Mixing Xanax and alcohol
October 21, 2008 6:38 PM   Subscribe

How long after taking .25 Mg or .5 Mg of Xanax should I wait before drinking any alcohol? I've taken Xanax frequently over the years to treat anxiety, fear of flying, etc. and never had any problems.

I've also gotten drunk after taking it many times without dying but I was looking around on the net and it seems that most people think this is a lethal combination... Is this just over-exaggerated? Have I proven it's not lethal for me by having done it many times? The bottle does not day DO NOT DRINK it just has the typical warnings about alcohol intensifying the effect, etc. So, I'm careful and wait 3-4 hours after taking it. I know YANAD and YANMD, just looking for constructive advice. My doctor knew I was a social drinker when he prescribed it to me. I've read that it stays in your system for 11+ hours, but the effect sure seems to wear off at about 4, so I was assuming that was safe.
posted by Raichle to Health & Fitness (13 answers total)
When people talk about dying from benzos+alcohol they're usually talking about suicides. As in, taking a WHOLE BUNCH of benzos and mixing it with a couple pints of scotch. You're not going to keel over from taking a quarter mg of Xanax and then having a beer. This is not, however, me advocating washing your xanax down with beer.

If you've gotten drunk after taking it many times and didn't die then you already know this. It's not going to suddenly become deadly to take a quarter mg and have some drinks later. That said; it's not at all a good idea to get drunk after taking benzos. I've been around people who did so and it definitely makes them very woozy and out of it. They were not in great shape and unscrupulous people could try to take advantage of that, particular since you are a female. Not smart.
posted by Justinian at 8:49 PM on October 21, 2008

Well, as I said, I wait a few hours until the effects from the pills have worn off. I don't feel any more drunk than usual and I make sure I don't go overboard with the drinking. But I read all these panicky posts saying that I would get alcoholic hepatitis, brain damage, etc if I had a beer within 24 hours of taking a pill... I don't have a doctor that I can call but it got me a little worried. Thanks!
posted by Raichle at 9:16 PM on October 21, 2008

Um, I feel a little weird. I said it isn't good idea even if you aren't going to croak from a quarter mg or whatever and a drink or two later. 'Cause that doesn't make it a good idea. And, to be clear, as the dosage of the benzos or the dosage of alcohol increases it becomes even less of a good idea, and at that point you really could die.
posted by Justinian at 11:18 PM on October 21, 2008

Personally, I'd be very paranoid about this, and wait an absolute minimum of 24-48 hours before drinking (INADr.). My wife was on a low daily dose of Xanax following a suicide attempt. After having been on the daily dose for a few weeks, she had a few (3) light drinks at a friend's party. Within about a twenty minutes, she started acting incredibly drunk, to the point of self-danger. We ended up taking her to the emergency room and getting her stomach pumped. During the aftermath, the doctor mentioned that her blood toxicity was equivalent to having downed 50 shots in short order, and that had she not come in so quickly, she would have likely died.

Now, this may have had more to do with having had a build up of Xanax from her periodic morning dose, but I would play it as safe as possible on this one - a few drinks are not worth your life, in any situation.
posted by neolith22 at 11:26 PM on October 21, 2008

The thing about being drunk is that you're judgement is impaired, which makes it difficult to estimate exactly how impaired your judgement is. With Xanax, you get used to the effects, so while you may think the effects are over by 4 hours, you may just have stopped noticing them. People learn how alcohol effects them when they start drinking and work out how much they can have before bad stuff starts to happen. When you combine the two, you're essentially making every drink equivalent to a greater, but unknown quantity of alcohol. This means you'll be less able to determine exactly how drunk you are, which can lead you to overestimate your ability to do stuff and that can be risky.

So while it's very unlikely to cause any direct damage, it probably raises the risk of you getting hurt while drinking or making stupid decisions, particularly since the combination of Xanax and alcohol tends to make people more aggressive. And, importantly, this isn't something you'll be able to think clearly about at the time.
posted by xchmp at 1:22 AM on October 22, 2008

Damn it. "your" not "you're" in the first sentence.
posted by xchmp at 1:23 AM on October 22, 2008

You said: My doctor knew I was a social drinker when he prescribed it to me.

You also said: I don't have a doctor that I can call but it got me a little worried. Thanks!

IANA anything relevant, but these are medical questions and I hope you'll get qualified advice, not lay advice, with specifics as to what you must do and must not do.
posted by JimN2TAW at 7:53 AM on October 22, 2008

JimN2TAW I would think this might be an easy one to figure out. I HAD a doctor at one point. He prescibed this to me. Then, I lost my insurance coverage. Now I HAVE no doctor to call.
posted by Raichle at 8:35 AM on October 22, 2008

Well, to clarify. When I've done it before, I've still been able to safely bike 5 miles home. As I said, I'm not looking to get DRUNK. But I like to be able to have a few drinks with friends occasionally.
posted by Raichle at 8:39 AM on October 22, 2008

I'm just hoping that you'll get professional advice and set up some specific rules for yourself, for the sake of your own health. My very small two cents is that it seems risky to use AskMeFi as a substitute for that. What prompted my post (and derail, sorry) is that we've all seen very scary cases (infinitely scarier than yours) on this site. As for your insurance, that's not a factor in my wish for your good health and safety. Best of luck.
posted by JimN2TAW at 11:10 AM on October 22, 2008

JimN2TAW I didn't want to seem non-appreciative and I apologize if it came off that way. I guess what I was looking for was someone to say that they had been given specific advice from a doctor in this regard. I guess I can assume that if I am very careful things will proceed the way that they have. I was more afraid of long term damage. Thanks!
posted by Raichle at 11:21 AM on October 22, 2008

Thing is, you already have medical advice about Xanax in the form of the warning on the bottle. It might not say DO NOT DRINK, but it definitely counts as advice. I can pretty much guarantee that no doctor you saw would tell you it was OK to drink with your medication.

To answer your question: It's unlikely to cause long-term damage. I can't find any reference to Xanax and brain damage. Xanax has been implicated in a few cases of liver damage/disease, but this seems to be very rare, so it's probably not a concern. The other things people have mentioned are much likelier to be a problem.

I guess I can assume that if I am very careful things will proceed the way that they have.

Various things can cause Xanax's rate of clearance to go down, which could increase its effects completely without your knowledge. It's not safe to assume that you'll be fine every time you do this because you've been fine before. Various medications will do this, but so would quitting cigarettes or drinking grapefruit juice. You could have an episode of subclinical hepatitis induced by a brief infection with one of a number of viruses (cytomegalovirus for example). Or something else could impact liver function or the enzymes involved in alprazolam metabolism. And you might still be fine, but you might not.
posted by xchmp at 12:09 PM on October 22, 2008

I don't like this particular combo because you go to a bar where they mix drinks strong or you had some tylenol or who knows what, and all of a sudden your partner finds you not breathing.

Which happened to me. It was terrifying. If he wasn't there, I might not be here. So I guess I don't think it's over-exaggerated.

If you MUST, I would suggest sticking to a single, bottled beer. But I generally don't think you should go there, especially if you take xanax regularly, it does build up in your system.

I would also think about going out with your friends and not drinking. Yeah, I know, it seems like it's no fun, but it actually is fun. Or abstaining from xanax for a few days beforehand if it's a big deal event.

Oh, and since you have no insurance but used to have a doctor, call that doctor and ask him to call you back, tell them there is no way you can come in for an appointment but you have a question. More often than not they'll call you back and talk to you for 5 minutes. Don't be shy.

Good luck, I know this is frustrating and you don't want to worry about it, but take care of yourself and everything will end up fine.
posted by sondrialiac at 1:06 PM on October 22, 2008

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