Xanax And Fentanyl: Dangers Of Mixing Alprazolam And Fentanyl

Medically Reviewed by Johnelle Smith, M.D. on December 14, 2020

Mixing fentanyl and Xanax can have deadly effects. People who struggle with substance use of one or more drugs can find treatment options before risking fatal overdose, long-term addiction, or other serious side effects.

Mixing Xanax And Fentanyl

Combining Xanax and fentanyl through polydrug abuse (abuse of two or more drugs at one time) can have serious side effects.

Fentanyl is a synthetic opioid often used to treat chronic pain that is between 80-100 times more potent than morphine. Because of its potency, fentanyl is highly sought by people with opioid addiction.

The opioid epidemic in the United States has led to abuse of more easily accessible opioids than illegal drugs like heroin, such as prescription opioids.

Though opioid prescription drugs like oxycodone and Percocet have been more regularly used as drugs of abuse, fentanyl has had higher instances of abuse in the past few years.

Its potency also makes it a highly dangerous opioid to abuse—especially when mixed with benzodiazepines (benzos).

Xanax (alprazolam) is a benzodiazepine that suppresses the central nervous system. Although Xanax is legally used to treat anxiety as a prescription drug, it can be deadly when used with opiates like fentanyl.

Benzos like Xanax pills are often used to amplify the high of fentanyl and alleviate the negative symptoms of short-term withdrawal.

However, people can quickly develop a dependency, long-term health symptoms, and increased risk of overdose when abusing fentanyl and Xanax. The following are some of the highest risks associated with abusing Xanax and fentanyl and treatment options for polydrug abuse.

Increased Risk Of Overdose

Both fentanyl and Xanax depress heart and lung activity and can cause death due to opioid overdose. When taken together in excess, heart attacks and respiratory failure can result in death or coma.

Xanax overdose most commonly occurs when taking the drug with other depressants, where it can cause vital systems to shut down. Counterfeit Xanax is also a contributing factor to these overdose deaths. Counterfeit pills may be stronger than true prescription medications.

Overdose from real or fake Xanax pills may result in these symptoms:

  • shortness of breath or inability to breathe (which can lead to pneumonia or death)
  • coma
  • tremors
  • weakness
  • loss of coordination
  • blurred vision and extreme dizziness

A fentanyl overdose can be recognized by the following symptoms:

  • changes in pupil size (pinpoint pupils)
  • cold or clammy skin
  • drowsiness, lethargy, and confusion
  • coma
  • decreased respiration rate/labored breathing (respiratory depression)
  • agitation and confusion

Risk Of Developing Addiction Or Dependency

When used together, Xanax and fentanyl flood the brain with serotonin and GABA neurotransmitters, producing a more intense-feeling opioid high. The high produced by fentanyl is very addictive and can result in physical and chemical dependency.

Heroin and morphine are well-known for being highly addictive drugs. Fentanyl is 50 times more potent than heroin. Dependency easily occurs when the body expects the dopamine rush and “reward” associated with drug use.


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Xanax and other benzos lessen the anxiety and negative feelings a person experiences when undergoing fentanyl withdrawal symptoms.

Xanax does not directly release dopamine like opioids, but it is still highly addictive. New studies suggest that benzos limit the brain’s ability to restrain dopamine release, causing a reward pathway.

Long-Term Effects Of Xanax And Fentanyl Abuse

When misused and abused, fentanyl and Xanax have severe long-term effects on the body and mind. We know that overdoses can result in coma and death and polydrug abuse complicates perceptions of drug tolerance, which can result in an overdose.

Some long-term effects of polydrug abuse involving opioid painkillers can be reversed with time in detox and rehabilitation. Other long-term effects permanently impact a person’s health and life.

Effects On The Brain And Body

The most serious, long-lasting effect of fentanyl abuse is irreversible brain injury sustained from respiratory system depression. This can cause dementia-like, permanent memory loss.

Long-term fentanyl abuse can negatively impact the body and mind:

  • cardiovascular system: low blood pressure, weakened heart valves, irregular heartbeat, heart attack, stroke
  • immune system: increased risk of cancers, infections
  • multiple organ system damage: commonly impacts kidney and liver function
  • constipation
  • memory loss and irritability
  • increased risk of chronic depression and pain sensitivity

Long-term abuse of Xanax can make its effects less potent. This makes people more likely to increase their dosage, which only amplifies long-term negative effects.

Long-term effects of Xanax abuse may include:

  • depression
  • irritability
  • concentration issues
  • breathing trouble
  • hallucinations
  • mania
  • suicidal ideas
  • cardiovascular palpitations and rapid heart rate
  • liver damage
  • long-term memory loss

Experiencing Withdrawal Symptoms

Withdrawal symptoms for both Xanax and fentanyl can be intense and very unpleasant. Benzos are occasionally prescribed to alleviate some symptoms of opioid withdrawal (like anxiety and irritability). However, a person who is addicted to both substances will have a more complicated detox.

Xanax withdrawal typically begins after a full day without the drug. Withdrawal symptoms can last anywhere between a few days and a few months—depending on the severity of drug use.

Xanax withdrawal can include very unpleasant side effects like:

  • seizures
  • irritability
  • sweats
  • erratic behavior
  • hallucinations
  • heart palpitations

Fentanyl withdrawal can occur up to two days after the last dose. However, withdrawal combined with full detox may last longer.

It is common for some detox regimens to include supervised use of methadone to assist in a more prolonged opioid taper.

Fentanyl withdrawal symptoms include:

  • chills and flushing
  • irritability
  • insomnia
  • vomiting, nausea, and diarrhea
  • increased blood pressure and heart rate
  • depression
  • general pain and weakness

Withdrawal from both Xanax and fentanyl can become dangerous and may lead to death when a person attempts to taper off of their drug of choice while unsupervised.

If an addicted person develops a lower tolerance for fentanyl and misjudges their Xanax or opioid dose, then overdose is more likely to occur.

Other Effects Of Polydrug Abuse

A person suffering from polydrug addiction to drugs like opioids and benzodiazepines may quickly lose impulse control to sustain their high. People who abuse drugs may become more prone to drug use from drug dealers.

Addicted people may put themselves in dangerous situations in an attempt to get drugs. They may also make poor decisions like theft or manipulating friends and family to gain access to drugs. Personal connections may fall apart and isolation can become the norm.

People who crush Xanax or process fentanyl to snort will experience an immediate rush. They also risk damage to the nose and mouth. Perforated septums and palates can occur. Loss of taste and smell can also happen.

Fentanyl taken intravenously is highly dangerous. Damage to veins and an increased risk of infection are early outcomes. Using shared or dirty needles can transmit serious needle-borne diseases like HIV/AIDS, Hepatitis B, and Hepatitis C.

Treatment Options For Opioid And Benzodiazepine Addictions

Addiction of any kind makes life more difficult. Living with an addiction to both opioids and benzodiazepines is a massive struggle, but substance abuse can be overcome. Life can get better with addiction treatment.

Do you need to stop using opioids and benzos? Do you have a loved one that is showing signs of drug addiction? We can help you.

Talk to one of our treatment specialists to learn more about addiction recovery. We can discuss the range of treatment options and drug treatment facilities to create lasting change.

By itself, fentanyl is highly addictive and dangerous. When fentanyl is combined with Xanax, the long-term risks, including overdose death, rise substantially.

Because of Covid-19, social distancing can create an environment of isolation where drug use increases. Don’t let drug abuse take over. Reach out to our helpline now to get started on the road to an addiction-free future.

This page does not provide medical advice. See more

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These include peer-reviewed journals, government entities and academic institutions, and leaders in addiction healthcare and advocacy. Learn more about how we safeguard our content by viewing our editorial policy.

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Medically Reviewed by
Johnelle Smith, M.D. on December 14, 2020


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