Alcohol and Benzodiazepines: Is It Dangerous to Mix Them?

Benzodiazepines (often called “benzos”) are prescription medications widely used to treat conditions like anxiety disorders, insomnia, and seizures. When used under medical supervision, these drugs can be effective in managing specific mental or physical health problems. Meanwhile, alcohol is among the most commonly consumed substances worldwide, frequently used for social, cultural, or recreational purposes. However, mixing benzodiazepines with alcohol can have perilous consequences. Both substances act as central nervous system (CNS) depressants, meaning they can exponentially increase the sedation and respiratory depression that each alone can cause. Unfortunately, this dangerous combination can lead to accidents, severe health complications, and even death.

In this article, we’ll explore what happens when benzodiazepines mix with alcohol, the risks and possible effects of this combination, and important considerations if you or a loved one is grappling with the misuse of these substances.

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What Happens If I Mix Benzodiazepines and Alcohol?

Mixing benzodiazepines and alcohol is risky primarily because both substances depress the activity of your central nervous system. Each on its own can slow down brain function, reduce alertness, and impair coordination. Combined, they enhance each other’s effects, leading to:

• Increased sedation and drowsiness
• Heightened risk of respiratory depression
• Impaired thinking and judgment
• Increased risk of accidents and injuries
• Potential for life-threatening overdose

When taken in tandem, alcohol and benzodiazepines can interfere with how your body processes each substance. This can result in higher concentrations of each in your bloodstream for longer periods, significantly elevating the risk of side effects. Even for people who have a legitimate prescription for benzodiazepines, drinking alcohol while on these medications can drastically impact their safety and efficacy.

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What Are Benzodiazepines?

Benzodiazepines are a class of prescription medications primarily used for their sedative, hypnotic (sleep-inducing), and anxiolytic (anti-anxiety) properties. They work by enhancing the effect of gamma-aminobutyric acid (GABA), a neurotransmitter that reduces nerve transmission in the brain, which has a calming effect on the central nervous system.

Commonly prescribed benzodiazepines include:

• Alprazolam (Xanax): Often prescribed for anxiety and panic disorders.
• Diazepam (Valium): Used for anxiety, muscle spasms, and seizure disorders.
• Lorazepam (Ativan): Commonly prescribed for anxiety disorders and for sedation.
• Clonazepam (Klonopin): Often prescribed for certain seizure disorders and panic disorders.
• Temazepam (Restoril): Generally used for short-term treatment of insomnia.

While benzodiazepines can be highly effective when used as directed for short-term treatment, they carry a risk of dependence. Over time, the body can become tolerant to their effects, meaning that higher doses may be required to achieve the same therapeutic benefit. Abrupt discontinuation can result in withdrawal symptoms, which can sometimes be severe. Because benzodiazepines slow the brain’s activity, mixing them with other CNS depressants, such as opioids or alcohol, can be particularly harmful.

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Do Alcohol and Benzos Have the Same Effects on the Body?

Although benzodiazepines and alcohol do share some similar effects—mainly sedation and lowered inhibitions—they aren’t identical in how they operate within the body.

• Mechanisms of action: Benzodiazepines primarily enhance GABA’s effect, while alcohol not only affects GABA but also alters glutamate, serotonin, and dopamine pathways, among others.
• Duration of action: Benzos typically vary in how long they remain active. Some (like alprazolam) have a relatively short half-life, while others (like diazepam) last much longer. Alcohol’s effect depends on how much is consumed, the person’s metabolism, and other factors like food intake.
• Social consumption: Alcohol is often consumed recreationally. Benzodiazepines, on the other hand, are medical treatments for specific conditions, but they can be misused recreationally or without a prescription.

Still, the biggest overlap is that both substances reduce brain activity and can lead to drowsiness, confusion, and slow reaction times. This makes them more dangerous when taken together, multiplying these depressive effects.

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Risks of Mixing Alcohol and Benzos

When benzodiazepines and alcohol converge, a host of serious risks arise:

• Severe Sedation and Drowsiness: Alcohol and benzos both slow down brain activity. Together, they can cause profound sedation, making it impossible to stay awake or alert. This sedation increases the risk of accidents, such as car crashes or falls, which could lead to serious injuries.
• Respiratory Depression: One of the most alarming risks of combining these depressants is suppressed breathing. If your breathing slows excessively, you may not get enough oxygen, resulting in organ damage, brain injury, or potentially fatal complications.
• Memory and Cognitive Problems: Both substances can cause memory lapses, confusion, and poor decision-making on their own. When they interact, the chance of blackouts or significant memory impairment can substantially increase.
• Physical and Psychological Dependence: Using alcohol and benzodiazepines frequently or in higher doses can accelerate dependence on one or both substances. Over time, this can lead to increased tolerance, meaning you need more of each substance to feel the same effects, and subsequently harsher withdrawal symptoms when you try to stop.
• Overdose Potential: The sedative effects of alcohol and benzos compound, heightening the risk of overdose, which can present as extreme drowsiness, dangerously slow breathing, coma, and even death.

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Effects of Mixing Benzos and Alcohol

Someone mixing alcohol and benzodiazepines may exhibit a range of symptoms. In the short term, you might notice:

• Extreme fatigue or lethargy
• Unsteady gait and loss of coordination
• Slow or slurred speech
• Confusion or disorientation
• Blurred vision
• Slowed reaction times
• Difficulty focusing or staying awake

Over the long term, sustained use of both substances can lead to:

• Increased tolerance: Needing higher doses of benzos or alcohol to reach the same sedative effect.
• Dependence and addiction: A cycle where stopping or even cutting down becomes psychologically and physically challenging.
• Worsening mental health: Existing anxiety or depression can intensify, and new mental health issues may develop.
• Organ damage: Excessive alcohol use can damage the liver, heart, and other organs, while chronic benzo use can impair cognitive and physical functioning.

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How Long After Taking a Benzo Can You Drink?

The safest guideline is to avoid mixing alcohol and benzodiazepines altogether. However, if you have been prescribed a benzodiazepine and are wondering when it’s safe to have an alcoholic drink, you should always consult with your doctor or pharmacist first. Different benzodiazepines have different half-lives, so the waiting period varies:

• Short-acting benzos (e.g., alprazolam): Effects can last anywhere from 6 to 12 hours, but there can be residual amounts in your system for up to a day or more.
• Long-acting benzos (e.g., diazepam): The half-life can be 20 hours or longer, with metabolites lasting even longer in the body.

Because these drugs can build up in your system, even after waiting the recommended time, it’s possible to have lingering effects that might interact negatively with alcohol. The most prudent choice is to avoid alcohol entirely if you are regularly taking benzodiazepines.

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Is It Possible to Overdose on Alcohol and Benzos?

Yes, it is absolutely possible—and unfortunately, quite common. The combination of benzos and alcohol is notorious for increasing the likelihood of overdose. Overdoses can happen even with doses of benzodiazepines that may be considered safe when taken alone. The added depressant effect of alcohol can push the body into critical respiratory depression more quickly.

Signs of a potential overdose from alcohol and benzodiazepines can include:

• Extremely slow or shallow breathing
• Weak or irregular pulse
• Inability to wake up or severe unresponsiveness
• Pale, clammy skin
• Blue-tinged lips or fingertips

If you suspect an overdose, call 911 immediately. Quick medical intervention can be lifesaving, as overdose can rapidly lead to irreversible brain damage or death.

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Seeking Help

If you or a loved one is struggling with the misuse of alcohol and benzodiazepines, professional help is available. Recovery is possible with proper medical supervision, evidence-based therapies, and a supportive environment. A comprehensive treatment plan typically includes:

• Medically supervised detox to manage withdrawal symptoms safely.
• Individual therapy to address underlying mental health conditions or co-occurring disorders.
• Group therapy to foster peer support and accountability.
• Medication management to help reduce cravings and prevent relapse.

At The Recovery Village Palmer Lake, a team of professionals can guide you or your loved one through every step of the recovery process. From detox and residential treatment to outpatient care, our evidence-based approach aims to address both the physical and psychological aspects of substance use disorders.

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Final Thoughts

Mixing alcohol and benzodiazepines poses a serious threat to both physical health and emotional well-being. What might start as a “casual” combination can quickly escalate into a life-threatening situation, putting you at heightened risk of accidents, health complications, and overdose. By understanding the inherent risks, you can take informed steps toward safety—ideally, avoiding the combination of these two CNS depressants altogether. If you are struggling with dependence or addiction, know that help is within reach. Professional treatment, personalized support, and ongoing care can empower you to reclaim your health and well-being.

Know When It’s Time for Help

If you’re worried that you or a loved one are at risk due to mixing benzodiazepines and alcohol, it’s important to know when to seek help. You can get started by taking one of our free and confidential alcohol assessments:

• CAGE Alcohol Assessment
• MAST Alcohol Assessment
• AUDIT Alcohol Assessment

If it’s time to seek help, contact us today. We have a long history of providing successful, caring treatment at our facilities in Palmer Lake, Colorado.