What Happens When You Mix Benzodiazepine and Alcohol?

Individuals dealing with anxiety may be prescribed benzodiazepines for short-term or occasional relief. These medications are known for their effectiveness in quickly reducing anxiety symptoms by calming the central nervous system (CNS), leading to a sense of calmness. Also, many people with anxiety often use alcohol as a way to manage their symptoms, so it’s common for people on benzodiazepines to also drink alcohol according to an article published in the Journal of Psychiatric Research. However, both benzodiazepines and alcohol target the same brain receptors, potentially intensifying the effects of each substance. While benzodiazepines can lead to addiction due to their soothing and euphoric properties, they are less likely to cause fatal overdoses when taken alone. Notably, around 80% of individuals who misuse benzodiazepines do so alongside other substances.
Mixing alcohol with benzodiazepines poses significant risks, as both substances are depressants, and both increase the release of gamma-aminobutyric acid (GABA) in the brain. Since both substances are CNS depressants, they can slow down breathing and increase sedation, leading to effects that are greatly amplified which may lead to respiratory failure, coma, or even death. The effects of combining benzodiazepines with alcohol can also include:
- Drowsiness
- Dizziness
- Impaired motor skills
- Memory issues
- Increased likelihood of injuries, falls, accidents, violence, and risky sexual behavior
- Greater risk of developing substance use disorders
For individuals who become dependent on both alcohol and benzodiazepines, withdrawal symptoms can arise when they try to stop using them. If someone has been using these substances for a long time or in large quantities, withdrawal can be dangerous and, in some cases, life-threatening, potentially leading to seizures. Withdrawal from severe alcohol addiction can cause delirium tremens (DT) which if untreated can cause hallucinations, paranoia, heart attack, stroke, and death.
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Can You Cross Tolerance Alcohol and Benzodiazepines?
Cross-tolerance is a phenomenon that occurs when developing tolerance to one drug leads to a tolerance of another drug. This typically occurs when two substances share comparable effects or mechanisms, such as targeting the same cell receptors or influencing neurotransmitter activity. Both benzos and alcohol interact with the GABA receptor complex, which can lead to cross-tolerance, as highlighted in a study published in the Journal of Neurophysiology. Because they act on the same system, chronic alcohol use can lead to tolerance, where the individual needs more alcohol to achieve the same effect. Similarly, tolerance to benzodiazepines develops in the same way. When someone consumes alcohol chronically, they may develop a tolerance, requiring larger amounts to achieve the same effects. The same process applies to benzodiazepines, meaning that if a person has built up a tolerance to alcohol, they may also experience diminished effects from benzodiazepines, and vice versa.
The development of cross-tolerance between benzodiazepines and alcohol poses significant risks, as increased tolerance heightens the likelihood of addiction and overdose. As tolerance escalates, individuals may resort to taking larger doses of one or both substances, particularly dangerous when they are used concurrently. On the flip side, cross-tolerance can play a helpful role during detoxification, as benzodiazepines may be utilized to alleviate withdrawal symptoms from alcohol. However, the danger remains that addiction to one substance can predispose an individual to addiction to others. During detox, medications intended to manage withdrawal can be misused, especially if individuals are not closely monitored, potentially leading to a cycle of substituting one addiction for another.
Is It Okay to Drink Alcohol While Taking Anxiety Meds?
Individuals taking anti-anxiety medications may be tempted to drink alcohol, especially if alcohol has been a way to reduce stress or part of their social interactions. However, combining benzodiazepines or other anxiety medications with alcohol is highly discouraged. Both alcohol and these medications act as central nervous system depressants, which can magnify the adverse effects of each. Even consuming just a couple of drinks can pose significant dangers, such as impaired coordination, increased drowsiness, and slowed cognitive function, all of which heighten the risk of accidents. Moreover, mixing these substances as a way to deal with triggers can elevate the likelihood of developing dependence and misuse, potentially leading to substance use disorders. It’s crucial to remember that benzodiazepines can stay in your system for up to five days, meaning that even if you took your medication a day or two prior, drinking alcohol during that time can intensify its effects. Additionally, excessive consumption of either substance while on the other can result in overdose.
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Why Is My Anxiety So Bad When I Drink Alcohol?
Although alcohol might provide temporary relief from anxiety, its effects can lead to increased anxiety once they fade. Healthline notes that alcohol alters serotonin levels and other neurotransmitters, resulting in a “rebound effect.” This situation is exacerbated by issues like sleep disruption, dehydration, and the adverse effects of impaired judgment while under the influence. Moreover, chronic alcohol use can either trigger or intensify anxiety symptoms, as the brain becomes reliant on alcohol to manage GABA levels. When an individual stops drinking, the brain struggles to regulate GABA independently, which can result in heightened anxiety and even panic attacks during withdrawal.
What Is Used to Detox from Benzos?
Benzodiazepine withdrawal is not only extremely uncomfortable, but it can also be dangerous. Individuals can also experience rebound anxiety when stopping their medication, with more severe symptoms than when they first started their medication. Detoxing from benzos involves removing the drug from the system, but needs to be done properly to ensure safety during the process. Medically supervised detox involves expert guidance and often a tapering down schedule, which is reducing the dose slowly. It can also involve using less potent and long-acting benzodiazepines such as Diazepam (Valium) or Clonazepam (Klonopin) to reduce withdrawal symptoms as the dose is reduced. Flumazenil, a drug primarily used to treat benzodiazepines, has shown some success in reducing withdrawal symptoms of long-acting benzos by blocking its effects since it can attach to the same pleasure centers in the brain as benzodiazepines.
Contact Resurgence Behavioral Health if You Cannot Stop Using Benzodiazepines and Alcohol
Due to the high risk associated with mixing benzodiazepines and alcohol, it is never recommended to consume these substances together. If you or someone you know is struggling with this combination, it’s important to seek professional help as they are at risk for substance use disorders or a deadly overdose. At Resurgence Behavioral Health we offer comprehensive treatment programs to address benzo and alcohol abuse and addiction. We specialize in treating addiction with co-occurring mental health disorders through dual diagnosis treatment, allowing us to effectively manage symptoms of addiction and anxiety concurrently for the best chance of recovery.
We understand that individuals dealing with anxiety may feel reluctant to discontinue their medication due to fears of symptom recurrence, even when addiction is severely affecting their lives. However, our programs at Resurgence Behavioral Health are crafted to facilitate not only recovery from benzodiazepine and alcohol dependence but also to alleviate underlying anxiety symptoms. Utilizing psychotherapy and holistic methods, we empower you to manage anxiety without relying on medications or substances.
If you are ready to take the next step towards a life free from alcohol or benzodiazepine abuse, contact Resurgence Behavioral Health today at 855-458-0050 to schedule your initial intake appointment.
External Sources
- Journal of Psychiatric Research – Benzodiazepines and alcohol
- Journal of Neurophysiology – Tolerance to Sedative/Hypnotic Actions of GABAergic Drugs Correlates with Tolerance to Potentiation of Extrasynaptic Tonic Currents of Alcohol-Dependent Rats
- Healthline – Alcohol and Anxiety