alcohol use is involved, medications for alcohol use disorder are available.
Treatment for benzodiazepine and alcohol use disorder can be complicated, especially because benzodiazepines are sometimes used to treat alcohol withdrawal. Speak with your child’s doctor or treatment provider about best options.
Why is it so dangerous to mix alcohol and benzodiazepines?
Both alcohol and benzodiazepines are central nervous system depressants. Depressants cause the body to slow down. As a result, using them together can make their effects much stronger or even deadly.
- Using benzodiazepines and alcohol together can cause respiratory depression, which is when breathing becomes slow or shallow. This can cause someone to stop breathing, have a heart attack, or go into a coma.[10]
- The combination can make someone much more intoxicated. This can result in risky choices and poor decisions that can lead to injury, like driving under the influence.
- Combined use can put patients at a higher risk of illness and death. 20% of benzo-related deaths studied over the course of a decade also involved alcohol.[11]
- People who drink heavily or have a mental health condition have a higher risk of misusing benzodiazepines. Many people with alcohol use disorder often also struggle with benzodiazepine use.[12] Individuals who experience addiction and mental health struggles together are also at higher risk of developing a benzodiazepine use disorder.[12]
If your loved one struggles with benzodiazepine and alcohol use and are not ready for treatment, them your loved one to take measures to reduce the risks of an overdose. This might include never using alone or using in moderation.
What if my loved one is prescribed benzodiazepines?
- Monitor their use to make sure they taking the correct amount and not longer than prescribed.
- Keep prescriptions locked up and secure.
- Make sure that their doctor or treatment provider knows about any existing substance use or mental health conditions.
- Keep them updated on the potential risks associated with benzo use and encourage them not to drink or use other substances.
People who drink regularly should not use benzodiazepines due to the risk of overdose. Speak with their medical provider about alternative medications or treatment options.
The bottom line
It’s natural to feel worried when your child is prescribed a benzodiazepine. The most protective you can do is stay close to what’s going on. Gently check in about how they’re taking the medication, make sure their doctor has the full picture of any substance use or mental health disorders, and keep the conversation about risks open and judgment-free.
If drinking has been a struggle for your child, it’s worth asking their provider about other options together. And if things ever feel like they’ve gone beyond what you can manage on your own, it doesn’t mean you’ve failed. It just means it’s time for extra support. You don’t have to navigate this alone. Our helpline (855-378-4373, or text CONNECT to 55753) is free, confidential, and here whenever you need to talk it through.
Frequently Asked Questions
Can you drink alcohol while taking benzodiazepines?
No. Combining alcohol with benzodiazepines makes their effects stronger, increasing the risk of poor decision-making, overdose, and death.
Is it okay to just have one drink while on a benzodiazepine like Xanax or Klonopin?
Even small amounts of alcohol can amplify a benzodiazepine’s effects. Most providers advise avoiding alcohol altogether while taking these medications.
Why is mixing alcohol and benzos so dangerous?
Together, they can cause breathing to become too slow or shallow, which can lead to a buildup of carbon dioxide in the blood. That can result in a coma, heart problems, or death.
Can mixing alcohol and benzos cause memory loss?
Yes. The combination is strongly linked to blackouts, amnesia, and memory gaps, more than either substance can do on its own.
Are benzodiazepines ever used to treat alcohol withdrawal?
Yes. Benzodiazepines like lorazepam and diazepam are commonly used in medical treatment to safely wean someone off alcohol, since alcohol withdrawal can be dangerous or fatal on its own.
What are the signs someone has mixed alcohol and benzodiazepines?
Watch for slurred speech, difficulty staying awake, confusion, slowed or irregular breathing, poor coordination, and unresponsiveness. These can be signs of an overdose and require immediate help. Call emergency services even if you’re unsure.
How is benzodiazepine dependence treated?
Treatment usually involves a gradual, medically supervised detox off the medication over several days or weeks.
What should I do if my loved one is prescribed a benzodiazepine and also drinks?
Talk with their doctor about the risks, make sure the provider knows about any alcohol use, and encourage them to avoid drinking entirely while on the medication. If they have an alcohol use disorder, ask their provider about alternate treatment options.