Can You Overdose on Xanax: Signs, Symptoms, and Treatment

What you will learn

• Xanax is a benzodiazepine medication that’s used to treat anxiety, but it’s often abused for its calming effects.
• It’s possible to overdose on Xanax, especially with misuse or abuse.
• Xanax overdose can have lasting effects, including impaired brain function.
• Taking Xanax as directed and getting help for abuse and addiction is the best way to reduce Xanax overdose risks.

Xanax (alprazolam) is a benzodiazepine medication that’s used to treat anxiety disorders. It can be effective and safe when used as directed, but Xanax is often abused for its relaxation effects. Misusing or abusing Xanax, especially at high doses, can cause a potentially life-threatening overdose.

Learn more about the risks of Xanax overdose, its symptoms and treatment, and what to do if an overdose occurs.

What is Xanax?

Xanax is a benzodiazepine medication that’s prescribed for the treatment of anxiety or panic disorders. It’s occasionally used off-label for conditions such as premenstrual dysphoric disorder (PMDD) and certain phobias.

Xanax works by decreasing the excitation levels in the brain to relieve the symptoms of extreme anxiety or panic disorders. However, these calming effects can lead people to abuse Xanax and develop an addiction.

Can You Overdose on Xanax?

Xanax can be safe when taken at recommended doses provided by a doctor. However, it’s possible to overdose on Xanax in high doses or if Xanax is mixed with other depressants like opioids or alcohol. Xanax may have greater toxicity and mortality risks than other types of benzos.[1]

What Does a Xanax Overdose Look Like?

Xanax overdose symptoms can present differently depending on how much was taken, your individual tolerance, and whether other substances were involved. The common Xanax overdose symptoms include:[2]

• Altered mental status
• Impaired coordination and movement
• Slurred speech
• Slowed or stopped breathing

In severe cases, breathing can stop entirely, causing respiratory arrest, coma, or death. This doesn’t often occur with Xanax alone, but it’s more likely when Xanax or other benzodiazepines are taken in conjunction with alcohol, opioids, or other depressant drugs.

These side effects of too much Xanax are more likely in people who abuse the drug or obtain counterfeit pills laced with other depressants like fentanyl. In many cases, the person didn’t realize they were combining fentanyl with Xanax, as they purchased counterfeit Xanax on the illicit market.[3]

What to Do if Someone Overdoses on Xanax

Xanax overdoses are a medical emergency and require immediate medical attention. If you think someone is experiencing Xanax overdose effects – or any other type of overdose – call 911 immediately. A Xanax overdose can be treated with rapid medical intervention.

If you suspect that an opioid is involved, you can administer naloxone if you have it. This prescription medication can block opioids and reverse their effects. If they haven’t taken an opioid, it won’t help the overdose, but it doesn’t cause any harm.

How Much Xanax Does It Take to Overdose?

There’s no specific threshold for a Xanax overdose because it depends on your tolerance and other factors. However, overdose risk is increased when you take more than your prescribed dose, you mix Xanax with other substances, particularly other central nervous system depressants like fentanyl, heroin, or alcohol, or you use it recreationally or without medical supervision.

Answering “How many mg of Xanax is too much?” isn’t easily defined, as it varies. Even small increases over the prescribed dose can be dangerous, especially in people with a low tolerance or when combined with other sedatives.

Xanax Overdose Treatment

If someone overdoses on Xanax or other benzos, medical professionals will provide the appropriate care based on their condition and history. Often, this includes supportive care, such as fluids, intubation to maintain an open airway, and mechanical ventilation.[4]

In some cases, a drug called flumazenil may be used to reverse benzodiazepine sedation.[5] This drug works a little differently from naloxone, however, and must be used with caution. It can cause acute benzo withdrawal symptoms, including life-threatening seizures.

Xanax Addiction and Overdose Statistics

Xanax addiction and drug overdoses are on the rise. The Drug Enforcement Agency reports that Xanax is one of the most common benzodiazepines on the illicit market, increasing the risk of addiction and abuse.[6]

Illegal benzos have been involved in more overdoses in recent years, with a 519% increase in overdose deaths from 2019 to 2020.[7] In 2021, nearly 14% of overdose deaths involving opioids also involved benzos.[8] Research shows that people who use opioids and benzos concurrently are at a higher risk of visiting the emergency department, being admitted to a hospital for a drug-related emergency, and dying of a drug overdose.

Risk Factors for Xanax Overdose

Several risk factors increase the likelihood of a Xanax overdose, including:

• Using Xanax with other substances, particularly depressants
• Buying illicit Xanax, which may contain dangerous contaminants like fentanyl, without your knowledge
• Taking too high a dose of benzos
• Combining benzos and opioids, whether prescription or illicit

Long-Term Impact of Xanax Overdose

It’s possible to recover from a Xanax overdose with medical intervention. During an overdose, the slowed or stopped breathing reduces the amount of oxygen that reaches the brain, causing a condition known as hypoxia. Like opioids, benzo overdoses can cause irregular breathing, followed by cyclic breathing and gasping.[9] Without reversal, the breathing stops entirely, causing hypoxia, brain injury, and problems with memory and concentration.

Hypoxic brain injury can occur with just one severe overdose, but multiple overdoses increase the injury over time and may produce long-lasting effects, especially if they occur close together.[10] In severe cases, hypoxic brain damage can leave someone in a vegetative state, but there can be milder lasting effects like:[11]

• Headache
• Poor coordination
• Poor balance
• Vision problems
• Recurrent seizures
• Difficulty forming sentences
• Confusion
• Trouble communicating
• Difficulty with reason, focus, and logic
• Poor memory
• Changes in sensory perception
• Trouble speaking and swallowing
• Changes in sleep patterns
• Changes in sexual function
• Motor impairment
• Personality changes
• Mood swings
• Depression
• Disorientation
• Inappropriate behavior

Tips to Prevent Overdose

Overdoses can occur for various reasons. Here are some ways to reduce the risk of Xanax overdose:

• Take your Xanax only as prescribed, never in larger doses or more frequent doses
• Do not take Xanax without a prescription
• Don’t obtain Xanax from illicit sources
• Do not mix Xanax with other depressants like opioids or alcohol

Seeking Treatment for Xanax Addiction

Xanax overdoses are more likely to occur if you misuse, abuse, or become addicted to Xanax. If you’ve experienced a Xanax overdose or struggle with Xanax abuse or addiction, it’s crucial to get help as soon as possible. The longer you abuse Xanax, the more likely you are to experience an overdose or other adverse effects.

The first step is getting an evaluation from an addiction treatment professional to determine the extent of your substance use disorder. This may include details about your substance use history, medical history, and treatment goals to choose the best treatment for your current circumstances.

Often, the first step in benzo addiction treatment is detox to manage Xanax withdrawal. Benzo withdrawal can have potentially life-threatening symptoms like seizures, but detox offers medical support and supervision to reduce the likelihood of complications and alleviate your symptoms.

Detox can form a strong foundation for addiction recovery, but it’s not enough on its own. You may need a complete addiction treatment program to address the underlying causes of addiction, which may include counseling sessions, behavioral therapies, and support groups.

Don’t Wait to Get Help

Xanax overdoses aren’t as common as opioid overdoses or other types of overdoses, but they’re no less concerning. Xanax can have a greater risk of toxicity and mortality than other benzos, particularly when mixed with other drugs. If you misuse Xanax or feel you struggle with Xanax abuse or addiction, it’s important to seek help as soon as possible to reduce the risk of Xanax overdose and other adverse effects.

Amanda is a prolific medical content writer specializing in eating disorders and addiction treatment. She graduated Magna Cum Laude from Purdue University with a B.S. in Social Work. Read more