Is it safe to mix Xanax and Cocaine?

Last Updated: April 22, 2024

Xanax and cocaine are commonly combined, but the consequences can be incredibly dangerous, even lethal. Xanax (generic name alprazolam) is a popular prescription benzodiazepine that is FDA-approved to treat anxiety and panic disorders. Like other benzodiazepines, Xanax is a central nervous system (CNS) depressant. Cocaine is a stimulant associated with euphoria, high energy and increased sociability.

As controlled substances, both Xanax and cocaine can be dangerous drugs on their own and have a high risk of causing dependence and addiction. When they are taken together, the risk of immediate and long-term negative health and social consequences increases substantially.

What Happens When You Take Xanax?

As a central nervous system depressant, Xanax slows down brain and body activity by enhancing the effects of the brain’s calming neurotransmitter gamma-aminobutyric acid (GABA). Xanax’s side effects reflect this, for example:

  • Drowsiness
  • Lightheadedness
  • Depression
  • Headache
  • Dry mouth
  • Constipation
  • Diarrhea

What Happens When You Take Cocaine?

As a stimulant, cocaine works to speed up brain and body activity by increasing the level of neurotransmitters like dopamine, which also triggers the brain’s reward circuit. This can lead to several different effects like:

  • Euphoria followed by a crash
  • Irregular heartbeat
  • Heart problems
  • Stroke
  • Seizure
  • Death

Why Do People Mix Xanax and Cocaine?

People may co-use stimulants and depressants for several reasons. As a stimulant, cocaine can cause euphoria, which people find desirable, but it can also cause unpleasant effects like irritability and paranoia. For this reason, some people may take Xanax to curb the acute effects of cocaine or ease the discomfort associated with “coming down” from a cocaine high.

Likewise, some people take cocaine as an “upper” to counteract the “downer” depressant effects of Xanax, including drowsiness and a sense of low energy.

What Happens When You Mix Xanax and Cocaine?

Xanax and cocaine have opposing effects on the brain. Xanax, a “downer,” enhances the action of an inhibitory neurotransmitter called gamma-aminobutyric acid (GABA), which slows down the central nervous system. This is how Xanax can limit anxiousness and promote a sense of calm.

Cocaine is an “upper” that increases the amount of an excitatory neurotransmitter called dopamine, which is responsible for alertness and wakefulness and  plays a key role in addiction development. Because of the oppositional effects of these two drugs, someone who has ingested both Xanax and cocaine may miss warning signs of an overdose because they might not feel as high as they actually are.

Dangers of Mixing Xanax and Cocaine

Cocaine and Xanax are both dangerous drugs. As of 2016, cocaine was the third most lethal drug in the U.S., accounting for 17.8% of drug-related deaths, and Xanax was the fifth most lethal drug, accounting for 9.8% of drug-related deaths.

One of the most substantial dangers associated with mixing uppers and downers is the increased risk of an overdose. Because uppers and downers mask some of the negative side effects of each other, it can be difficult or impossible for someone who has taken them together to recognize the overdose warning signs of an overdose.

For example, a cocaine overdose causes a rapid heart rate, elevated body temperature, sweating and trembling. These symptoms are exactly what Xanax was designed to minimize. As a result, someone who has consumed a dangerous amount of cocaine with Xanax may not show the cardinal symptoms of a cocaine overdose. This may prove to be a fatal consequence of mixing cocaine with Xanax, especially if someone continues to use cocaine even after reaching a dangerous level.

Another key danger of mixing Xanax and cocaine is an increased risk of developing dependence and addiction to one or both of them. When taken together, they limit the effectiveness of each other, which may lead to someone taking higher doses of one or both drugs than they normally would. Abusing one substance increases the chances of becoming addicted to additional substances.

As the brain adapts to the presence of the drugs (becomes “tolerant”), increased doses are required to achieve the desired effect. Xanax and cocaine are both notoriously addictive, and regular use can quickly lead to debilitating dependence and addiction that can be challenging to overcome.

Importantly, someone who has developed a dependence on Xanax should never try to quit taking the drug without professional assistance. While cocaine detox and withdrawal can be profoundly uncomfortable, they are generally not dangerous. Someone who quits Xanax “cold turkey” is at risk for a dangerous, even fatal detox and withdrawal experience.

Treatment for Polysubstance Abuse and Addiction

At Orlando Recovery Center, cocaine addiction treatment and Xanax treatment can be addressed simultaneously. Our multidisciplinary team of experts understands polysubstance use disorders and has demonstrated excellence in helping people succeed in recovery.

Polysubstance abuse occurs when someone misuses or abuses more than one drug simultaneously or concurrently. Polysubstance abuse can increase the rate at which someone develops dependence and addiction, and multi-drug dependence can make overcoming a polysubstance use disorder very challenging.

People struggling to overcome a polysubstance use disorder will have the best chance at short- and long-term success in recovery if they entrust their care to rehab professionals who can address every aspect of their physical and psychological recovery. For most people, recovery will begin with medically supervised detoxification and transition into residential and/or outpatient care, followed by aftercare designed to motivate and inspire those in recovery.

Orlando Recovery Center is an in-network provider for a range of insurance companies, including Aetna, Cigna and America’s Choice. Learn more about the insurance we accept by visiting our insurance page. Contact us today to learn how we can help you regain control of your life.


National Institute on Drug Abuse. “What are prescription CNS depressants?” Revised March 2018. Accessed June 28, 2022.

Hedegaard, Holly; Bastian, Brigham A.; Trinidad, James P.; et al. “Drugs Most Frequently Involved in Drug O[…] States, 2011–2016.” National Vital Statistics Reports, December 2018. Accessed June 28, 2022.

Vo, Kim; Neafsey, Patricia J.; Lin, Carolyn A. “Concurrent use of amphetamine stimulants[…]dergraduate students.” Patient Preference and Adherence, January 22, 2015. Accessed June 28, 2022.

Crummy, Elizabeth A.; O’Neal, Timothy J.; Baskin, Britahny M.; Ferguson, Susan M. “One Is Not Enough: Understanding and Mod[…]ng Polysubstance Use.” Frontiers in Neuroscience, June 16, 2020. Accessed June 28, 2022. “Alprazolam.” November 9, 2020. Accessed June 28, 2022.

Drug Enforcement Administration. “Controlled Substances.” June 7, 2022.  Accessed June 28, 2022.

U.S. Department of Justice, Drug Enforcement Administration. “Drugs of Abuse.” April 2020. Accessed June 28, 2022.

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