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The Dangers of Mixing Xanax and Codeine

Medically reviewed by

Isaac Alexis, M.D., AAMA, AMP-BC

January 23, 2019

Both Xanax and codeine are commonly prescribed drugs in the United States. As central nervous system depressants, both drugs can cause similar effects on the body despite being prescribed for different reasons. The combination of Xanax and codeine, however, can be far more dangerous than most people would think.

Xanax: What You Should Know

Xanax is a common brand of alprazolam which is a type of anti-anxiety medication. Xanax is in a category of drugs known as benzodiazepines, which is essentially a light tranquilizer that has anti-anxiety, sleep inducing, sedative, muscle relaxant, and anticonvulsant effects on the body. Xanax and other types of benzodiazepines can be prescribed to treat panic attacks, anxiety, and sometimes depression and seizures.

While benzodiazepine addiction has not made the news like the opioid epidemic has, they are still a very dangerous and addictive type of drug. Benzodiazepines like Xanax bind to benzodiazepine receptors in the brain that can cause some signals sent by neurotransmitters to become slow or blocked, resulting in a calming or relaxing effect.

Benzodiazepine receptors can adapt quickly to the elevated levels of the drug when it is consumed. This adaptation can result in a tolerance being built to the drug, rendering a ‘typical’ dose too weak to have the same effect on the body as it did before. Tolerance adds to the cycle of addiction, causing the user to take larger doses more frequently. Withdrawal symptoms can occur after prolonged use, making it even harder to stop taking the drug.

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What Is Codeine?

Codeine is a widely prescribed opioid – so widely prescribed that it is considered to be the most commonly taken opioid. The World Health Organization even lists codeine as an essential medication to carry on hand at a hospital. Codeine is commonly sold under the brand names Tylenol-Codeine No.3, Tylenol-Codeine No.4, and Vopac.

As a member of the opioid family, codeine carries with it a high risk of dependency. Similar to the way that a benzodiazepine interacts with your brain, opioids also bind to opioid receptors to inhibit or slow the sending and receiving of signals sent by neurotransmitters to relay feelings of pain, stress, anxiety, etc. This effect is often what individuals who abuse the drug recreationally are after.

It is a common myth that codeine is a ‘safe’ opioid to take. While it is not one of the more potent types of opioid, it does still carry with it the same risks as other opioids on the market. Codeine has the same potential for tolerance and dependency as Fentanyl, the strongest opioid available. While its effects may not be as intense, it is still possible to overdose on codeine, especially when taking it against what as prescribed, or when combining it with another drug.

Side Effects Of Mixing Xanax And Codeine

Both Xanax and codeine are considered central nervous system depressants, which can affect many vital functions such as blood pressure, heart rate, and respiration rate. This effect has also gained these drugs the term ‘downer’, of which the opposite would be an ‘upper’ such as caffeine or cocaine.

Common side effects of abusing Xanax and codeine include:

  • Drowsiness
  • Dizziness
  • Slurred speech
  • Inhibited motor skills
  • Inability to make sound decisions
  • Hand tremors
  • Night sweats
  • Slowed or limited breathing
  • Slowed heart rate
  • Sudden change in blood pressure
  • Anxiety, depression
  • Mood swings

When you consume a downer with another downer, it is more than just 2x the effectiveness of only consuming one downer. Combining two drugs like Xanax and codeine can cause the effects on your central nervous system to increase exponentially. This increase can quickly lead to accidental overdose as it can be difficult for individuals under the influence of the drugs to perceive the changes happening in with their vital functions and nervous system.

Accidental Overdose From Mixing Codeine And Xanax

With drugs like codeine and Xanax, your body can quickly build a tolerance to the effects of the drugs. This means a higher dose is needed to achieve the same effects as the first dose of the drug. Tolerance can occur even when a drug is taken exactly as prescribed, which is why doctors may change the dose they prescribe to a patient from time to time.

When this tolerance occurs, the individual taking the drug is often tempted to think that it isn’t working. Unfortunately this is a myth as just because you are not feeling the effects of the drug does not mean it isn’t having subconscious effects like decreasing your heart rate or slowing your breathing.

Sometimes individuals are tempted to take more of the drug if they believe the first dose did not work. Additional doses can be very dangerous as they continue to depress your central nervous system which affects breathing, heart rate, blood pressure, reaction times, pain tolerance, memory, and ability to make sound decisions. Additionally, the calmer or more sluggish an individual becomes, the less likely they are to notice some of the changes occurring in their bodies. Death can occur quickly and quietly in circumstances such as this.

Accidental overdoses are unfortunately not uncommon, especially in opioids like codeine. While there are drugs available, such as Narcan, that can reverse the effects of an opioid overdose, they have to be administered within a certain window of time to be effective. Additionally, with chemical dependencies drugs like codeine and Xanax, the danger of overdose is usually not enough to pull an individual out of the grips of addiction.

Get Help With Codeine and Xanax Abuse

If you are battling addiction, you do not have to struggle alone. We have a team of addiction treatment specialists that provide support and answers around-the-clock for individuals who are personally struggling with addiction or who have loved ones who are struggling. Our specialists are experts when it comes to getting you the help and support you need to begin your journey to recovery. Contact us today.

Drugs.com - Xanax

Drugs.com - Drug Interactions Between Codeine And Xanax

MedicineNet - Acetaminophen/Codeine

MedlinePlus.gov - Codeine

Yale Journal of Biology and Medicine (via NCBI) - Prescription Sedative Misuse and Abuse

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