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The Dangers of Mixing Methadone with Xanax

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

Medically reviewed by

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

January 17, 2019

Methadone and Xanax are both central nervous system depressants with a high potential for abuse and addiction. Taking these drugs together can intensify the effects and lead to several adverse health consequences including overdose.

These drugs work heavily upon a user’s brain. It’s this action which is responsible for both the pleasurable and addictive, life-threatening effects of these drugs. Within situations of abuse, each drug on its own can cause fatal levels of CNS depression. Together, this happens more quickly and heavily and can progress to fatal levels far more easily. The American Family Physician (AFP) warns that “an estimated 80 percent of benzodiazepine abuse is part of polydrug abuse, most commonly with opioids.”

What Is A Central Nervous System Depressant?

Our physical and mental health relies on several critical systems which keep things running smoothly and efficiently. The CNS is regulated by the brain and the spinal cord and is tasked with overseeing some very critical life support systems, such as:

  • Breathing (respiration)
  • Blood pressure
  • Heart rate
  • Temperature

Certain drugs slow, or depressed, the central nervous system. For this reason, they are referred to as CNS depressants. Both opioids and benzos are considered such. When CNS depression occurs, the aforementioned systems begin to function less optimally at reduced rates. Even with the prescribed use of these drugs, these effects occur.

When used as prescribed, opioid painkillers and benzodiazepine drugs can be used safely, with benefit to the patient’s life and health. However, when used together these drugs depress the user’s CNS in a way which increases numerous risks. Within situations of abuse or addiction, larger dosages of these drugs compound these risks.

What Is Methadone?

Methadone is a full opioid agonist like heroin. This means that it works by activating the opioid receptors in your brain to the fullest extent. This action is what causes CNS depression. It also produces the pain-relieving effects which are characteristic of all opioid drugs. But unlike heroin, it’s a medication with therapeutic value.

Methadone is used for two purposes: either as an analgesic (painkiller) for severe pain or as a medication used to treat opioid use disorders. In the latter case, it’s used to treat withdrawal and as maintenance, medication to help prevent relapse. Despite these uses, like heroin and other opioid narcotics, methadone can be abused in a way which leads to addiction.

Even though methadone was designed to have a decreased potential for abuse, far too many individuals misuse and abuse this drug. Methadone is long-acting, which means it gradually works to produce a steady level of the drug within your brain. Used properly, this design prevents the drug from creating a quick rush which illicit drug abusers seek. Unfortunately, when a person alters the prescribed dosage, they can overcome these features and achieve a pleasurable effect.

What Is Xanax?

Xanax is a high-potency benzodiazepine drug. As such, it is also a CNS depressant with a primary action as a sedative and anti-anxiety drug. Xanax too offers patients safe and effective treatment when used as prescribed. But, like methadone and many other prescription drugs, it’s widely abused.

Xanax has a high potential for abuse, namely due to its potency and short-half life. These attributes mean that it works rapidly and intensely, making it one of the most frequently abused drugs within this class. Xanax has another characteristic which makes it even more dangerous as a drug of abuse: like other benzos, Xanax is most commonly abused with other drugs, versus on its own.

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Why Do People Abuse These Drugs Together?

Polydrug abuse, or abusing two drugs at once, mainly occurs for two reasons. First, a person may seek to increase the high or euphoric effects of one drug by using another. Other people may use one drug to decrease the side effects associated with the first. Methadone and Xanax abuse follow the same path.

These polydrug abusers use these drugs to increase their high, with some reporting effects similar to heroin. On the other hand, some people may use Xanax to self-medicate symptoms of methadone withdrawal. Should these individuals relapse back to methadone use while Xanax is in their system, complications could arise.

The AFP comments on this abuse, noting that “studies indicate that from 5 percent to as many as 90 percent of methadone users are also regular users of benzodiazepines. High-dose benzodiazepine abuse is especially prevalent in patients who are taking methadone.” Despite this prevalence, this combination can be very harmful to your health and even jeopardize your life.

Is It Abuse If You Misuse Your Own Prescription?

Some individuals may actually have prescriptions for these two drugs. Many people mistakenly think that if they have a prescription their behaviors don’t count as abuse. This is untrue. As a person alters their dosage (even to address the condition for which the drug was originally prescribed) their risk for a substance use disorder rises. The hard truth is that prescription drug misuse can gain momentum over time and lead to addiction.

What Are The Risks Of Mixing Methadone And Xanax?

As we’ve discussed, both methadone and Xanax depress your CNS, a risk which is heightened by misuse and abuse. Using both at once increases the potency of each drug and intensifies the effects caused by CNS depression. These complications are so serious, in fact, that in August of 2016 the FDA issued “black box warnings,” their most severe form of drug labeling.

In certain proportions, these drug interactions become so severe that the aforementioned life-support systems actually begin shutting down. This is an overdose. A BMJ article reports that roughly 30 percent of all opioid overdose deaths involve benzodiazepines. Additionally, it writes that “Compared with opioid users who did not use benzodiazepines, concurrent use of both drugs was associated with an increased risk of an emergency room visit or inpatient admission for opioid overdose.”

Signs Of Overdose

Some signs of overdose include:

  • Blue lips or fingers
  • Decreased blood pressure
  • Drowsiness
  • Slowed or irregular heartbeat
  • Struggling or failing to breath
  • Unconsciousness and/or coma

Overdose can be fatal and requires immediate emergency medical help. Prescription drug abuse doesn’t have to end this way.

Take Steps Towards Prevention And Treatment

Inpatient drug rehab can help you or your loved one to avoid these risks while working on your sobriety goals. This residential format is beneficial for those with serious addictions, such as those which revolve around polydrug abuse. With concerns of opioids and benzos, a person will likely undergo detox before continuing into treatment. A combination of medications, counseling, and behavioral therapies will be used to treat methadone and/or Xanax addiction.

Get Help Today To Save Your Life

Are you concerned that you’re beginning to misuse your prescriptions in such a way that you’re endangering your health? Getting support now can help you to gain control over these behaviors before they become an addiction. If you’re already caught up in serious abuse or addiction, can work with you to develop a treatment plan. Contact us today.

American Family Physician - Addiction: Part I. Benzodiazepines—Side Effects, Abuse Risk and Alternatives

MedlinePlus - Methadone

The BMJ - Association Between Concurrent Use Of Prescription Opioids And Benzodiazepines And Overdose: Retrospective Analysis

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