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Mixing Benzos and Cocaine – Is it Safe?

mixing benzos and cocaineCocaine is a dangerous illicit drug that acts as a stimulant, increasing heart rate and blood pressure, raising body temperature, helping to keep a person awake, and heightening energy levels, focus, and attention capabilities.

Benzodiazepines, often called benzos for short, are a class of central nervous system depressants that are regularly prescribed to treat anxiety and panic disorders, muscle tension, convulsant disorders, and insomnia, and to aid in the management of alcohol withdrawal symptoms. Functions of the central nervous system, like heart rate, blood pressure, respiration, and body temperature, are slowed and lowered by the presence of a benzo.

 As a general rule, cocaine and benzos are considered polar opposites. Cocaine is an “upper” while benzos are “downers.” Taken together, these two substances can have extreme and unpredictable side effects.

Interaction of Benzos and Cocaine on the Brain

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Cocaine is a short-acting drug that impacts levels of dopamine in the brain. Dopamine is one of the brain’s neurotransmitters that serves to act on energy levels and mood regulation. Elevated levels of dopamine can create an intense and euphoric “high.”

According to the 2015 National Survey on Drug Use and Health (NSDUH) published by the National Institute on Drug Abuse (NIDA), close to 15 percent of Americans aged 12 and older have reported abusing cocaine at some time in their lives. A cocaine high does not last very long and is generally followed by a significant “crash.” During this crash, an individual will usually feel fatigued, hungry, depressed, and both physically and mentally sluggish. These feelings may encourage a person to want to take more of the drug, often in a “binge” pattern. The intensity of the cocaine high and subsequent crash may also entice a person to take another drug like a benzo to “smooth” out these significant effects.

Benzos, drugs like Xanax (alprazolam) and Valium (diazepam), act on the stress response of the brain, increasing the presence of the neurotransmitter gamma-aminobutyric acid (GABA). This chemical messenger depresses the “fight-or-flight” reaction, thus increasing relaxation, relieving muscle tension, and lowering anxiety levels. These drugs are commonly diverted and misused, as they can also create a mellow high when abused.

The 2014 NSDUH reports that nearly 2.5 million American adults were considered to be currently misusing prescription sedative or tranquilizer drugs at the time of the survey. These drugs may be taken as a form of self-medication for stress and anxiety relief, as an aid for insomnia, or for relaxation. They are often combined with other substances as well.

They may be combined with a stimulant drug like cocaine in an attempt to counteract the sedative effects, helping a person to stay awake longer and have more energy. Individuals may also mix cocaine and benzos in order to enhance or prolong the high. This practice is highly dangerous, however, as the combination of stimulant and depressant drugs can significantly impact brain chemistry, which can have numerous short-term and long-term consequences.

The combination of stimulant and depressant drugs can be highly dangerous and significantly impact brain chemistry.

Potential Risks of Combining Cocaine and Benzos

Overdose is a possible consequence of misusing both cocaine and benzodiazepine drugs, and when the two are combined, the risk for a potential life-threatening overdose is multiplied. Drug overdose deaths continue to rise in the United States, as the Centers for Disease Control and Prevention (CDC) reports that between 2000 and 2015, over a half-million Americans lost their lives to a drug overdose.

Drug overdoses commonly involve more than one drug. Polydrug abuse can increase the potential side effects of all drugs involved and make an overdose more difficult to treat.

cocaine overdose is indicated by:

  • High blood pressure
  • Racing pulse and irregular heart rate
  • Sweating and high body temperature
  • Nausea
  • Extreme mental confusion
  • Agitation
  • Tremors
  • Psychosis

Stimulants like cocaine can mask the effects of depressant drugs, such as Xanax and Valium, as well; therefore, a person can easily take too much of the benzo, leading to overdose. Taking a long-acting drug like Valium with cocaine may be even more dangerous than mixing a short-acting benzo like Xanax with the stimulant since the depressant drug will be active in the bloodstream longer. As published by CNN, in 2013, benzodiazepine drugs were the second most involved class of prescription drugs in overdose deaths (behind only opioids), as 30 percent of all prescription drug overdose fatalities involved a benzodiazepine drug.

Signs of a benzodiazepine overdose include:

  • Blurred vision
  • Sluggish movements
  • Dizziness
  • Confusion
  • Slow breathing
  • Being cold to touch and having a bluish tinge to the lips, skin, and nails
  • Tremors
  • Sedation and trouble staying awake
  • Loss of consciousness

There may be additional possible interactions and overdose side effects when multiple drugs are involved, as there is virtually no way to predict how multiple drugs may impact each individual. This can complicate overdose reversal attempts as well.

Cocaine raises blood pressure and heart rate while benzos slow them down. The strain on the heart from taking both cocaine and a benzo can wreak havoc on it, potentially leading to lasting heart complications.

The method of use can lead to additional issues as well. For instance, someone who snorts drugs increases the risks of damaging the nasal and sinus cavities while a person who smokes drugs can damage their lungs and experience respiratory problems. Injecting drugs can lead to a host of potential hazards, including collapsed veins, skin infections, and a heightened risk for contracting an infectious disease like hepatitis or HIV/AIDS. Combining cocaine and a prescription benzodiazepine also interferes with normal brain function and can raise the potential for drug dependence, withdrawal symptoms, and addiction.


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Increased Rate of Addiction

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Cocaine and benzodiazepine drugs interact with the pleasure and reward center of the brain when these drugs are misused. They have mind-altering effects, which can lead to bad decisions, poor judgment, and out-of-character behaviors. Abusing these drugs increases the chance for a person to be involved in an accident, get injured, or become aggressive and even potentially violent. Benzos can impair memory as well, so a person may have difficulties remembering things that happen while they are under the influence.

Both benzos and cocaine are addictive substances. The manner in which cocaine is taken, often in a binge pattern, increases its addictive potential as well, as does taking multiple drugs at the same time.

Over 8 percent of adults in America battled addiction in 2014, the Substance Abuse and Mental Health Services Administration (SAMHSA) reports. Addiction is a brain disease that has physical, emotional, and social ramifications, and it is characterized by difficulties controlling or stopping drug use.

Psychoactive drugs change the way the brain sends signals around the central nervous system, increasing the presence of some neurotransmitters while decreasing others. Movement, transmission, production, and reabsorption of these important brain chemicals are impacted by the interaction of drugs. Introducing multiple drugs increases these negative interactions.

With repeated drug use, the brain stops working as it did before and instead relies on the drugs to remain balanced. This is drug dependence, and a major side effect of dependence is the onset of difficult withdrawal symptoms and cravings when the drugs wear off. Significant mood swings, difficulty feeling pleasure, impaired cognitive abilities, and physical discomfort are all possible side effects of benzo and cocaine withdrawal. Appetite and weight fluctuation as well as trouble sleeping are additional issues associated with cocaine and benzo addiction and withdrawal.

Cocaine and benzodiazepines may be taken to enhance moods and ease stress, but they can actually end up compounding possible mental health concerns. SAMHSA reports that around 8 million adults in the United States struggle with co-occurring mental health and substance use disorders. Substance abuse can interfere with treatment and recovery of a mental health disorder and vice versa. Adding in more than one drug can further complicate matters.

It is important to disclose all drugs that are being taken before entering into a treatment program in order to ensure that all possible interactions are accounted for. Much of the time, a drug test is done along with an assessment to determine the proper type and level of care.

Benzodiazepine drugs are not to be stopped “cold turkey” without professional help, as the associated withdrawal symptoms can be severe and even life-threatening. A medical detox program can aid in safely allowing these drugs to process out of the body under a tapering schedule, often with the help of other medications. In the case of polydrug abuse, medical detox is often considered the optimal first level of care. After detox, individuals can then enter in to an integrated treatment program that can promote recovery from all co-occurring medical and mental health disorders and drug abuse concerns.

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