Medically Reviewed

Xanax Overdose: Signs, Symptoms & Treatment

Xanax, or alprazolam, is a type of benzodiazepine approved for the treatment of generalized anxiety disorder and panic disorder.1 Benzodiazepines like Xanax are central nervous system (CNS) depressants and are widely prescribed for their calming, anti-anxiety properties.

It is possible to experience Xanax toxicity or overdose. At high enough doses, people may experience life-threatening symptoms or death.2 When taken with other substances, such as alcohol or opioids, overdose symptoms such as significantly slowed breathing and airway compromise become more likely.2

Although Xanax can be helpful when taken at recommended doses by those its prescribed to, the drug may have relatively greater toxicity and mortality risks in overdose than other types of benzodiazepines.3

This page will cover symptoms of a Xanax overdose, what to do if someone is overdosing on Xanax, and how Xanax overdose is treated.  Here, you can learn Xanax overdose rates, the risk factors for overdose, and how to prevent overdoses on this drug in the future.

If you think that you or your loved one has a problem with compulsive Xanax misuse, American Addiction Centers can help. Call

Xanax Overdose Symptoms

Someone overdosing on Xanax or another benzodiazepine may exhibit certain classic symptoms, including:3,4

  • Altered mental status.
  • Impaired coordination and movement (ataxia).
  • Slurred speech.
  • Slowed or stopped breathing.

In cases of overdose, CNS depressants like Xanax can lead to respiratory arrest, decreased delivery of oxygen to the brain, and resultant hypoxic brain injury, coma, and death.4 Though such pronounced benzodiazepine toxicity seldom occurs in instances of benzodiazepine use alone, the risk greatly increases with concurrent use of another substance, such as alcohol, opioids, or other sedating drugs.2

Many of the fatal overdoses involving benzodiazepines also involve opioids. A report on U.S. overdose trends between 2019-2020 found that nearly 93% of benzo overdose deaths also involved an opioid.5 More specifically, illicit versions of the powerful synthetic opioid fentanyl were found to play a role in a little over 66% of these benzodiazepine overdoses.5

To learn how to spot an opioid overdose—which can include signs such as profoundly decreased levels of consciousness, as well as shallow or stopped breathing—visit our opioid overdose page.6

In some instances of polysubstance overdose, people combining opioids like fentanyl with Xanax may be inadvertent. For example, the DEA reports that some counterfeit Xanax sold on the illicit market contains fentanyl, and people could unknowingly ingest both of these substances.6

If you or a loved one are overdosing on Xanax, opioids, or any other drug, call 911 immediately or seek medical help at once.

What to Do if Someone Overdoses on Xanax

A Xanax overdose is an emergency that requires immediate medical attention. If you suspect someone is experiencing any type of overdose, you should act quickly and immediately call 911 so that first responders can treat the individual with airway management and other lifesaving measures.4

Xanax Overdose Treatment

When a person overdoses on Xanax or any type of benzodiazepine, clinicians will use their best judgment to understand which treatments constitute the best course of action for the patient. Typically, treatment for benzodiazepine overdose consists of supportive care, which could include intubation for airway management and mechanical ventilation, if needed.2

In more limited situations, those who are overdosing on benzodiazepines may be given a drug called flumazenil as an “antidote” to reverse benzo-activated sedation. Flumazenil administration is not without its own risks, because of it can precipitate acute benzodiazepine withdrawal symptoms, and increase the risk of life-threatening seizures in some people.2

Administration of active charcoal, hemodialysis, or whole bowel irrigation does not usually play a role in the treatment of Xanax overdose.

Regardless of what combination of drugs you think someone has taken, if you suspect that someone is experiencing any type of overdose, be sure to call 911 immediately.

Xanax Addiction & Overdose Statistics

In terms of addiction and drug overdoses, Xanax and other types of benzos showed alarming trends, such as:3,5,8,9

  • The U.S. Drug Enforcement Agency (DEA) reports that alprazolam is one of the most frequently diverted benzodiazepines on the illicit market.
  • Xanax may be more likely to cause serious harm in an overdose than other types of benzos.
  • The involvement of illegal benzos in drug overdoses skyrocketed, a 519% increase in overdose deaths from 2019-2020.
  • 10 times more likely to die of an overdose than those who just take opioids.

Risk Factors for Xanax Overdose

The major factor that increases the risk of a Xanax overdose is using Xanax with other substances, including alcohol. Other risk factors for overdose can include:2,5,6,10

  • Buying illicit Xanax, which can be laced with dangerous drugs that the consumer isn’t aware of, including fentanyl.
  • Taking too high a dose of benzos than is warranted for a given clinical condition.
  • Taking benzos at the same time as opioids, even by prescription.

Long-Term Impacts of Xanax Overdose

Most people recover from a Xanax overdose, with benzo overdoses without other substance involvement making up only about 7% of all fatal overdoses.5

If the brain is deprived of oxygen during a benzodiazepine overdose or an overdose involving a combination of benzodiazepines and other substances, a condition known as hypoxia may develop. When severe, hypoxia can lead to coma and other potentially persistent neurological injury.4

Is It Time for Rehab?

If you or your loved one experience a Xanax overdose, a thorough evaluation by a medical professional after you are medically stabilized may be recommended. For someone who fits the criteria of a substance use disorder, it will likely be beneficial to discuss their potential treatment options for substance use disorder recovery.

You don’t have to wait to seek help for substance abuse issues until experiencing something as dangerous and extreme as an overdose. No matter what severity your substance use disorder (even if you are unsure of whether you suffer from substance abuse issues), a thorough evaluation by an addiction treatment professional can help you better understand your current situation and what type of treatment you should receive.

If you are concerned about your use of Xanax, getting help and finding a Xanax rehab program could be your next best step. In some cases, unmanaged Xanax withdrawal can be dangerous. When a person has become dependent on Xanax or other benzos and is at risk for experiencing withdrawal, they may benefit from a supervised drug detox and medical withdrawal management.11

It is important to note that medically managed withdrawal alone is not considered complete treatment for a substance use disorder. Detox is only the first stage of treating dependence on a substance and serves to prepare people to seek further treatment that address other underlying issues associated with substance abuse, such as the social or psychological factors of addiction.11

Sources:

  1. National Alliance on Mental Illness. (2021). Alprazolam (Xanax).
  2. Kang, M., Galuska, M. A., & Ghassemzadeh, S. (2021). Benzodiazepine Toxicity. In StatPearls [Internet]. StatPearls Publishing.
  3. Brett, J., Murnion, B. (2015). Management of benzodiazepine misuse and dependence. Australian Prescriber, 38(5), 152-155.
  4. National Institute on Drug Abuse. (2018, March 6). Prescription CNS depressants: Drugfacts.
  5. Centers for Disease Control and Prevention. (2021, August 26). Trends in nonfatal and fatal overdoses involving benzodiazepines-38 states and District of Columbia, 2019-2020.
  6. U.S. Drug Enforcement Administration. (2021). Counterfeit pills.
  7. Centers for Disease Control and Prevention. (NIOSH). (2018, October 5). Opioids in the workplace: Responding to a suspected opioid overdose.
  8. National Institute on Drug Abuse. (2022, January 11). Naloxone: DrugFacts.
  9. U.S. Drug Enforcement Agency. (2020). Benzodiazepines.
  10. National Institute on Drug Abuse. (2022, April 21). Benzodiazepines and opioids.
  11. 11. U.S. Food and Drug Administration. (2011). Xanax.
Last Updated on August 9, 2022
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