The act of taking stimulants and depressants—that is, “uppers” and “downers”—in combination, has been done for generations. Users engage in this form of polysubstance abuse to take the edge off a stimulant high or extend the sensation of euphoria. They also do it in the hopes of having the drugs counteract each other’s negative effects.

A host of celebrities engaged in this sort of polysubstance abuse and paid for it with their lives: Elvis Presley, Whitney Houston, Philip Seymour Hoffman, Chet Baker, and River Phoenix, to name a few.

One upper-downer combination that has become increasingly commonplace is the abuse of cocaine and Xanax. One drug is almost solely used as a recreational drug, while the other is prescribed as an anti-anxiety medication. Because doctors prescribe Xanax, people mistakenly view it as a safe drug, effectively underestimating its ability to aid in overdose and death.

In fact, abusing Xanax with any sort of stimulant is simply a bad and deadly idea.

What Is Xanax and Why Is It Abused?

Xanax, the brand name for the drug alprazolam, belongs to a class of drugs known as benzodiazepines. The U.S. Food and Drug Administration (FDA) approved Xanax in 1981. When it hit the market, it became the first drug approved for treating panic attacks. Since its introduction, Xanax has become a mainstay in the treatment of psychiatric disorders. It is one of the most prescribed drugs in the U.S., along with Klonopin, Ativan, and Valium.

Doctors prescribe Xanax specifically to treat anxiety disorders, panic attacks, and anxiety that comes from depression. Xanax is intended for short-term use and can be taken as a tablet, disintegrating tablet, or liquid. The tablet form comes as an immediate-release (IR) or extended-release (XR) medication.

Like other benzodiazepines, Xanax binds to the gamma-Aminobutyric acid (GABA) receptors and induces feelings of calm, relaxation, and sleepiness. GABA receptors are neurons that compose part of the brain’s reward system. When GABA is activated, it causes the release of chemicals like dopamine and serotonin, which are associated with elevated mood.

Because Xanax impacts the brain’s reward system so profoundly, people feel compelled to abuse it. When combined with a stimulant like cocaine, the likelihood of addiction is heightened.

Is Xanax an Upper or Downer?

Cocaine is a powerful stimulant, also called an upper. Mixing similar drugs can risk an overdose, so is Xanax an upper or a downer? Xanax (alprazolam) is a downer, which is also called a central nervous system depressant. It works similarly to alcohol by slowing down activity in your nervous system. This can cause drowsiness, sedation, and relaxation. In many ways, Xanax is in a category that is the chemical opposite of stimulants like cocaine.

However, that doesn’t mean they cancel each other out. Mixing the two together can still put stress on your body and lead to overdose symptoms and toxicity for different reasons than when two similar drugs are mixed together.

What Cocaine Addiction Looks Like

Derived from the leaves of a plant found mostly in South America, cocaine has been around in some form for thousands of years. The stimulant is so old that its use and function have become cloaked in myth.

The white powder form of cocaine, cocaine hydrochloride, was originally formulated in the late 19th century. It is the version that is the most popular and recognizable. The most common cocaine ingestion method is snorting. Users also rub it in their gums or dissolve it in water to inject it. It can also be smoked as crack cocaine. Crack cocaine is processed with baking soda or ammonia and is ingested this way.

When cocaine enters the body, it binds to the dopamine transporter. This action also stimulates the brain’s reward pathway, causing a rapid buildup of dopamine and producing a short, intense burst of euphoria. When users crest on a cocaine high, they feel happy, energetic, alert, and sociable. But that high burns out quickly due to the drug’s brief half-life. This requires users to take more and more of it to recapture that sensation. Recreational users will take cocaine with alcohol or Xanax to extend or amplify its effects.

By combining substances, they also subject themselves to life-threatening withdrawal and overdose symptoms.

The Dangers of Taking Cocaine While on Xanax

Cocaine and Xanax are mind-altering substances that completely rewire your brain. When combined, the effects they have on your body, particularly the cardiovascular system is disastrous. There is no safe amount you can take that won’t produce withdrawal symptoms and effects that range from uncomfortable to downright deadly.

Xanax can be addictive when it is taken beyond a recommended time frame. It can also hook people who take it as prescribed. Xanax causes the following benzodiazepine withdrawal symptoms:

  • Anxiety
  • Worry
  • Panic attacks
  • Spasms
  • Tremors
  • Hyperventilation
  • Sleep disturbances
  • Muscle spasms
  • Weight loss
  • Anorexia
  • Visual disturbances
  • Altered mood
  • Excessive sweating

Severe withdrawal symptoms can also include delirium, seizures, and psychotic symptoms.

When cocaine is added to the mix, those effects are amplified. Xanax and stimulant use can also produce symptoms such as depression, anxiety, and sleep disturbances. Because cocaine at high doses can act as a sedative, adding Xanax to the mix can result in respiratory depression and over-sedation. Ultimately, if someone unknowingly takes too much of both substances, the result can be overdose:

Signs of an overdose on Xanax and/or cocaine include the following:

  • Mental confusion
  • Irregular heart rate
  • Disrupted breathing
  • Drowsiness and sedation
  • Nausea and vomiting
  • Tremors or seizures
  • Extreme mood changes
  • Coordination and balance issues

Thus, mixing Xanax with stimulants will produce this push-pull effect on the heart that is ultimately injurious and debilitating. It’s worth noting that if you are abusing Xanax and/or cocaine with alcohol, it can also have a toxic effect on the heart.

Why Do People Mix Cocaine and Xanax?

Even though mixing drugs can be potentially dangerous, cocaine and Xanax may be mixed for various reasons. One potential reason may be accidental mixing. Xanax may be prescribed for several days or weeks, long enough to become a normal part of your everyday activity. If you go about your life and encounter cocaine, you may take it, forgetting that it can clash with your prescription medication.

If you have a substance use disorder that involves cocaine or other stimulants, you may find it difficult to quit taking it, even if you’re prescribed a medication that could clash with it. If this is the case, you may need to seek treatment for your substance use issues before or while taking medication.

In many cases, Xanax is mixed with powerful stimulants like cocaine to achieve a unique high. Cocaine can cause intensely euphoric effects, including excitement and a sense of empowerment. But it can also cause unpleasant symptoms, such as anxiety, panic, paranoia, insomnia, and jitteriness. Some cocaine users try to avoid these side effects by mixing them with drugs that might have counteracting effects.

The idea is to counteract the stimulant with a drug that has depressant-like qualities. Alcohol, benzodiazepines, and barbiturates are depressants because they slow activity in the brain and body. Since Xanax is used to treat panic and anxiety disorders, it may be used to alleviate the anxiety that is often caused by cocaine. However, Xanax may mask some of the effects of cocaine, causing you to take higher doses than you can take safely.

Coke and Xanax Effects on the Liver

Cocaine and Xanax don’t potentiate one another as Xanax can with depressants like alcohol. The danger of mixing cocaine and Xanax comes from the way Xanax can mask the effects of high doses of cocaine. However, they do interact in another way. Cocaine can be toxic to your liver in high doses. This is thought to be caused by a metabolite of cocaine, which is a chemical formed when cocaine is broken down. These metabolites can be toxic to the liver and in other areas of the body. High doses of cocaine can damage your liver, and long-term cocaine abuse can lead to liver disease.

However, benzodiazepines can also be damaging to the liver in high doses. Xanax is rarely associated with liver problems, but some cases have been reported. Liver damage from Xanax may be more likely if the drug is used in high doses for too long.

Mixing Xanax and cocaine may also cause dangerous effects on your liver. Very high doses of one or both drugs can cause acute overdose symptoms and may be toxic. However, liver damage may be even more likely if you mix the drugs regularly for a long time.

Signs of Dependence and Addiction

The dangers of taking both drugs lie in how quickly they produce dependence and addiction. When someone becomes dependent on Xanax and stimulants, they will take more of the drugs to achieve the desired high that a previous dosage yielded. They will not feel normal without both substances existing in their body.

When that dependence morphs into addiction, which happens rather quickly with both substances, users will exhibit compulsive behaviors around obtaining the drugs. They will also use both in the face of adverse circumstances. They will likely isolate themselves from family, friends, and colleagues. They will also exhibit extreme mood swings. Someone who is addicted to Xanax will display these observable signs:

  • Memory problems
  • Withdrawal symptoms when not using
  • Frequent periods of confusion
  • Paranoia
  • Depression
  • Headaches
  • Nausea and vomiting
  • Tremors
  • Excessive drowsiness
  • Noticeably altered sleep patterns
  • Swollen arms and legs
  • Chronic dry mouth

While cocaine can cause agitation, anxiety, and paranoia, other behavioral signs of cocaine addiction may include:

  • Excitability
  • Irritability
  • Risky behavior
  • Talkativeness
  • Poor hygiene
  • Financial instability
  • Changes in sleep patterns

If you or someone you care about is exhibiting any of these signs, it is imperative that you undergo professional addiction treatment.

Why Addiction Treatment Is Crucial

Professional addiction treatment begins with medical detoxification. It is the most critical step of your recovery journey.

In detox, Xanax, cocaine, and other toxins will be safely removed from your body. A medical staff will monitor you 24 hours a day for any complications that result from withdrawal. They will ensure that your detox is safe and comfortable. This process can last up to seven days or longer depending on the severity of one’s addiction.

The next step in your recovery is to enter ongoing care at a treatment facility. The best treatment option for people who have engaged in polysubstance abuse is residential treatment. In residential treatment, you will stay in a facility, receive comprehensive treatment and counseling tailored to your needs. Counselors and therapists will help you get to the root of your addictions. Residential treatment typically lasts 30-to-90 days, but a 90-day stay is most effective in helping you attain sustained sobriety.

If our team believes that you can undergo treatment while living at home, they may recommend an outpatient treatment program.

Our team will help coordinate your aftercare once residential treatment is completed.

Xanax and Cocaine Statistics

  • The cocaine-related overdose death rate from 31 states increased by 52.4 percent from 2015 to 2016, according to the U.S. Centers for Disease Control and Prevention (CDC).
  • According to the National Institute on Drug Abuse (NIDA), there were 14,556 overdose deaths involving cocaine in 2017.
  •  In 2016, there were 10,684 overdose deaths from benzodiazepines like Xanax.
  • There were 1.2 million emergency room visits that involved the non-medical use of pharmaceuticals, according to the National Institute on Drug Abuse.
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