Gary Brooks, a 39-year-old consultant in Brussels, gets anxiety when he flies. The magic formula to quell his nerves? Two substances: alcohol and Xanax. “The alcohol makes the Xanax work quicker and more strongly,” he explains. “Light doses make for giddy euphoria and a sense of womb-like security.”
Perhaps less desirably, he also experiences “complete memory loss,” he said. “One time, I was flying, and the last thing I remember was taking a pill with a large red wine, then coming to seemingly seconds later checking into my hotel in Warsaw a thousand miles away.”
The mixture of alcohol and Xanax is similarly double-edged for Cortne Bonilla, a 26-year-old writer in New York who takes Xanax at night for sleep and anxiety reduction. “The combo for me is an intense body high. Everything feels soft and good and laid back with a little heart fluttering,” she said. However, she’s also been known to fall asleep in public after consuming both substances.
What do Xanax and alcohol do to your brain?
Alcohol and Xanax, a type of benzodiazepine, are both depressants, but they work through slightly different mechanisms, said James Giordano, professor of neurology and biochemistry at Georgetown University Medical Center. Xanax (also known by the generic name alprazolam) works on a receptor called the benzodiazepine-GABA binding site that inhibits activity in the nervous system, which is why it so effectively decreases anxiety.
Alcohol does its own work on the GABA system, which acts like a “brake pedal for the excitation of the brain,” said Michael DeLay, a biophysicist specializing in how drugs affect the body and cofounder of DemystifyingScience.com. Alcohol also blocks the brain’s NMDA receptors, causing central nervous system depression, and changes the excitability of nerve cells, leading to euphoria and loss of inhibitions, Giordano said.
"Because both drugs affect the GABA receptor, each is quite capable in their own right of restraining stressful negative emotions,” DeLay said. “The combination can be an overwhelming feeling of joy and relaxation and even entrancement. The simplest of activities, most mundane of entertainment, and the dullest of foods can take on an entirely new zest.”
The dangers of combining Xanax and alcohol
However, the combination can also be very disorienting, with some experiencing “the inability to discern the speech of others, dizziness, and even memory loss,” DeLay added. “Some users report rage and irritability.”
Alcohol decreases the activity of liver enzymes that break down Xanax, so it will increase the amount of Xanax in your system, as well as how long it stays there, Giordano said. Xanax in turn interferes with your liver’s ability to break down alcohol, so taking both at once is like taking higher doses of each. “You get a double whammy — and not necessarily a good one—out of this,” he said.
Oral contraceptives also impede the metabolism of Xanax in a similar way, so the effects of alcohol and Xanax may be amplified if you’re on the pill, Giordano added. What’s more, fruity drinks — such as those containing grapefruit juice, seville oranges, pomelos, and tangelo — can also produce this effect, since they require liver enzymes to process compounds called furanocoumarins, and this further inhibits the breakdown of Xanax, DeLay said.
Since both alcohol and Xanax impair your coordination and impulse control, their combined effect can deal a major blow to these abilities. Brielle Diskin, a 23-year-old writer in New York City, can attest to this. “I couldn't see straight, and my roommate had to take me home like 20 minutes into the first party we went to,” she recalled of taking Xanax with alcohol in college. Impairments to your coordination can also put you at risk for accidents and injuries.
The increase in toxicity caused by combining the two can lead to nausea and, in severe cases, seizures, said Giordano. And with high doses of both, it’s possible that your breathing could slow down to dangerous levels.
“The combination of alcohol and Xanax can lead to short-term memory deficits, and in some cases blackouts—a complete loss of memory of events—both during the period of intoxication and while the intoxication is wearing off,” Giordano said.
In short, as those who swear by Xanax washed down with alcohol can attest, the combination is risky. Given how long each substance stays in your system, it’s best to wait at least 11 hours after taking Xanax to drink alcohol, and at least eight hours after drinking alcohol to take Xanax, said Giordano.
“Outright avoidance is the safest bet,” DeLay said. “The most important thing to remember, if you decide to try this combination, is to dose slowly. The toxic consequences of the combination scale with dose.”