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Cocaine And Xanax: Can You Safely Use Them Together?

A drug with limited medical uses in the United States, cocaine is mostly an illegal recreational drug that is distributed on the street as a white powder or in small “rocks” called crack cocaine. The drug is rubbed on the gums, smoked, snorted, or injected for its rapid onset and extremely powerful high. The  2018 National Survey on Drug Use and Health (NSDUH) reports that close to 2 million Americans were classified as current cocaine users.

Cocaine is a stimulant drug, which means it can increase pleasure, energy, and focus while suppressing appetite and the need for sleep. A cocaine high burns out fast, often within a few minutes of use. As a result, other drugs are often taken with cocaine to prolong the euphoric effects or to counteract the crash or comedown of the drug. Mixing other drugs with cocaine may also be a method to enhance the high.

Xanax (alprazolam) is a benzodiazepine medication prescribed to treat anxiety and panic disorders. It is a central nervous system (CNS) depressant that slows down bodily functions by dampening the stress response in the brain and body. More than 20 percent of people older than age 11 in the United States have misused a prescription drug at least once, per the National Institute on Drug Abuse (NIDA). As a sedative-hypnotic benzodiazepine drug, Xanax is commonly misused for its mellowing and euphoric side effects.

Mixing cocaine (an upper) and Xanax (a downer) can result in many damaging side effects.


Cocaine enters the bloodstream, crosses the blood-brain barrier quickly, and causes a spike of dopamine, the “pleasure” neurotransmitter. Focus, energy, and attention levels increase, and the associated euphoria can be intense. When levels of dopamine go up quickly, a person feels extremely happy and wide awake.

Cocaine also elevates body temperature, heart rate, respiration rate, and blood pressure. If taken on a regular basis, large amounts of cocaine can cause a person to experience paranoia and potentially become aggressive and violent.

Cocaine wears off very quickly, and the U.S. Drug Enforcement Administration (DEA) reports that it is often taken in a binge pattern, or in repeated doses back to back to prolong the high and minimize the crash. A cocaine crash can be equally as intense as the high, and this comedown can cause a person to feel fatigued, depressed, anxious, and mentally drained.
Taking cocaine repeatedly builds up a tolerance to the drug, and higher doses will be needed each time. Drug dependence can set in rapidly with cocaine use, and when the drug wears off, low moods and intense cravings can make it difficult to stop repeated use. As a result, cocaine is considered to be extremely addictive.


Cocaine is regularly combined with other drugs, and unpredictable side effects can result. For instance, with the combination of cocaine and heroin called a speedball, the intention is that each drug counteracts the possible negative effects of the other drug. Heroin is an opioid depressant, which slows everything down, and cocaine is a stimulant that speeds everything up. When taken together, the drugs actually can amplify the effects of each other and raise the risk for an overdose.

NIDA warns almost 20,000 Americans died from an overdose involving cocaine. Taking cocaine with alcohol can create a dangerous byproduct called cocaethylene, which can have a toxic effect on the heart.

Xanax, like alcohol and opioid drugs, is also a depressant, and it may seem helpful to take it with cocaine to try and take the edge off. This combination can be deadly, however. Benzodiazepine drugs were involved in nearly a third of all prescription drug overdose deaths in 2013.

The cocaine can cover up the sedative effects of Xanax, and a person can unknowingly take too much, resulting in a toxic 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


Mixing drugs can create many complications. The push-and-pull impact of cocaine and Xanax on the heart can have lasting effects on the cardiovascular system. Both are considered to be addictive substances, and combining them increases the risk of addiction to one or both.

Since cocaine is mostly a recreational drug of abuse, there is no safe amount of the drug that can be taken. Xanax is a prescription medication that is only designed to be taken for the short-term relief of anxiety. The U.S. Food and Drug Administration (FDA) publishes that the drug is not meant to be taken long-term due to its addictive nature.

As with cocaine, taking Xanax regularly can cause a tolerance to form, which can then escalate to drug dependence. When Xanax processes out of the body, withdrawal symptoms can be potentially dangerous, as the central nervous system functions that had been suppressed rebound back. Heart rate, blood pressure, body temperature, and respiration can all spike. In addition, tremors, nausea, muscle cramps, diarrhea, blurred vision, concentration issues, insomnia, depression, seizures, and anxiety are all potential side effects of Xanax withdrawal.

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Taking cocaine concurrently with Xanax can complicate withdrawal and exacerbate some of the symptoms.

Both cocaine withdrawal and Xanax withdrawal can result in depression, sleep issues, and anxiety, and the crash from a dual Xanax/cocaine high may make these side effects even more pronounced.

Both cocaine and Xanax are mind-altering. Both drugs can change the thinking process and make it hard to make rational decisions and good choices. Taking both of these drugs together can increase aggression and risky behaviors, and the combination can further impair thinking and memory functions. Increased suicidal thoughts and actions may also be a side effect of combining cocaine and Xanax.

In short, there is no safe amount of cocaine and Xanax that can be taken together. If there is a legitimate prescription and medical need for Xanax, adding cocaine to the mix will only further deregulate moods and emotions, and it can have unpredictable consequences. Cocaine also can be cut with a variety of different substances, any of which can be toxic or interact with Xanax in unknown ways. The combination of Xanax and cocaine should be avoided altogether.

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The longer you wait before seeking help, the harder it will be to make things right. If you or a loved one suffers from cocaine addiction, the time is now to act. Call Pathway To Hope right now at (844) 230-8932 and begin your journey to a sober life.


Substance Anuse and Mental Health Services Administration. (2019, August 20) 2018 NSDUH Annual National Report. Key Substance Use and Mental Health Indicators in the United States: Results from the 2018 National Survey on Drug Use and Health. Retrieved

NIDA. (n.d.). Cocaine. Retrieved

(January 2018). What is the Scope of Prescription Drug Misuse? National Institute on Drug Abuse. from

Drugs of Abuse A DEA Resource Guide 2017 Edition. Drug Enforcement Administration. from

(August 2018). Overdose Death Rates. National Institute on Drug Abuse. from

(July 2002). Effects of Concurrent Use of Alcohol and Cocaine. Addiction. from

(February 2018). Benzodiazepine Deaths Soared in Recent Years, Study Finds. CNN. from

(September 2016). Xanax. U.S. Food and Drug Association. from

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