Risks of Mixing Xanax and Heroin

Polysubstance use—or the use of more than one drug at a time—is frequently associated with heroin use.¹ In fact, studies suggest 77-93% of people with a heroin use disorder also have at least one other co-occurring substance use disorder.²

The combination of benzodiazepines like Xanax and heroin is one example of polysubstance use.

This page will cover the differences between Xanax and heroin, the dangerous consequences of mixing xanax and heroin, and how to access treatment for polysubstance misuse or addiction.

Differences Between Heroin and Xanax

There are numerous differences between heroin and Xanax. Heroin is an opioid drug that is both illegal and highly addictive.¹ It is most frequently injected, but users may also smoke or snort it.¹

Heroin may be referred to with slang terms such as smack, dope, tar, black tar, junk, brown, brown sugar, China white, and many others.³

It is categorized by the U.S. Drug Enforcement Administration (DEA) as a Schedule I drug, which means it has no accepted medical use and has a high potential for misuse.⁴

Xanax, a brand name formulation of alprazolam, is classified as a benzodiazepine drug.⁵ It is a legal prescription medication approved to treat generalized anxiety disorder and panic disorder.⁵

Xanax is classified by the DEA as a Schedule IV drug, a class of drugs with a known risk of misuse and dependence.⁴

Examples of Xanax misuse can include:⁵

• Taking a dose higher than prescribed.
• Taking it without a prescription.
• Concurrent use of alcohol, other medications, and illegal drugs.

Heroin Effects

Heroin is used to achieve a “rush” of pleasure, or “high” (euphoria). It has many side effects, including:^6,7

• Slowed breathing and heart rate
• Flushing of the skin
• Nausea and vomiting
• Dry mouth
• Itching
• Clouded thinking
• Going between consciousness and semiconsciousness (i.e., “on the nod”)
• Arms and legs feeling heavy

Xanax Effects

Xanax is used primarily for its sedative effects. It has numerous other side effects, including:^5,7,8

• Lowered anxiety.
• Slowed breathing.
• Lowered blood pressure.
• Drowsiness and sleepiness.
• Fatigue.
• Feelings of light-headedness.
• Poor coordination.
• Irritability.
• Dry mouth.
• Difficulties with concentration.

Mixing Xanax and heroin can result in unintended consequences.

Life-Threatening Consequences of Mixing Xanax and Heroin

Both Xanax and heroin cause sedation and impair cognitive functioning. Heroin can cause depression of the respiratory system, which is characterized by slowed and sometimes irregular breathing.^7,8

Xanax generally doesn’t cause significant changes in breathing on its own, but studies have shown the combination of both drugs causes more pronounced effects than each of the substances does on its own.^7,8,9

When mixing Xanax and heroin, these synergistic effects lead to increased risk of a potentially fatal overdose characterized by oversedation (severe drowsiness and potential loss of consciousness) and life-threatening respiratory depression where a person’s breathing slows or stops.¹⁰

Dangerously slowed (or stopped breathing) can lead to brain damage, coma, or death.^5,11

Heroin and Xanax Overdose

An overdose entails taking too high a dosage of a drug and suffering ensuing negative effects.⁵ Both Xanax and heroin present the risk of overdose on their own.^5,6

However, mixing heroin and Xanax is linked to an increased risk of both non-fatal and fatal overdose.^9,11

Misuse of benzodiazepines including Xanax has been involved in many cases of overdose and fatalities amongst those who use heroin.¹²

In fact, 16% of the opioid-related overdose deaths in 2020 also involved benzodiazepines.⁸

One study found that the risk of fatal overdose is 10 times higher among people concurrently using the combination of drugs as opposed to an opioid, such as heroin, on its own.⁸

Signs of an overdose from mixing Xanax and heroin can include any of the following:^13,14

• Slurred speech
• Ataxia (loss of muscle control)
• Confusion or altered mental state
• Cold or pale skin
• Slow or stopped breathing
• Gurgling or choking sounds
• Vomiting
• Loss of consciousness
• Limp body
• Lips or fingernails turning purplish or blue

Long-Term Effects of Mixing Xanax and Heroin

Beyond each drug’s individual long-term effects, potential long-term effects of mixing Xanax and heroin can include:

• Brain and other organ damage.^11,15
• Increased risk of tolerance and physical dependence.^9,15
• Withdrawal symptoms when use is reduced or stopped abruptly.¹⁵

Evidence shows that benzos like Xanax heighten both the rewarding and reinforcing effects of opioids such as heroin.⁹

This provides an understanding as to why some people use these drugs together.⁹

Xanax may be taken to amplify the intoxication caused by heroin, including not just increasing its intensity, but also its duration.⁹

These combined effects contribute to the risk of physiological dependence and addiction.⁹

Find Help for Polysubstance Use

Effective treatment is available for people struggling with Xanax and heroin use.¹⁶ Abrupt cessation of either benzos such as Xanax or opioids including heroin can cause severe symptoms of withdrawal as well as emotional distress, and people can benefit from the safety, comfort, and supervision of a medically managed detox.¹⁷

Detoxification on its own is rarely sufficient for those with a substance use disorder to achieve long-term sobriety.¹⁷

Detox is generally considered to be a first step and can help people get ready to enter and then transition them into a substance use disorder treatment program.¹⁷

Efficacious treatment for substance use disorders does not just focus on a person’s drug use and detoxification; it addresses all needs.¹⁸

Screening for and treatment of other mental disorders is of extreme importance.¹⁸ Attention to physical health and the possible need for medications are also parts of the process of getting help for substance use problems.¹⁸

After the detox process, treatment is available in many types of settings.¹⁸ These include outpatient addiction treatment or inpatient and residential facilities.

Both inpatient and outpatient treatment provides individual and/or group counseling. Evidence-based behavioral therapy is a common component of an addiction treatment program.¹⁸

River Oaks Treatment Center is a premier drug rehab near Tampa, Florida. By calling , you can speak to an admissions navigator 24 hours a day, 7 days a week.

A caring admissions navigator can provide you with information about and guidance regarding:

• Levels of addiction treatment offered at River Oaks.
• The treatment admissions process.
• Rehab payment options, including insurance coverage for rehab.

You can also quickly and securely. Please don’t delay in reaching out for help. Recovery is possible and we are here to support you every step of the way.

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