Mixing Xanax & Cocaine: What to Expect

Person with an addiction mixes cocaine and xanax

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 treats anxiety disorders. Like other benzodiazepines, Xanax is a central nervous system (CNS) depressant. Cocaine is an illicit CNS stimulant that is associated with euphoria, high energy and increased sociability.

Both Xanax and cocaine can be incredibly dangerous drugs on their own and each has a high risk of developing dependence and addiction. When they are taken together, the risk of immediate and long-term negative health and social consequences is substantially increased.

People may co-use stimulants and depressants for a number of reasons. Cocaine is a notorious drug that is associated with high energy levels, excitability and mental alertness, but it can cause irritability and paranoia as well. Some people may take Xanax to curb the acute effects of cocaine or to ease the discomfort associated with “coming down” from a cocaine high. Cocaine may also be taken to counteract the depressant effects of Xanax, including drowsiness and a sense of low-energy.

What Happens When Mixing Xanax and Cocaine

Xanax and cocaine have opposing effects on the brain. Xanax, a “downer”, increases the amount of an inhibitory neurotransmitter called gamma-aminobutyric acid (GABA), which prevents the brain from entering a state of hyperexcitability. 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 that also plays a key role in addiction development. Because of the oppositional effects of these two drugs, someone who has co-ingested Xanax and cocaine may miss warning signs of an overdose.

Dangers of Xanax and Cocaine

Cocaine and Xanax are both incredibly dangerous drugs. According to 2016 data from the Center for Disease Control, 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. The risks of an adverse outcome is substantially increased when these drugs are combined.

A key danger of mixing Xanax and cocaine is an increased risk of developing dependence and addiction to one or both of them. When they are taken together, they limit the effectiveness of each other, which may lead to someone taking higher doses of one or both of the drugs than they normally would.

As the brain adapts to the presence of the drugs (becomes “tolerant”), increased doses are required in order 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 incredibly 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.

Xanax and Cocaine Overdose

One of the most substantial dangers associated with mixing uppers and downers is the increased risk of an overdose. Because these drugs 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 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 and someone who has consumed a dangerous amount of cocaine alongside Xanax is unlikely to experience 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 having reached a dangerous level.

Xanax and Cocaine Addiction Treatment

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 who are 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 facet of their physical and psychological recovery. For most people, recovery will begin with medically supervised detoxification and will transition into residential and/or outpatient care, followed by aftercare that is designed to motivate and inspire people in recovery.

At The 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 achieve success in recovery. 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 October 6, 2019.

National Institute on Drug Abuse. “What is cocaine?” Revised July 2018. Accessed October 6, 2019.

Hedegaard, Holly; et al. “Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2011–2016.” National Vital Statistics Reports, December 2018. Accessed October 6, 2019.

Medical Disclaimer: Orlando Recovery Center aims to improve the quality of life for people struggling with a substance use or mental health disorder with fact-based content about the nature of behavioral health conditions, treatment options and their related outcomes. We publish material that is researched, cited, edited and reviewed by licensed medical professionals. The information we provide is not intended to be a substitute for professional medical advice, diagnosis or treatment. It should not be used in place of the advice of your physician or other qualified healthcare provider.