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Can You Safely Mix Heroin and Xanax?

You cannot safely mix heroin and Xanax. Both substances are dangerous to abuse on their own, but mixing them only compounds those risks.

What Type of Drug Is Heroin?

Heroin belongs to the opioid class of drugs, which are typically painkillers, though heroin has no medical purposes. It is bought and sold on the illegal drug market as a white or brown powder, or a black tar-like substance.

Heroin is typically mixed with water and injected via a needle into the user’s veins, but it can also be smoked or snorted. Whether heroin is injected, smoked, or snorted, it enters the brain very quickly, which makes it highly addictive.

People who regularly use heroin are likely to develop significant health problems with continued use. Heart and lung infections, as well as kidney and liver disease, are often seen in people with a heroin addiction. Additionally, people who inject heroin are at an increased risk of contracting infectious diseases, such as HIV and hepatitis B or C, via unsterilized needles.

Despite the risks associated with heroin use, people use it for the intense high it produces. Heroin interacts with opioid receptors in the brain that are responsible for sending messages of pain and pleasure throughout the body.

A rush of heroin causes someone to experience an intense euphoric high almost immediately after taking the drug. This high is a type of behavioral reward that encourages repeated drug use and ultimately leads to addiction.

drowsy woman

What Drug Class Does Xanax Belong To?

Xanax, generically known as alprazolam, is a benzodiazepine drug. It has been approved for the medical treatment of generalized anxiety disorder and panic disorder, though doctors sometimes also prescribe it for the treatment of insomnia and to help people get through alcohol withdrawal. Xanax is meant to be used for the short-term treatment of these disorders, however, as benzodiazepines are highly addictive.

Physical dependence on Xanax is a typical response to taking the drug and can occur in as little as two weeks of daily use. Although dependence is an expected response to taking the medication, use must be closely monitored so that an emotional dependence, followed by addiction, does not develop.

People use Xanax recreationally for the calming and euphoric effects it produces. The primary effect of Xanax is to make people feel more relaxed almost immediately, which leads some people to misuse it.

In addition to a sense of relaxation, Xanax can also produce a sense of euphoria when taken in high enough doses. Similar to heroin, this pleasurable and rewarding high is what people who abuse the drug become addicted to.

Potential Risks of Mixing Heroin and Xanax

drug effects

The National Alliance on Mental Illness (NAMI) explains that combining Xanax with opioids, such as heroin, can lead to serious side effects, including significantly impaired breathing and death. Mixing benzodiazepines with opioids can cause an overdose which can be fatal.

There are specific signs of an overdose to look for.

  • Slowed breathing
  • Dizziness or lightheadedness
  • Impaired coordination
  • Altered cognition
  • Loss of consciousness

The above are signs of an overdose that require immediate medical attention. There are antidotes that can be given to treat benzodiazepine and opioid overdoses.

Flumazenil can be administered to reverse the effects of a benzodiazepine overdose, while naloxone can reverse the effects of an opioid overdose. Naloxone is commonly carried by emergency medical responders and law enforcement agents, and it can even be kept in the homes of people at risk for an opioid overdose. Flumazenil, however, can only be administered through an IV at a hospital, so it is important to seek medical care as soon as someone starts displaying signs of an overdose.

Short-Term and Long-Term Effects of Heroin

Heroin is immediately converted into morphine when it enters the brain, explains the National Institute on Drug Abuse (NIDA). As it binds to opioid receptors, a surge of pleasurable feelings is felt. How much heroin is taken and the way it is administered affect how intense the rush is.

Short-term effects can occur with a rush of heroin.

  • A feeling of warmth on the skin
  • Dry mouth
  • A heavy feeling in the arms and legs
  • Nausea and vomiting
  • Intense itching
  • Altered mental function
  • Drowsiness
  • Slowed heartbeat
  • Reduced breathing

Long-term chronic use of heroin can lead to physical and physiological changes in the brain.

Long-term imbalances of neurons and hormonal systems in the brain occur, which are difficult to reverse. Studies have found that chronic heroin use over an extended period of time can cause white matter in the brain to deteriorate. This impacts one’s decision-making skills, behavior regulation, and stress responses.

In addition to the behavioral changes heroin causes, long-term use is also likely to lead to tolerance and addiction. Tolerance, which is often addressed by increasing drug use, happens when you no longer respond to a drug in the way you used to.

Following tolerance, dependence often occurs, where your body becomes physically dependent on having heroin in your system to be able to function properly. Tolerance and dependence are not the same thing as addiction, though they are steps in that direction.

Opioid use disorder is often seen in people who repeatedly use heroin over an extended period of time.

NIDA explains that heroin is extremely addictive no matter how you use it. Injecting and smoking heroin are likely to lead to an addiction sooner, however, as they allow the drug to reach the brain faster, making it more addictive.

Long-term effects of an opioid use disorder include significant health, financial, and personal problems that most likely need to be addressed through a formal substance abuse treatment program.

drug addiction

Short-Term and Long-Term Effects of Xanax

As a prescription medication, Xanax has many well-documented short-term and long-term side effects. When used under a doctor’s supervision, your response to Xanax, including any side effects, will be closely monitored and your prescription can be altered if any serious side effects start to occur. Recreational use of Xanax, however, requires you to be aware of your own experience of side effects and adjust your use accordingly.

There are many short-term side effects of Xanax use.

  • Drowsiness
  • Dizziness
  • Low energy
  • Headache
  • Depression
  • Insomnia
  • Impaired coordination
  • Restlessness
  • Impaired memory
  • Muscle twitching
  • Dry mouth or increased salivation
  • Nausea and vomiting
  • Skin rash
  • Irregular heartbeat
  • Chest pain
  • Decreased blood pressure
  • Increased or decreased appetite
  • Changes in weight

The greatest long-term risks associated with continued Xanax use are developing dependence on and addiction to Xanax. Chronic use of Xanax is associated with an increased risk of developing a substance use disorder. Substance use disorders of any kind put you at a greater likelihood of experiencing long-term health problems, overdoses, and a need for formal addiction treatment.

What to Do When Heroin and Xanax Are Mixed

People may be drawn to mix heroin and Xanax to amplify the euphoric high experienced by either drug, but it is not a safe combination to experiment with.

If a batch of heroin is mixed with Xanax, the safest thing to do is to not take the combination of drugs. If you must use them together, you can utilize harm reduction techniques, such as starting out with a very small dose to see how your body responds to the combination and having an emergency plan in place in the event of an overdose.

Again, the best course of action is to avoid taking these drugs together.


Alprazolam (Xanax). (January 2019). National Alliance on Mental Illness.

Heroin. (June 2018). National Institute on Drug Abuse.

Heroin. (November 2018). U.S. National Library of Medicine: Medline Plus.

The Use of Anti-Anxiety Medication Xanax. (November 2018). Verywell Mind.

What You Need to Know About Xanax. (December 2017). Medical News Today.

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