Mixing Xanax, Klonopin, and Benzos with Other Drugs
The Basic Rundown on Benzos
How Common Is Benzo Abuse?
Xanax: The Most Commonly Prescribed Short-Acting Benzo
Klonopin: The Long-Acting Benzo
Interactions Between Benzos and Other Drugs
Treatment for Combined Benzodiazepine and Other Drug Use
Xanax and Klonopin are the respective trade names for alprazolam and clonazepam, two medications that belong to the benzodiazepine class of drugs (nicknamed “benzos”).
As sedative anxiolytic drugs, benzodiazepines help patients manage various physical discomforts and psychological conditions. Treatment with Xanax or Klonopin may be prescribed if you are suffering from:
- Anxiety disorders.
Benzodiazepine in its pure form is a psychoactive drug comprised of the chemical compounds diazepine and benzene, the latter of which was once commonly used as a solvent to decaffeinate coffee (it was later discontinued for use in this manner when it was found to have carcinogenic properties).
Marketed since the 1960s, the benzodiazepine class of medications has grown to include dozens of short- and long-acting spin-off drugs, including:
- Alprazolam (Xanax).
- Clonazepam (Klonopin).
- Diazepam (Valium).
- Lorazepam (Ativan).
Benzodiazepines are classified as central nervous system (CNS) depressants by the National Institute on Drug Abuse, which divides the drugs into two categories:1
- Anxiolytics (e.g., diazepam, or Valium).
- Used for reducing anxiety.
- Sedatives (e.g., midazolam, or Versed).
- Used as a pre-surgical anesthesia induction agent.
The primary therapeutic effects of benzodiazepines are:
- Decreased anxiety.
- Muscle relaxation.
- Anti-convulsant activity.
The Positive Effects of Benzo Therapy
The benefits of benzodiazepines vary based on:
- The age and specific condition of each patient being treated.
- The type of benzo administered.
- The severity of the condition treated.
Available in tablet and liquid forms, benzos are typically taken orally, though in some cases the drugs are administered intravenously. In rare circumstances, benzos are administered through intramuscular and rectal routes.
- Short- and intermediate-acting benzos are good for treating anxiety.
- Longer-lasting benzos are generally better for managing seizure disorders or the effects of acute alcohol withdrawal.
In most cases, courses of benzodiazepines are indicated only for short-term management of anxiety. Benzo treatments lasting less than a month are usually safe, though the drugs can become habit-forming with prolonged use.
Adverse Effects of Benzo Usage
Users may experience adverse effects through improper or excessive use and may have withdrawal symptoms once treatment has ended – especially when use is abruptly halted.
Adverse effects caused by prolonged benzo use include:2
- Physical dependence.
- Psychomotor retardation.
- Memory loss.
- Cognitive impairment with problem solving, concentration, and visuospatial abilities.
The risk of physical dependence with benzos is high, even if the drug is used correctly and over a short period. Three key indicators of physical dependence are:3
- Tolerance: you need to take a higher dose of the drug to achieve the same high you used to experience with a smaller dose.
- Cravings: the compulsion to keep taking the drug, even though you experience negative consequences.
- Withdrawal: When you stop taking the drug, you experience withdrawal symptoms.
With benzos, this may include:4
- Emotional turmoil.
According to the Centers for Disease Control and Prevention, benzodiazepines are gaining popularity as recreational drugs.5
Between 2004 and 2008, ER admissions involving benzo abuse jumped by 89%. In order of the largest percentage increase in emergency department visits, the individual benzos responsible for these admissions ranked as follows:
- Alprazolam (Xanax): 125%
- Lorazepam (Ativan): 107%
- Clonazepam (Klonopin): 72%
- Diazepam (Valium): 70%
Xanax is the most commonly identified trade name for alprazolam. Alprazolam and all of its trade formulations are prescribed to treat anxiety. Xanax acts as a sedative, anticonvulsant, muscle relaxant, and anxiety reducer.6
Xanax delivers its potent effects with a relatively swift onset of action for users seeking short-term relief from panic and other anxiety disorders.
Side Effects of Taking Xanax
In the short-term, patients who take Xanax for its anti-anxiety benefits are unlikely to develop significant levels of tolerance to the drug, though it can become habit-forming when used for longer than recommended durations. 6
Commonly seen side effects associated with Xanax use include:
- Slurred speech.
- Respiratory depression.
Some of the more severe reactions to Xanax are far less common, but can include: 6
- Urinary retention.
- Loss of control of body movements.
Paradoxical symptoms are even less likely, though feelings of mania, aggression, and hostility are occasionally triggered in certain Xanax users.
Klonopin is the U.S. trade name for clonazepam, and has one of the longest half-lives of all the benzodiazepines, Klonopin is used primarily in the treatment of epilepsy (various seizure disorders). Klonopin is effective in the treatment of:7
- Akinetic seizure.
- Myoclonic seizure.
- Absence seizure.
- Panic disorder.
Side Effects Associated with Klonopin Usage
Depending on the conditions of each user and the doses administered, Klonopin can have side effects ranging from mild to severe.
Like many of its sister benzos, Klonopin can produce feelings of:7
- Cognitive disruption.
Possible yet infrequent among Klonopin users are feelings of: 7
- Diminished libido.
- Motor impairment.
- Anterograde amnesia, in which memories surrounding the time of dosage are lost upon the user.
Due to the tolerance potential of Klonopin, treatments are generally preferable on a short-term basis. Withdrawal symptoms may be experienced by users regardless of dosage, though the precise effects can vary from person to person. Some of the worst cases of Klonopin withdrawal after high-dose treatments involve seizures and intense rebound panic attacks.
Mixing drugs is never recommended, yet interactions between benzos, alcohol, and other drugs (both prescription and illicit) often depends on the specific substance combination in question.
Some people choose to use benzos with other substances simply to experience a different type of high than benzos alone. Others use stimulant substances to counter the depressant effects of benzos so they can enjoy the relaxing sensation while feeling alert and awake.
Benzos and Hallucinogens
When it comes to hallucinogens like LSD, benzos can work to alleviate some of the stress associated with bad trips.8
Benzos and Stimulants
The sedative nature of benzos may also alleviate symptoms that typically occur during methamphetamine comedowns, such as irritability and insomnia, and may be used to blunt the negative effects of cocaine use, such as anxiety, agitation, or paranoia.9
Benzos and Opioids
Potentially more dangerous are mixtures of benzos and opioids, both of which have central nervous system depressing effects. Opioid drugs such as heroin, morphine, methadone, and codeine put people into mellow states, as do benzos, so it’s no surprise that some of the most dangerous cases of polydrug use involve multiple depressants.10
If the sedatives in benzos cross with the downer effects of opioids, the combination of depressive qualities can result in potentially lethal respiratory failure.
In fact, between 2005 and 2011, nearly one million emergency department visits were related to the use of benzodiazepine medications combined with either opioids or alcohol. 10 The combination of benzodiazepines and opioids has been found to increase the risk of a serious outcome by 37% compared with benzos alone. 10
Co-abusers of benzos with opioid painkillers report that they use these substances together because they believe that it can enhance the opioid high.11
Benzos may be used to boost the effects of opioids, or to substitute for other sedative-hypnotic drugs that the person has built up a tolerance to.12
Dangers of Mixing Alcohol with Benzos
Benzos and alcohol make another extremely dangerous combination, because alcoholic beverages also act as depressants on the CNS, and work via similar communication pathways in the brain.
These compounding effects lead to additive interactions between benzos and alcohol, increasing the risks associated with each individual drug, particularly breathing problems.13,14,15
When a person takes a benzo and drinks large amounts of alcohol, the body’s ability to metabolize both substances is impaired.16 This effect may not be seen with lower amounts of alcohol, but in either scenario, the user may still experience the intense compounding effects of both substances.
It only takes a couple of drinks to exacerbate the process of other chemicals in the body, which can severely boost the potency of already powerful sedative drugs such as Xanax and Klonopin. Users may also be at much greater risk while under the influence of alcohol, because drunkenness can lead to forgetful and irresponsible behavior concerning medicine consumption.
Which Drugs Are Typically Used in Combination with Benzos?
The American Academy of Family Physicians suggest that benzos are rarely the sole drugs of choice among substance abusers, as summarized by the following findings:17
- 15% of heroin users consume benzos daily for periods exceeding 12 months.
- 73% of heroin users consume benzos weekly.
- Roughly 90% of methadone users engage in benzo poly-usage.
- Roughly 41% of alcoholics recurrently abuse benzos.
When combining benzodiazepines with other drugs, it is vital to consider that the substances might interact in dangerous and unpredictable ways. If you or someone you love has fallen into the dangerous habit of mixing benzos with other drugs, reach out for help now. Please call 1-888-744-0789 to connect with a member of our rehabilitation support team who can provide information about recovery programs that provide comprehensive treatment for both substances.
Concurrent substance abuse of benzodiazepines and other drugs often requires treatment that is tailored to the particular drug pairing. Because every drug interacts with benzos differently, and each user will have their own particular treatment needs, it is important to consider these key aspects when evaluating a program:
- Does the facility offer professional medical monitoring?
Detox and withdrawal from benzos alone can cause life-threatening symptoms, let alone the combination with other risky drugs, such as alcohol. Benzodiazepines, in particular, require gradual tapering of doses.18
Medical monitoring during treatment is vital for someone recovering from polydrug abuse.
- What kind of psychiatric care does it provide?
Therapy and counseling are a major part of treatment for substance abuse, especially for polydrug abuse. There are many different approaches to therapy, so make sure the facility is willing to work with you to find the kind that is most effective for you.
The Benefits of Luxury Treatment
Sobering up from concurrent abuse of benzodiazepines and other drugs is often an uncomfortable experience, so finding the right treatment facility can make a big difference in a person’s recovery. Luxury and executive programs place a big focus on comfort and providing patients with things to do to distract themselves from their discomfort.
Luxury programs provide various amenities for patients to take advantage of, such as:
- Outdoor activities.
- Spa and meditation services.
- Internet access.
- Increased privacy options.
They may also offer more one-on-one care than many traditional programs, which does come with a higher price tag. Both luxury and traditional treatment programs can provide high-quality treatment that will help users through recovery, so if cost or comfort is a major concern for you, be sure to consider the benefits of each option when evaluating programs.
While benzodiazepines are generally safe for chemical-free patients who suffer from acute symptoms of restlessness and anxiety, they are often abused. If you find yourself struggling with abuse of benzos, alcohol, or other drugs, contact us today. We can help you find the best exclusive residential treatment facility that you need to heal. Call 1-888-744-0789.
- National Institute on Drug Abuse. (2014). What Are CNS Depressants?
- Center for Substance Abuse Research. (2013). Benzodiazepines.
- American Psychiatric Association. (2013). About DSM-5.
- Petursson, H. (1994). The benzodiazepine withdrawal syndrome. Addiction, 89(1), 1455-1459.
- Centers for Disease Control and Prevention. (2010). Emergency Department Visits Involving Nonmedical Use of Selected Prescription Drugs — United States 2004-2008.
- U.S. Food and Drug Administration. (2011). Xanax.
- U.S. Food and Drug Administration. (2009). Klonopin.
- Lemer, A.G., Gelkopf, M., Skladman, I., Rudinski, D., Nachshon, H., and Bleich, A. (2003). Clonazepam treatment of lysergic acid diethylamide-induced hallucinogen persisting perception disorder with anxiety features. International Clinical Psychopharmacology, 18(2), 101-105.
- Lamonica, A.K. and Boeri, M. (2012). An Exploration of the Relationship between the Use of Methamphetamine and Prescription Drugs. Journal of Ethnographic and Qualitative Research, 6(3), 160.
- Substance Abuse and Mental Health Services Administration. (2014). Benzodiazepines in combination with opioid pain relievers or alcohol: Greater risk of more serious ED visit outcomes.
- Jones, J. D., Mogali, S. and Comer, S. D. (2012). Polydrug abuse: A review of opioid and benzodiazepine combination use. Drug and Alcohol Dependence, 125(1-2), 8-18.
- Smith, D. E. and Landry, M. J. (1990). Benzodiazepine dependency discontinuation: Focus on the chemical dependency detoxification setting and benzodiazepine-polydrug abuse. Journal of Psychiatric Research, 24(2), 145-156.
- Scavone, J.M., Greenblatt, D.J., Harmatz, J.S. and Shader, R.I. (1986). Kinetic and dynamic interaction of Brotizolam and ethanol. British Journal of Clinical Pharmacology, 21, 197–204.
- Linnoila, M., Stapleton, J.M., Lister, R., Moss, H., Lane, E., Granger, A. and Eckardt, M.J. (1990). Effects of Adinazolam and Diazepam, alone and in combination with ethanol, on psychomotor and cognitive performance and on autonomic nervous system reactivity in healthy volunteers. European Journal of Clinical Pharmacology, 38, 371–377.
- Dorian, P., Sellers, E.M., Kaplan, H.L., Hamilton, C., Greenblatt, D.J., & Adernethy, D. (1985). Triazolam and ethanol interaction: Kinetic and dynamic consequences. Clinical Pharmacological Therapy, 37. 558-562.
- Tanaka, E. (2002). Toxicological interactions between alcohol and benzodiazepines. Journal of Toxicology/Clinical Toxicology, 40(1), 69-75.
- Longo, L.P. and Johnson, B. (2000). Addiction: Part 1. Benzodiazepines—Side Effects, Abuse Risk and Alternatives. American Family Physician, 61(7), 2121-2128.
- Ashton, H. (1994). The treatment of benzodiazepine dependence. Addiction, 89(11), 1535-1541.