If I Take Xanax in the Morning, Can I Drink Alcohol at Night?

Panic attacks can be debilitating, like a wave that swallows us whole as we try to find our bearings — and “words of encouragement” tend to make things even worse. As Elyn Saks writes in The Center Cannot Hold: My Journey Through Madness, “In my experience, the words “now just calm down” almost inevitably have the opposite effect on the person you are speaking to.”

While there are many ways to relieve anxiety (more on that later!), for many of us, medications such as Xanax can serve as lifelines. But what about interactions of Xanax and alcohol? In particular, you might be wondering, “If I take Xanax in the morning, can I drink alcohol at night?” The short answer is — not really. It’s best not to risk it. But what are the dangers, exactly? Let’s find out!

When Panic Attacks

Anxiety — when it reaches the level of panic attacks and impacts our daily lives — can be debilitating. It can cause problems at work (especially if our job involves presentations in front of large groups of people, meetings with clients, and even regular huddles with coworkers). It can put a strain on relationships, making us hesitant to accept invitations to weddings or weekend outings. It can steal valuable hours of sleep at night as we toss and turn, unable to get our mind to settle no matter how many sheep we count in our head.

And yet, anxiety is extremely common. In fact, according to the National Institute of Mental Health, over 19% of U.S. adults struggle with it! That’s almost one in five people at that board meeting or at least a couple of members of the wedding party — or a total of about 40 million people around the country. As physician Will Cronenwett tells TODAY.com:

“We live in an unsettled time … There’s inflation. The war. Stuff in the news. And we’re still dealing with COVID and what that did to our baseline anxiety levels … People feel less safe, and feeling unsafe about yourself in the world is similar to the feeling of anxiety disorder.”

For many, medication becomes a lifeline, and benzodiazepines such as lorazepam (Ativan), clonazepam (Klonopin), diazepam (Valium), and alprazolam (Xanax) have historically been some of the most popular. That said, they have their drawbacks — in particular, their sedating side effects and potential for addiction, which we’ll get into a bit later. 

What Is Xanax?

Like its benzodiazepine cousins, alprazolam (better known by its brand name Xanax) is frequently prescribed for panic attacks and anxiety disorders. Patented in 1971, Xanax was invented by Jackson Hester Jr. and has been on the medical scene in the U.S. since 1981. In 2021, it ranked 42nd on the “most commonly prescribed medication” list, with more than 15 million prescriptions doled out to (presumably) anxiety sufferers around the country. 

How Do Benzodiazepines Work?

Benzodiazepines (affectionately known as “benzos”) work by enhancing the effects of GABA — an inhibitory neurotransmitter in the brain. If this rings a bell, there’s a good reason — alcohol works through a similar mechanism by enhancing GABA and decreasing glutamate, its excitatory counterpart.

What Makes Xanax Different

As far as benzos are concerned, Xanax is a bit of a “bad boy.” It has stronger effects on some and acts within minutes, with effects lasting between four to six hours. Because it’s more fast-acting than its counterparts, it has more potential for addiction, as well as a heavier presence “on the street.” As Cronenwett explains, “It tends to act quickly and wear off fairly quickly. Often people feel they need to use it more and more frequently. And then the thought of living without it becomes frightening. In some cases, it can begin to look like addiction.” It can also cause severe withdrawal symptoms, such as seizures, especially in those taking a large dose.

There are many slang terms for Xanax in popular culture. Top of the list? “Xannies,” or “Zannies.” Additionally, Xanax is sometimes referred to as “bars,” “ladders,” “footballs,” “planks,” “poles,” “sticks,” “blues,” or “blue footballs.” (All describing the physical shape of the pills, if you haven’t guessed it already.)

A 2022 documentary, Take Your Pills: Xanax, looks deep into the “soul” of this somewhat controversial medicine, describing it as “a cure for some and a curse for others.” Regardless of the path we take when it comes to Xanax alone, however, there’s definite trouble on the horizon when it comes to Xanax and alcohol interactions.

Xanax and Alcohol: A Risky Combo

Can you drink on Xanax? Most people know better than to chase a pill with a shot of tequila. But what if we take it in the morning — does it make that margarita or round of beers after work off limits? The truth is, we’re better off staying away from booze for at least 24 hours after taking Xanax. Let’s dive into the reasons why mixing alcohol and Xanax could mean trouble, even with a time gap in between. 

1. Xanax and Alcohol Interactions

Both Xanax and alcohol are depressants that slow down the central nervous system. When we take them together, the depressant effects get amplified and could put us in danger. Here’s why:

• Depressants cause drowsiness. Both Xanax and alcohol make us nod off, and when mixed together, the effect is even stronger. And while dozing off in the middle of dinner or on our friend’s living room couch might be embarrassing, in some situations (think driving, operating machinery, and so forth) it could be downright dangerous.
• They could lead to respiratory depression. One of the most dangerous effects of combining booze and Xanax is respiratory depression. Both substances slow down our breathing rate, and when they join forces, the effect is that much stronger. Danger zone!

In short, mixing two depressants isn’t worth the risk. But that’s not the end of the story!

2. Side Effects Amplified

In addition to excessive sedation, there are other side effects of Xanax that could linger for hours after our dose. Many of them don’t mix with alcohol, so drinking on the same night could be a recipe for trouble.

• Cognitive difficulties. Thinking clearly after a few drinks is tough, and with Xanax in our system it could be even harder. Alcohol is notorious for impairing our cognitive abilities and can cause brain fog that persists well into the next day.
• Memory problems. In addition to our cognitive abilities, our memory tends to tank when we’re under the influence. Ever notice how much harder it is to remember someone’s name after a few drinks? Well, with Xanax in the picture, it could be even harder. In addition to causing embarrassment, memory glitches could also be dangerous. (Leaving the tea kettle on, forgetting to lock the door at night — whatever it is, a small memory lapse could lead to big trouble if it happens to be “one of those days.”)
• Impaired judgment. It’s not just our memory that suffers — our judgment does, too. Both Xanax and alcohol affect the prefrontal cortex, inhibiting our decision-making abilities and making us likely to take unnecessary risks. For example, we might decide to drive under the influence or walk in an unsafe area with both substances clouding our judgment.
• Dry mouth. While less serious than the rest, this side effect of Xanax is still a pesky one. And alcohol is almost certain to make it worse. A notorious dehydrator, booze depletes us of fluids and electrolytes, leaving us feeling parched for hours afterwards. Who needs that?
• Constipation. Xanax can leave us feeling backed up, and so can alcohol! With all of our body’s resources redirected to getting booze out of the system, digestion tends to take a “back seat.”
• Libido changes. Trouble in the bedroom? Could be the Xanax. And with booze in the picture, there might be even less room for romance. While alcohol initially increases sexual desire (beer goggles, anyone?), it’s notorious for causing sexual dysfunction in men and women alike.

As we can see, the side effects of Xanax and alcohol together aren’t worth the risk. We’re better off avoiding the combo, and waiting until evening to drink doesn’t necessarily mean we’re in the clear.

3. Increased Anxiety

When it comes to treating anxiety, Xanax and alcohol are not on the same team (even though they might initially appear to be). While it’s common to think of alcohol as “relaxing,” any relief we feel is the depressant effect at play. However, as the brain attempts to rebalance itself after being flooded with the reward neurotransmitter dopamine and GABA, it releases dynorphin — a neurochemical that is part of our brain's natural way of dampening down the feel-good response. It's like putting on the brakes when things are getting too rowdy. The result? We end up feeling more anxious than we did before.

4. Risk of Dependence

That flood of dopamine we’ve mentioned a few times? Research shows that Xanax in particular triggers a hefty dose of dopamine to be released in the striatum (part of the reward center of the brain). While all benzodiazepines do so to some degree, alprazolam stands out among the rest. As a result, combining the two substances leads to a more intense dopamine flood — and more potential for dependence, as our brain starts to expect it as the “new normal.” 

In fact, Xanax alone should be treated with caution, as far as dependence is concerned. According to NIDA, overdoses on benzos skyrocketed in the last couple of decades, rising from 1,135 in 1999 to 11,537 in 2017. After a brief decline to 9,711 deaths in 2019, overdoses were on the rise again, climbing to 12,499 by 2021. And with more potential for dependence than its chemical cousins, Xanax in particular is responsible for a large chunk of those numbers.

5. Risk of Overdose

The combination of Xanax and alcohol also increases our chances of having an overdose. With alcohol in our system, the concentration of Xanax in our bloodstream gets higher. As a result, effects (such as sedation) get more pronounced.

So If I Take Xanax in the Morning, Can I Drink Alcohol at Night?

Remember how we said it’s best to wait at least 24 hours after taking Xanax before having a drink? That’s because it typically takes about 11.2 hours for half of our Xanax dose to metabolize and leave our body. And given that we’re better off waiting until most of it has left our system, a full day is the way to go.

That said, there are many additional factors at play when it comes to determining the exact timing of when it might be safe to drink after taking Xanax.

• Age. If we’re older, our metabolism is likely to be slower, and Xanax might stay in our system for a longer time.
• Weight. The lower our weight, the stronger the effect substances such as Xanax or alcohol will have on us.
• Overall health. Our overall health plays a role in metabolism, so it’s another factor to consider.

All in all, mixing benzos and alcohol is risky business. Most doctors advise against drinking on any benzodiazepines, as the combo can be unpredictable, potentially causing severe side effects and complications.

Ease Your Anxiety and Stay Safe!

Finally, here are some tips for reducing anxiety while staying safe when it comes to the Xanax and alcohol combo.

1. Avoid the mix. First and foremost, avoid mixing Xanax with alcohol. The risks are simply not worth it, and you’re likely to end up more anxious than before.

2. Address the core issue. If your anxiety has a root cause — for example, family or relationship problems — it’s important to address it. If alcohol is in the mix, it could be that booze itself is causing anxiety (both directly and indirectly, through the effects it’s having on your life). Cognitive behavioral therapy, which targets cognitive distortions (thought “traps” that keep us stuck in unhealthy behavioral response patterns) can be one of the best ways to address anxiety-related issues and alcohol misuse alike.

3. Start a mindfulness practice. Mindfulness is all about focusing on one thing at a time — your breath, walking, folding laundry, the clouds floating by overhead, or even your own thoughts. It can work wonders for anxiety relief!

4. Take some deep breaths. It sounds too simple, but stay with us! Doing some deep breathing is a great technique to curb anxiety right there in the moment. No tools necessary — just your breath! It might take a bit of trial and error to find a method that works best for you, but a good one to start with is circular breathing: in through your nose and out through your mouth. 

5. Try sound healing. It sounds (no pun intended) a bit out there, but it works! Brainwave entertainment therapy and binaural beats are some of the best ways to stop panic attacks without the need for medications (or alcohol, for that matter). Both work by “tricking” your brain into certain patterns that promote peace and relaxation. And there’s science behind it!

6. Spend time outside. Being outdoors naturally relieves anxiety. Plus, you can walk around the neighborhood park to combine it with exercise!

7. Write it out. Putting your thoughts on paper sometimes makes them more manageable. It’s cathartic and can create much-needed space in your mind, allowing you to process your emotions and then set them aside.

With these tips, you’ll be able to manage your anxiety better. You might find that you’re not even craving that drink at night after all! And remember, Reframe is always here to help if you’re struggling and want support on your alcohol journey.