Can You Overdose on Xanax? – Xanax (alprazolam) is a prescription medication indicated for the treatment of anxiety and panic disorder. Because Xanax depresses the central nervous system (CNS), drinking alcohol or consuming another CNS depressant while on Xanax can cause an overdose.
Xanax belongs to the drug class benzodiazepines or benzos. Benzos function by inciting the production of a chemical called gamma-aminobutyric acid (GABA) in the brain. GABA is an inhibitory neurotransmitter that slows down the central nervous system and thereby induces feelings of contentment, relaxation, and euphoria.
Normal Xanax Dosages
Ordinarily, a daily dose of between 0.25 and 0.5 mg is prescribed. Since Xanax enters and exits the body rapidly, Xanax is usually taken in multiple doses throughout the day. When starting a therapeutic regimen, a low dose of Xanax is administered then increased until the desired effect ensues, and thus, a final daily dose can exceed 10 mg.
Lethal Xanax Dosages
A lethal amount of Xanax varies from person to person and depends on multiple factors, including the following:
- Weight
- Age
- How well your body metabolizes Xanax
- The presence of other conditions, such as of the kidney, liver, or heart
- The presence of other substances in the system
According to scientific research on rats, the lethal dose of Xanax ranges from 331 to 2171 mg/kg. This fact suggests that a person would have to consume a hundred to a thousand times the usual dose of Xanax to lethally overdose. Nevertheless, overdose is still possible at any dose higher than those prescribed by a physician and generally comes about by other means.
The risk of serious side effects, including overdose, is increased for people over the age of 65. Elderly patients are more sensitive to Xanax’s effect and are generally prescribed smaller doses to prevent adverse reactions.
Xanax Interactions
Most often, a lethal overdose of Xanax transpires because it interacts with other substances in our system.
After Xanax is ingested, our body rids itself of this foreign substance and does so by breaking it down with enzymes. However, some substances can inhibit the activity of these enzymes, making it very difficult for the body to clear out the Xanax. As such, Xanax concentrations can build up and become toxic, particularly when accompanied by substances with a similar mechanism of action, like opioids or alcohol.
Medications which block the activity of these monooxygenase enzymes include the following:
- Sedatives
- Alcohol
- Some antifungals, such as ketoconazole and itraconazole
- Opioid painkillers, such as oxycodone and fentanyl
- Muscle relaxers
- The antidepressant Serzone (nefazodone)
- Fluvoxamine, a medication that treats obsessive-compulsive disorder (OCD)
- Tagamet (cimetidine), a heartburn medication
Common Xanax Side Effects
Like other medications, even low doses of Xanax often cause relatively mild side effects, which include the following:
- Drowsiness
- Dizziness
- Headache
- Blurred vision
- Poor sleep patterns
These side effects are typically minor and short-lived, subsiding within a few hours or days following Xanax use. If such side effects occur during a prescribed therapeutic regimen, this does not necessarily indicate an overdose. If these side-effects present intensely and impair daily life, however, your physician will likely decrease the dosage or switch medications altogether.
Signs and Symptoms of a Xanax Overdose
The symptoms of an overdose on Xanax or some other benzo can range from mild to severe, and, in some cases, life-threatening. The majority of severe or fatal Xanax overdoses occur when it is consumed alongside other CNS depressants, such as opioid medications or alcohol.
According to recent data from the Centers for Disease Control and Prevention (CDC), more than 10,500 people died in 2016 from an overdose related to benzos. Considering that medical examiners don’t always report all the drugs found (sometimes just cause of death) that number could be considerably higher, and indeed, has continued to rise sharply over the past few years.
The prescriber should be aware of other medications or substances you may be taking, including over-the-counter medications, nutritional supplements, and vitamins, or if you drink alcohol regularly. If an interaction is suspected by your physician, an alternative to Xanax is likely to be prescribed to avert dangerous complications.
The severity of overdose symptoms depends on several factors, including the following:
- How much Xanax was consumed
- Overall body chemistry
- Sensitivity to depressants
- Other substances present alongside Xanax
Mild Xanax overdose symptoms include the following:
- Drowsiness
- Lightheadedness
- Muscle weakness
- Elevated heart rate
- Slowed reflexes
- Confusion
- Agitation
- Loss of balance
- Impaired coordination
- Blurred vision
- Tremors
- Uncontrolled muscle movements
Severe Xanax overdose symptoms include the following:
- Slurred speech
- Extreme drowsiness
- Fainting and unconsciousness
- Hallucinations
- Abnormal or erratic heart rhythm
- Low blood pressure
- Chest pain
- Respiratory depression or difficulty breathing
- Seizures
- Unresponsiveness
- Coma
- Death
If you suspect that you or a loved one is overdosing on Xanax, contact emergency medical services at 911 immediately.
Treating an Overdose
If an overdose occurs, medical personnel will immediately transport the overdosing individual to the closest emergency room. While en route, they will administer activated charcoal, which can absorb some of the medication after ingestion and mitigate potentially fatal symptoms.
Once at the hospital, the doctor may pump the individual’s stomach to clear out any undigested medication, thereby preventing an even greater problem. Also, they will usually administer a chemical called flumazenil, which is a benzo agonist that blocks and reverses the effects of Xanax in the brain. Finally, they may run fluids intravenously to rebalance the system with vital nutrients and reverse any dehydration.
Xanax and Suicide
If someone you know is under the influence of Xanax and appears to be at immediate risk of suicide, self-harm, or other violent or erratic behavior:
- Call 911 or another local emergency number
- Stay calm and remain with the individual until help arrives
- Confiscate or clear away any weapons, drugs, or anything else that can be used to cause harm
- Listen to them without threatening, yelling, judging, or arguing
Treatment for Xanax Addiction
If you or someone you know is abusing or has overdosed on Xanax, another drug, or alcohol, please seek help as soon as possible. Xanax is a drug with a high potential for misuse, tolerance, and dependency.
Xanax addiction can be treated using a variety of therapeutic techniques, such as cognitive behavior therapy, individual and family counseling, and group support.
Research has shown that addiction is best approached using a comprehensive plan that also includes holistic practices such as yoga, meditation, and art and music therapy.
Detox is usually the first step in the recovery process, following directly by residential inpatient treatment and intensive outpatient treatment (IOP). Inpatients receive around-the-clock medical and mental health care, while outpatients visit the center several times per week for therapy sessions and counseling.
Many patients continue with IOP following inpatient treatment while they transition back to normal life, sometimes residing in a local sober living environment. Still, other patients opt only for IOP due to time restraints, as it allows them the freedom to attend to essential life responsibilities such as school, employment, and family.
Following intensive therapy, we offer aftercare planning services to ensure that former patients can connect with resources outside of the center and engage in therapy and counseling for ongoing recovery maintenance. We also host alumni activities for the promotion of long-term peer support and comradery.