Mixing benzos and alcohol is dangerous because both slow down the brain and body, and together their effects multiply. The National Institute on Alcohol Abuse and Alcoholism warns that combining alcohol with anxiety medications like Xanax, Klonopin, Valium and Ativan can cause drowsiness, dizziness, slowed or difficulty breathing, impaired motor control, unusual behavior, memory problems and increased risk for overdose. The FDA’s advice is simple: do not drink alcohol with benzodiazepines.
Whether you take a benzodiazepine as prescribed and wonder about having a drink, or you have been using the two together to cope, this guide explains the risks without judgment and shows you where to turn for help.
Why Mixing Benzos and Alcohol Is So Risky
Benzodiazepines and alcohol are both central nervous system depressants. They calm brain activity, slow reaction time and, at higher levels, slow breathing. StatPearls describes the combination of alcohol and benzodiazepines as causing dangerous synergistic CNS depression, meaning the combined effect can be stronger than either substance alone.
Here is what makes this combination especially concerning. When benzodiazepines are taken alone in an overdose, StatPearls notes that outcomes are often favorable and serious breathing problems are uncommon. But when benzodiazepines are combined with alcohol, opioids, or other sedatives, the risk of death rises significantly. In other words, alcohol can turn a medication that is usually tolerated into a life-threatening one.
The FDA’s boxed warning for all benzodiazepines states that alcohol can increase the risk of serious and life-threatening side effects. That warning applies to every medication in the class, including alprazolam, clonazepam, lorazepam and diazepam. Learn more about specific medications in our guides to Xanax addiction and Klonopin addiction.
Effects of Combining Alcohol and Benzodiazepines
The effects can range from uncomfortable to deadly. According to the NIAAA, they may include:
- Drowsiness and dizziness
- Slowed or difficult breathing
- Impaired motor control and coordination
- Unusual behavior
- Memory problems, including gaps in memory
- Increased risk for overdose
Because these effects stack on top of each other, the safest choice is to follow the FDA’s guidance and avoid alcohol completely while taking a benzodiazepine.
Who faces higher risk
- Older adults. The NIAAA explains that aging slows the body’s ability to break down alcohol, so it stays in the system longer. Older adults are also more likely to take several medications that interact with alcohol. StatPearls adds that longer-acting benzodiazepines can build up in the body, raising risk for older adults.
- Women. Women generally reach higher blood alcohol levels than men after drinking the same amount, according to the NIAAA.
- People who also use opioids. Adding opioids makes the combination even more dangerous. NIDA reports that nearly 14% of overdose deaths involving opioids in 2021 also involved benzodiazepines.
Signs of an Overdose and What to Do
StatPearls lists typical signs of benzodiazepine toxicity as slurred speech, ataxia, and altered mental status. Ataxia means clumsy, unsteady movement. When alcohol is involved, watch closely for:
- Extreme drowsiness or being very hard to wake
- Confusion, slurred speech or unusual behavior
- Stumbling, poor coordination or being unable to stand
- Slowed or difficult breathing
What to do
- Call 911 right away.
- Give naloxone if opioids may be involved. Naloxone does not reverse benzodiazepines or alcohol, but many people use more than one substance, and pills bought outside a pharmacy may contain fentanyl. Learn the signs of a fentanyl overdose. The CDC says naloxone will not harm someone if they are not overdosing on an opioid.
- Lay the person on their side to prevent choking.
- Stay with them until help arrives.
See our guide on how to use Narcan for step-by-step instructions.
Stopping Safely: Withdrawal Is Serious
If you have been using benzos and alcohol together regularly, do not stop both suddenly on your own. Alcohol and benzodiazepine withdrawal can be life-threatening and need medical supervision.
- The FDA warns that stopping benzodiazepines abruptly or reducing the dose too quickly can result in withdrawal reactions, including seizures, which can be life-threatening.
- StatPearls describes alcohol withdrawal as ranging from mild symptoms to life-threatening delirium tremens.
When someone is dependent on both, withdrawal needs careful medical management. That is why medical detox is often the right first step. Our article on medical detox explains what to expect, and our timelines for benzo withdrawal and alcohol withdrawal walk through the stages.
When Mixing Becomes a Pattern
Many people who combine these substances started trying to manage anxiety, panic or sleep problems. Alcohol may seem to take the edge off, and adding a benzodiazepine can feel like a stronger fix, but the combination brings real physical danger and the risk of dependence on both. Our article on alcohol and anxiety explains how drinking can affect anxiety.
If you notice you are drinking while on a benzodiazepine, taking more than prescribed, or using the two together to relax or sleep, it may be time to talk with a professional. Treatment can address both substance use and the anxiety underneath it. If mixing benzos and alcohol has become a regular habit, you are not alone, and there is no shame in asking for help. A treatment team can look at the whole picture, including your mental health, and help you build a safer plan.
Frequently Asked Questions
Can I have one drink while taking a benzodiazepine?
The FDA advises against drinking alcohol with benzodiazepines because it can increase the risk of serious and life-threatening side effects. Talk with your prescriber before drinking any alcohol while on these medications.
How long after taking Xanax or Klonopin can I drink?
It depends on the medication, your dose and your health. Some benzodiazepines stay in the body for a long time. Ask your prescriber or pharmacist for guidance specific to you.
Why are benzodiazepines used to treat alcohol withdrawal?
In a medical setting, doctors may use benzodiazepines to manage alcohol withdrawal once a person has stopped drinking. StatPearls notes they are the drugs of choice for the treatment of alcohol withdrawal in the inpatient setting. This is done under close medical monitoring, which is very different from drinking and taking benzos at the same time.
Is mixing benzos and alcohol an overdose risk?
Yes. Both slow breathing and brain activity, and together they raise the risk of overdose and death, especially when opioids are also involved.
Get Help for Benzo and Alcohol Use in Lancaster, PA
If you are using benzodiazepines and alcohol together, you can get support for both at once. The Ranch Pennsylvania Outpatient Services offers a partial hospitalization program (PHP) and an intensive outpatient program (IOP) with integrated dual diagnosis care, psychiatric evaluation and medication management, CBT and DBT. If medical detox is needed first, it can be coordinated with residential care at The Ranch Pennsylvania. Explore our overviews of benzodiazepine addiction and alcohol addiction, or verify your insurance today. Our admissions team is available 24/7, and calls are free and confidential.
