Xanax is a useful medication commonly used in the United States. It’s mainly used to treat anxiety disorders, which are among the most common mental health problems in the country. But Xanax may also be used as a recreational drug with alcohol-like effects. Xanax can be dangerous to abuse on its own, but it’s even more dangerous when mixed with other substances. Besides legal and widely decriminalized drugs like alcohol and marijuana, one of the most commonly used recreational substances is heroin.

Heroin is relatively cheap and widely available in the United States. For people who have developed a dependence on prescription opioids, heroin presents a cheaper alternative to maintain an opioid use disorder. Illicit heroin is unpredictable and may contain dangerous adulterants like the powerful synthetic opioid fentanyl.

As dangerous as heroin is on its own, When heroin and Xanax are mixed, it could cause serious side effects that would not be as intense if the drugs were used separately. But what are the dangers of mixing Xanax and heroin? How much is too much, and is there any safe amount? Learn more about Xanax and heroin and why they shouldn’t be mixed.

What Is Xanax?

Xanax is the brand name for the generic drug alprazolam. The active ingredient is a benzodiazepine, which is a class of drugs that work as central nervous system depressants. That means that they slow down activity in your brain and body by influencing naturally occurring chemicals called gamma-Aminobutyric acid (GABA). GABA is an important chemical messenger that’s responsible for rest, relaxation, and sleep. It also calms your nerves when it’s time to rest and recover. However, many people have disorders that cause their nervous system to work overtime so that their body’s natural chemicals aren’t enough to facilitate sleep and relaxation.

Xanax, like other benzodiazepines, binds to GABA receptors to increase the overall effectiveness of the natural chemical. With Xanax, GABA is more potent in causing sedation, hypnosis, and antianxiety.

Alprazolam was the 41st most popular drug in the U.S. in 2019. That year, 17,533,262 ​​were given out. It’s a useful medication for those who need it. The drug works in the body in a way that’s similar to alcohol and other depressants. In high enough doses, it can cause intoxicating effects similar to alcohol, including a relaxing high. However, it can also cause drowsiness, slurred speech, memory impairment, impaired motor skills, and passing out. Like alcohol, it can make driving and other activities dangerous.

How Does Heroin Work?

Heroin is a common name for a substance called diamorphine, which was once used for medical purposes in the United States. But its addictive potential caused it to be replaced by other options. Today it’s primarily used as an illicit recreational substance. Like other opioids, heroin works by mimicking naturally occurring chemicals in your brain called endorphins. Endorphins are designed to mitigate your body’s pain response. These chemicals can bind to receptors all over the body to stop pain signals from being sent and received.

Heroin is derived from morphine, which is remarkably similar to endorphins. So much so that the name endorphin comes from the term “endogenous morphine.” Heroin can bind to the same opioid receptors that endorphins bind with. The difference is that heroin is much more potent. Like other opioids, it stops pain, but it also causes an intense euphoric high, extreme comfort, a sense of bodily warmth, and sedation. It also causes the release of dopamine, which is your body’s primary reward and pleasure chemical.

These pleasant sensations cause heroin to be extremely addictive, quickly leading to a substance use disorder after a period of repeated use. Heroin addiction is notoriously difficult to overcome, but it can be treated.

What Happens if You Mix Xanax with Heroin?

Xanax and heroin can both be dangerous when they are used in heavy doses. Heroin is associated with thousands of overdose deaths each year. Even though Xanax is a relatively safe prescription, it can cause unpleasant or dangerous side effects in high doses. Benzodiazepines are generally not associated with fatal, accidental overdose deaths when they are taken on their own. But they can cause drowsiness, memory impairment, and poor motor functions that can lead to accidents. Still, very high doses can cause fatal consequences.

Even though Xanax and heroin are in separate drug classes, they can interact by causing a phenomenon called potentiation. Potentiation is when two or more similar drugs combine to create more intense effects in the body. Even though Xanax and heroin work differently, they have similar nervous system depressing effects.

When they are combined, they will slow down the nervous system more than they would separately. This can cause heavy intoxication and a loss of consciousness. Potentiation makes overdose more likely, and you may experience life-threatening symptoms. As your nervous system is affected, vital functions will be suppressed, including your breathing and heart rate. In many fatal cases of opioid and benzodiazepine overdose, death is caused by oxygen deprivation.

Are Benzos Responsible for Overdoses?

Heroin and opioids have drawn a lot of the focus in the opioid crisis, and with good reason. More than 70,000 overdose deaths in 2020 involved opioids, according to the Centers for Disease Control and Prevention. However, a surprising number of opioid overdoses also involved benzodiazepines. According to the National Institute on Drug Abuse (NIDA), 16% of opioid overdoses also involved benzodiazepines. Illicit heroin is extremely dangerous on its own, just because its potency is unpredictable and it may have dangerous adulterants added to it. But mixing it with benzos makes it even more dangerous.

Why Do People Mix Xanax and Heroin?

Even though mixing heroin and benzodiazepines is extremely dangerous, many people do it for various reasons. Xanax is a fairly common prescription drug in the United States, and it’s possible that many people mix the drug with heroin by accident. Someone with a Xanax prescription may be on the drug when they decide to heroin for recreational purposes, not realizing they will conflict.

Though some may mix the drugs by accident, others may combine them intentionally. Since combining Xanax and heroin can potentiate the two drugs, they may be mixed to create a unique high. This is usually done by people that underestimate the danger of mixing the two substances.

Does Xanax Prevent Heroin Withdrawal?

Benzodiazepines are sometimes used to alleviate some of the symptoms of withdrawal, particularly alcohol withdrawal. Some may misuse it to self-medicate for opioid or heroin withdrawal symptoms. Benzos can aid in treating alcohol withdrawal because the drugs work in a way that’s similar to alcohol. Since opioids are different in the way they work, benzos may not be as effective in treating opioid withdrawal symptoms. Xanax certainly won’t prevent you from experiencing opioid withdrawal. A doctor may prescribe similar medications during opioid withdrawal if you’re struggling with anxiety, panic, or insomnia, but only after you’ve stopped taking heroin.

What Else Is Dangerous When It’s Mixed With Xanax?

Heroin isn’t the only substance that can be dangerous when it’s mixed with Xanax. When your doctor prescribes the drug to you, it’s a good idea to ask them about counter interactions, which are other treatments that may clash with Xanax. You can also read the label or talk to your pharmacist about substances you should avoid while taking Xanax. However, there are several drugs that can react in a way that’s similar to heroin when mixed with Xanax. Here are some substances to avoid:

  • Prescription opioids. Drugs like oxycodone and hydrocodone are used in opioid pain prescriptions, and they work in the body similarly to heroin. Mixing prescription opioids with Xanax can have similar effects on the body as mixing in heroin.
  • Other benzodiazepines. Of course, taking Xanax with other benzodiazepines can be dangerous and lead to an overdose. Other common benzodiazepine brands include Halcion, Valium, Ativan, and Klonopin.
  • Alcohol. Alcohol should be avoided when taking any one of several prescriptions. Alcohol is hard on the liver, and drugs processed in the liver could put extra stress on the organ. But alcohol also works in the brain in a way that’s similar to benzodiazepines, so mixing them risks an overdose.
  • Barbiturates. Barbiturates were once widely used in the U.S., but benzos replaced them for many of their common uses. They are still used for some medical applications today. Since they are also central nervous system depressants, mixing them with Xanax can cause an overdose.

Is Any Amount Safe?

It’s possible to take both drugs in small enough doses that they don’t cause an overdose, but doing so isn’t worth the risk. Heroin is inherently unpredictable, so it’s hard for you to know if you’re using a safe amount, even when you’re using it by yourself. Adding Xanax to the mix makes it even more dangerous. Plus, instead of a euphoric high, you may be more likely to become drowsy or pass out.

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