Xanax Overdose: Causes, Risks and Getting Help

Last Updated: January 19, 2021

Authored by Nena Messina, Ph.D.

Reviewed by Michael Espelin APRN

Xanax, also known as alprazolam, is a prescription drug prescribed to millions of Americans each year. Moreover, it is one of the most popular drugs prescribed for mental health. While it is designed to improve the quality of life by treating anxiety and panic disorder, it comes with a risk of abuse and addiction. All too often, this leads to dangerous situations, including overdose on Xanax.

Can You Overdose on Xanax?

Xanax overdose is caused by either consuming too much of the drug within a given timeframe or consuming the drug in conjunction with other drugs and alcohol. Compared to most other prescription drugs, the risk of a toxic reaction with Alprazolam is increased because it is fast-acting, allowing the body to become overwhelmed by the drug presence. Alprazolam overdose is considered more dangerous than on other benzodiazepines, with users being twice more likely to be admitted to intensive care units.

If consumed with central nervous system (CNS) depressants or alcohol, Xanax overdose symptoms tend to manifest with breathing problems and can possibly lead to coma and even death. Overdosing on Alprazolam alone is unlikely to cause such effects.

How Much To OD on Alprazolam?

Alprazolam is usually prescribed in the dosage of 0.25 or 0.5mg three times a day. For the treatment for certain conditions, the maximum prescribed dose is 10mg per day. However, if a patient is taking a lower dose but is also taking other medications or drinking alcohol, there is the potential for an overdose to still occur. The riskiest things to combine with Alprazolam are alcohol, other benzodiazepines, and opiates.

It’s also important to know about the existence of fake Alprazolam bars, which are produced without any regulations and can be laced with fentanyl – a synthetic opioid that is 100 times more powerful than morphine. The mix of alprazolam and fentanyl is a deadly combination and is very likely to cause lethal outcomes.

Even if one is not taking any other medications or consuming alcohol, there will be a lethal dose of Xanax; just the limit will vary based on height, weight, age, and general health status. All in all, this means there is no exact dosage that results in a serious adverse reaction, so it’s important to stick to the prescribed dosage.

Xanax Overdose Symptoms

Alprazolam is one of the most widely abused prescription drugs around the world. While the contributing factors to addiction vary from person to person, the speed with which the body develops a tolerance to the medication and a feeling of physical dependence on the medication are primary reasons. The medication can also create a feeling of euphoria when taken in larger doses, which is why cases of overdosing on Alprazolam are so common.

Recognizing the signs of Alprazolam overdose can be difficult as they are similar to other medical conditions. In fact, early Xanax overdose symptoms resemble the side effects of the standard use of the drug, including difficulty focusing, drowsiness, dry mouth, headaches. A user may also experience dizziness, nausea, and mood changes.

Depressed girl takes a lot of Xanax pills.

Because these signs are in line with prescribed Alprazolam use and are also common to other medical conditions, they are not strong indications an overdose is occurring. However, they do indicate the individual in question should be monitored over the next several hours.

There are also more symptoms, which are strong indications that an OD is occurring. At the very least, the person suffering from such symptoms is experiencing a major medical event and requires immediate care.

Advanced Signs of Xanax Overdose Include:

  • Confusion
  • Suicidal thoughts or actions
  • Labored breathing
  • Hallucinations
  • Changes in balance and hand-eye coordination
  • Sudden changes in memory
  • Seizures
  • Yellow tint to the whites of the eyes or skin
  • Loss of motor function or control
  • Extreme drowsiness or the inability to remain conscious
  • Shallow and slow breathing
  • Lack of response

These signs indicate that the person is in the advanced stages of overdose and requires immediate care to improve their survival chances.

OD Treatment

Treatment for someone who overdosed on Alprazolam and other benzodiazepines includes supportive care, depending on the severity of the symptoms. In rare cases, Flumazenil can be used in treatment. It can reverse respiratory depression in patients with isolated benzodiazepine overdose. However, it’s not used frequently as there is a high risk of dangerous adverse reactions. This is especially true in cases of a mixed overdose (taking benzodiazepines with other substances or alcohol) or in people with benzodiazepine tolerance.

Medical help in such cases is vital to avoid severe complications or death. Should advanced or emergency signs of Alprazolam overdose be observed, call 911 for emergency treatment. If one is uncertain and can’t find the right signs, contact Poison Control.

Facts About Xanax Overdose Deaths

Deadly Xanax effects result in a significant number of overdoses each year. According to Xanax OD deaths statistics compiled by the CDC, the medication has been in the top 5 causes of overdose deaths since 2010. Xanax overdose death was particularly likely when the medication was taken in conjunction with hydrocodone, oxycodone, and methadone. Alcohol is also a common contributor to fatal OD cases, being involved in about 22% of deaths related to the drug.

How to Prevent Taking Too Much Alprazolam?

Alprazolam OD prevention requires taking a few simple actions. First, the patients must always be honest with their doctor about the other medications they are taking. The patient should always list the medications they use, including over-the-counter drugs, and those only used occasionally. This will significantly reduce Xanax OD dangers.

Patient consults a doctor about Xanax overdose dangers.

Second, the patient needs to avoid drinking alcohol and the use of any recreational drugs when taking Xanax. The exact Alprazolam and alcohol OD amounts vary from person to person, so there is no safe limit. Third, the patient should only take the medication as prescribed and work with their doctor to eliminate its use as soon as possible to avoid building up tolerance to Xanax. Finally, any unused medication should be disposed of properly to prevent others from gaining access to it.

Remaining Safe When Prescribed Xanax

Every patient using Alprazolam must know how to recognize the signs and symptoms of a Xanax overdose. The earlier the signs and symptoms are spotted, the better the chances of survival will be. Of course, prevention is always better than cure, so the patient should always use the medication as prescribed, avoid drugs and alcohol, and inform their doctor of any other medications they are taking. As the medication risks increase the longer it is used, it is best to avoid long-term treatment with Xanax.

For those who have already developed tolerance and addiction to the drug, different treatment options are available. It’s important to go through the detox program as soon as possible before the drug takes over one’s life. Alprazolam withdrawal must be easier with the right medical and psychological support.


Page Sources

  1. National Drug & Alcohol Research Centre. Xanax overdose and related deaths - a podcast. https://ndarc.med.unsw.edu.au/blog/xanax-overdose-and-related-deaths-podcast
  2. National Vital Statistics Report. Drugs Most Frequently Involved in Drug Overdose Deaths: United States, 2010–2014. 2016. https://www.cdc.gov/nchs/data/nvsr/nvsr65/nvsr65_10.pdf
  3. Michael Kang; Michael A. Galuska; Sassan Ghassemzadeh. Benzodiazepine Toxicity. 2020. https://www.ncbi.nlm.nih.gov/books/NBK482238/
  4. Geoffrey K Isbister, Luke O'Regan, David Sibbritt, and Ian M Whyte. Alprazolam is relatively more toxic than other benzodiazepines in overdose. 2004. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1884537/
  5. FDA. Xanax Label. https://www.accessdata.fda.gov/drugsatfda_docs/label/2016/018276s052lbl.pdf
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  7. U.S. National Library of Medicine. Alprazolam https://medlineplus.gov/druginfo/meds/a684001.html

Published on: April 10th, 2018

Updated on: January 19th, 2021

About Author

Nena Messina, Ph.D.

Nena Messina is a specialist in drug-related domestic violence. She devoted her life to the study of the connection between crime, mental health, and substance abuse. Apart from her work as management at addiction center, Nena regularly takes part in the educational program as a lecturer.

Medically Reviewed by

Michael Espelin APRN

8 years of nursing experience in wide variety of behavioral and addition settings that include adult inpatient and outpatient mental health services with substance use disorders, and geriatric long-term care and hospice care.  He has a particular interest in psychopharmacology, nutritional psychiatry, and alternative treatment options involving particular vitamins, dietary supplements, and administering auricular acupuncture.