Drinking while taking benzodiazepines can be a serious mistake. Alcohol enhances the effects of the drugs. It also affects the way the benzos are metabolized. Both of these interactions can cause serious side effects, including death.
Benzodiazepines are depressants prescribed to treat anxiety, muscle spasms and seizures. They calm parts of the brain that cause anxiety and keep us awake.
Common benzodiazepines include:
Alcohol affects the same parts of the brain that benzodiazepines act on. If you take both substances at the same time, your brain will become heavily sedated. This can make it dangerous to drive a car or operate machinery. It can also make you pass out. Even at low doses, the combination can slow vital body functions such as breathing.
Mixing alcohol and benzos is dangerous because the substances have a synergistic effect on one another. That means the effects of mixing the substances is greater than the sum of the effects caused by either on its own. In other words, the combined effects of a low dose of a benzo and a low dose of alcohol are greater than a moderate dose of alcohol by itself.
Doctors who prescribe benzodiazepines should warn patients about the effects of consuming both substances. Patients can experience adverse events if they aren’t warned of the interaction or if they’re unaware of how long benzos last.
The effects of the prescription drugs last several hours, and metabolites of benzodiazepines can stay in your system for several days. In general, it’s best to avoid alcohol while you’re taking benzodiazepines.
Some people intentionally mix the substances to get high or feel relaxed. These people risk blacking out, passing out and getting into accidents. Using the substances in hazardous ways, such as snorting a benzo or chugging alcoholic beverages, increases the risk of serious health problems.
The short-term effects of taking benzos and alcohol are similar to the symptoms of alcohol poisoning and the symptoms of a benzodiazepine overdose. But the effects of the combination tend to occur more rapidly than the effects of using either substance on its own.
For example, it may take several hours of drinking for a person to black out. But mixing alcohol and a benzo can make a person quickly lose their memory.
Other short-term effects of mixing alcohol and benzos include:
The effects are more severe than taking those that occur when someone takes a benzodiazepine alone. It’s nearly impossible to die of a benzodiazepine overdose unless you experience an accident or injury. However, you can die of alcohol poisoning, and mixing alcohol and benzos can also kill you.
Overdoses involving benzos and alcohol cause death by respiratory depression. When you breathe too slowly, the brain doesn’t get enough oxygen. Oxygen deprivation kills brain cells. If you don’t die, you can still experience serious brain damage and other long-term problems if you overdose on alcohol and benzos.
Repeated use of benzodiazepines causes dependence and tolerance. The brain adapts to exposure to the substances, and it starts to rely on the substances to feel normal. It also requires higher doses to feel a therapeutic or recreational effect.
Alcohol can also cause dependence and tolerance when it’s consumed frequently. Because the substances affect similar areas of the brain, they can cause cross-tolerance, according to the Center for Substance Abuse Research. That means someone with a high tolerance to alcohol can have a high tolerance to benzos even if they don’t use benzos frequently.
People who regularly mix alcohol with benzos can develop a high tolerance quickly. They can also become severely dependent. That means they’ll require high doses to feel normal.
Without alcohol or benzos, alcohol- or benzo-dependent people experience withdrawal symptoms. The risks of withdrawal from either substance are life-threatening symptoms including seizure, coma and death.
Both tolerance and dependence are warning signs for benzodiazepine addiction. Addiction is a disease that causes compulsive substance use. People who regularly combine alcohol and benzos can become addicted to both substances. Recovering from addiction to both substances is difficult and requires professional treatment.
Alcohol dependence changes the way people metabolize the substance. Metabolism is the process the body uses to break down substances we eat or drink. Alcohol dependence also changes how the body breaks down certain medications, including benzodiazepines.
This can make the drug stay in the body for a longer period of time than it’s supposed to. As a result, large doses of the benzo can accumulate in the body and cause an overdose, according to a review published in the journal Alcohol Research and Health.
Withdrawal from alcohol is miserable. Some people try to quit drinking cold turkey and power through withdrawal to shorten the time they spend suffering. But this is dangerous because alcohol withdrawal can cause seizures and other life-threatening symptoms.
Tapering, or slowly reducing, your alcohol intake is the safest way to quit drinking on your own. But people addicted to alcohol are unable to control how much they drink.
Benzodiazepines are considered the “gold standard” of treatment for alcohol withdrawal, according to a 2015 review published in the Journal of Clinical & Diagnostic Research. They reduce the severity of withdrawal symptoms and prevent the most serious symptoms: seizures and delirium tremens.
The long-acting benzos Valium and Librium are likely more effective at preventing withdrawal symptoms throughout the day than short-acting drugs. But they may not be appropriate for patients with liver problems. Short-acting benzos, such as Ativan, may be more appropriate for individuals with liver damage.
People addicted to both benzos and alcohol should detox from the substances at a certified rehab facility. Doctors will provide supervised doses of benzodiazepines to ease benzo withdrawal and prevent an overdose.
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