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Is Xanax an Opioid? - Differences and Risks

  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Modified:
  • Reading Time: 13 minutes
  • Reviewed by: Dr. Carl Williams, Ph.D., LCADC
  • Last Update:
  • Reading Time: 13 minutes

Many people are curious about how Xanax compares to other medications, especially when it comes to understanding its risks and differences from opioids.

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The problem of Xanax addiction is escalating in several American states. If you or a loved one is grappling with this issue, it may prompt you to ask crucial questions: “Is Xanax an opioid?”

Is it classified as a dangerous drug? Is Xanax categorized as a narcotic? These questions are valid because both opioids and Xanax are legal medicines. However, they can cause addiction and dependency, leading to life threatening situations when abused.

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Classification, & Associated Risks

What Is Xanax?

Before answering the question, “Is Xanax an opioid or not, it’s vital to get an idea about what sort of drug Xanax is. Xanax, known by the brand name Alprazolam, is a popular drug for treating anxiety issues,

such as:
  • Anxiety disorders.
  • Insomnia and other sleep disorders.
  • The management of alcohol dependency (to control withdrawal symptoms).
  • Panic attacks.

Medical researchers have grouped Xanax under the class called benzodiazepines, and the DEA considers it a Schedule IV drug. The drug can cause addiction and dependency, especially when abused. While the drug can induce a state of serenity and joy, some people misuse it by taking it for leisure purposes.

The intake of Xanax and other anxiety medications has significant hazards. The negative effects of benzodiazepines depend on the dose. Using too much can lead to serious problems, like seizures or even death from overdose. There is still a need for awareness and vigilance regarding this potent drug.

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Definition & Common Medications

What Is an Opioid?

Opioids are strong medicines. They can come from opium poppy plants or be made in a lab. They are used in the medical field mainly due to their usefulness as analgesics for managing chronic pain.

When opioids are given, they act on specific receptors in the head and spinal cord and in other parts of the body to interrupt pain messages and hence provide a lot of relief. Opioids are one of the best choices for treating moderate to severe pain. They work well when other pain relievers are not strong enough.

Common opioid painkiller medications include:

  • Methadone.
  • Fentanyl.
  • Codeine.
  • Oxycontin.
  • Vicodin.
  • Hydrocodone.
  • Morphine.
  • Percocet.
  • Oxycodone.

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Central Nervous System Impact of Xanax & Opioids

What Are the Effects of Xanax and Opioids on The Body?

Xanax and opioids are toxic substances with a myriad of different influences on the body. The side effects that usually come with opioids include:

  • Constipation.
  • Skin itching.
  • Drowsiness.
  • Dizziness.
  • Nausea.
  • Dryness of the mouth.

Other potentially even more severe dangers include a lowered respiratory rate, a slow heartbeat, and narrowed pupils. Opioids are also highly addictive, leading to dependency and opioid overdose, all of which increase the risk of overdose death. Besides, opioids can also have effects on mood and cognitive abilities.

The side effects that can occur with use of Xanax include:
  • Drowsiness, fatigue.
  • Confusion.
  • Muscle weakness.
  • Light-headedness.
  • Dizziness.
  • Memory impairment.
  • Trouble concentrating.
  • Decreased mental alertness.
Severe side effects of Xanax may include:
  • Hyperlipidemia.
  • Confusion.
  • Memory loss.
  • Mental health disorders that are continuously worsening, including anxiety and depression.
  • Tolerance to Xanax can develop quickly, increasing the risk of dependency.
  • Psyamic side effects may also occur if the medication is stopped abruptly, especially if quitting cold turkey.

Similar Effects on The Central Nervous System

Xanax raises the levels of gamma-aminobutyric acid (GABA) in the brain. Some effects are drowsiness and impaired coordination; others include speech loss and slowed breathing.

In patients with pain, opioids work on the central nervous system. They bind to specific opioid receptors. This action stops pain signals from traveling in the brain and spinal cord.

Opioids like tramadol increase serotonin and norepinephrine levels. This can improve mood and act like an antidepressant.

Like all CNS depressants, Xanax and opioids slow down brain activity in some people. This can cause sedation, drowsiness, and trouble thinking clearly. These drugs should be taken as prescribed. Avoid activities that need full focus, as they can cause dizziness.

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Xanax is a Benzodiazepine, Not an Opioid

Potential For Addiction and Dependence

Even when prescribed, Xanax and opioids can nevertheless lead to physiological dependency and addiction. Xanax is among the most addictive prescription medications available, and you can become addicted in a matter of weeks.

Concerns about opiate addiction persist, as even short-term use of opioids can lead to addiction. Furthermore, the likelihood of developing addiction increases significantly when both narcotics are consumed together.

Risk of Overdose

Despite the possibility of Xanax overdose, it is uncommon for this drug to cause death. Nevertheless, concurrent use of the drug with opioids significantly increases the risk of death. Some studies show that benzodiazepines, like Xanax, can increase the risk of overdose. When combined with opioids and opiates, this risk is ten times higher.

Symptoms and signs of an opioid-involved Xanax overdose can include:

  • Vomiting or gurgling sounds.
  • Pale or sweaty skin.
  • Loss of speech.
  • Limp body.
  • Bluish or purplish nail/lip discoloration.
  • Unresponsiveness.
  • Slowed or halted breathing.
  • Weak or absent pulse.

A national poll from 2023 shows that 32% of US adults, about 82.7 million people, know someone who died from an overdose. Notably, 18.9% of these, or about 48.9 million adults, lost a family member or close friend. These findings highlight the serious impact of the opioid crisis and drug misuse on many communities in the US.

Negative Side Effects

When taken orally, the drug Xanax begins to work within half an hour to six hours. The side effects include:

  • Muscle weakness.
  • Light-headedness.
  • Nausea, vomiting, upset stomach.
  • Drowsiness, fatigue.
  • Dizziness.
  • Poor balance/coordination.
  • Slurred speech.
  • Worsening depression.
  • Memory impairment.
  • Confusion.
  • Trouble concentrating.
  • Blurred vision.

Is Xanax an Opioid Drug?

Xanax is in the benzodiazepine group of medications; it is not an opioid. It is a central nervous system depressant. On the other hand, opioids act as strong painkillers for easing moderate to severe agony. However, both types of drugs have sedative properties.

Definition Of Opioid

The word “Opioids” refers to a group of pain relievers. These can come from the opium poppy plant, like morphine. Morphine is given as Duramorph or MS Contin.

Opioids can also be made in labs, like fentanyl. Fentanyl is found in drugs such as Actiq and Fentora.

Other familiar opioids include:

  • Codeine.
  • Hydrocodone (commonly known as Vicodin).
  • Oxycodone (found in medications like OxyContin and Roxybond).

The way that opioids work is that they go through the circulation and bind to opioid receptors in brain circuits. This interaction efficiently blocks pain signals and may enhance sensations of pleasure, rendering it beneficial for pain alleviation. But, worries about this mechanism’s potential for misuse and addiction have long persisted.

Chemical Makeup of Xanax

The chemical structure of Xanax consists of the following components:

  • Chemical formula: C₁₇H₁₃ClN₄
  • Molecular weight: Approximately 308.76 g/mol.

Xanax is made up of a benzodiazepine ring and a triazole ring. It also has a chlorine atom in its structure. This arrangement is important for its ability to reduce anxiety. Doctors often prescribe Xanax to patients with anxiety and panic disorders.

Classification Of Xanax

Xanax is a type of benzodiazepine. It is classified as a Schedule IV controlled substance. This means it can be abused and may lead to dependence. The drug is a well-known member of a class of medications called benzodiazepines.

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Life-Threatening Risks

What Are the Risks of Combining Xanax and Opioids?

The concurrent use of Xanax and opioids is a powerful and potentially fatal combination. Both chemicals are central nervous system (CNS) depressants. This means they can reduce brain activity and create calming effects.

But when combined, these effects can become markedly intensified, resulting in several grave and sometimes fatal outcomes. Herein lies the rationale:

Increased Sedation and Respiratory Depression

Using Xanax and opioids together makes CNS depression worse. Each drug increases the effects of the other.

The combined effects on the central nervous system can cause serious breathing problems. This condition is marked by slow breathing, deep sleep, or even coma. If these issues do not get urgent medical help, they can be deadly.

In 2020, the Food and Drug Administration (FDA) added “black box warnings” to benzodiazepines and opioids. This was due to the serious harm that can happen when these drugs are combined.

The CDC also advises doctors and healthcare facilities not to prescribe Xanax and other benzodiazepines. This is especially important for patients taking opioid pain medications. This helps reduce harmful health effects.

Higher Risk of Overdose

Xanax and opioids are both highly addictive drugs capable of inducing physical dependency, even when taken as prescribed. Taking both of them together greatly raises the chance of an overdose. The body may have trouble managing the combined effects.

Given these risks, users must understand the dangers of using these drugs together. They should talk openly with their healthcare professionals about safe dosing.

Negative Interactions with Other Medications

Xanax and its use with other drugs, especially opioids, worry doctors. This is because each opioid has its own unique risks. Here are some of the risks of taking Xanax with specific opioids.

Xanax and Hydrocodone (Vicodin®)

Those who use Xanax with hydrocodone, a medication often used for severe pain, run the risk of serious complications. This can result in little to no ability to breathe and serious thinking problems. These issues can cause extreme tiredness, deep comas, or even death.

If narcotics are taken with other drugs, the risk of becoming dependent on either one goes up. This happens because both can cause feelings of euphoria.

Xanax and Oxycodone (OxyContin®, Percocet®)

The strong prescription opioid pain medication, Oxycodone, treats moderate to severe pain. When used together with Xanax, it can lead to excessive sleepiness, among other issues.

This combination may induce respiratory depression, profound lethargy, disorientation, or an unconscious condition. Moreover, it substantially increases the chance of a fatal overdose. Moreover, the simultaneous use of these drugs complicates withdrawal treatment and heightens the risk of dependency.

Xanax and Oxymorphone (Opana®)

Oxymorphone, which is a potent opioid analgesic when taken in combination with Xanax, increases sedation, risk of respiratory problems, and propensity for overdose. This combination also increases the likelihood of becoming dependent on both drugs, making future treatment options more difficult.

Xanax and Morphine (Kadian®, Avinza®)

The mix of morphine, a strong opioid, and Xanax carries serious risks. It can cause major problems with the central nervous system and breathing. This may lead to severe outcomes like coma or even death. Both opioids possess considerable potential for addiction, and their concurrent use increases the likelihood of physical dependency and intense withdrawal symptoms.

Xanax and Codeine

Codeine is not as potent as many other opioids. Doctors generally use it to treat mild to moderate pain and coughing.

However, it can also cause increased CNS depression when ingested in combination with Xanax. Some of the results that may show up could include excessive fatigue, slow breathing, and a higher risk of overdose. When taken together, these drugs increase dependence and withdrawal symptoms.

In addition to the opioids mentioned, many other substances can cause serious side effects. This is especially true when mixed with Xanax. These substances share a depressant effect on the central nervous system (CNS).

These common effects may include more sleepiness, trouble breathing, poor coordination, and thinking problems. You might also feel very happy, nauseous, or vomit. If you stop using it after a long time, you may have withdrawal symptoms.

There is also a higher risk of overdose. Notable other opioids that present these dangers when used in conjunction with Xanax include:

  • Fentanyl.
  • Hydromorphone.
  • Tapentadol.
  • Methadone.
  • Heroine (an illicit opiate).
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Safe Alternatives

What Are the Alternatives to Xanax and Opioids for Anxiety Treatment?

Here are some alternatives to Xanax and opioids for anxiety treatment:

Therapy and Counseling

Here are some therapy alternatives to using Xanax and opioids for anxiety treatment:

Cognitive Behavioral Therapy (CBT) is an effective technique for helping people learn and change negative thinking and behavior.

  • Mindfulness-Based Therapy: Mindfulness alleviates anxiety by strengthening your intrinsic capacity to remain present, attentive, and composed. In today’s world, filled with changes and stress, mindfulness can help you focus on the present. It allows you to notice your thoughts and feelings without reacting negatively.

Practicing mindfulness with breathing exercises, meditation, and mindful watching can help you manage problems and tasks more effectively. You may notice improvements in your daily life.

  • Exposure Therapy: It helps by showing you what makes you anxious in a safe way. This aims to reduce your fear over time.
Non-Addictive Medications

Anxiety disorders are among the most common mental health issues in the US and beyond. While therapy and lifestyle changes can help, there are times when medication is necessary. The downside is that some anti-anxiety meds, like Xanax, come with a risk of addiction or dependence. But the good news is that there are safe alternatives that can effectively reduce anxiety without those worries.

  • Selective Serotonin Reuptake Inhibitors (SSRIs): A drug like sertraline (Zoloft) or escitalopram (Lexapro) boosts serotonin levels in the brain. These drugs are good non-addictive alternatives to Xanax.
  • Serotonin-Norepinephrine Reuptake Inhibitors (SNRIs): Venlafaxine (Effexor) is a good alternative to the addictive Xanax for treating anxiety. It works on serotonin and norepinephrine. Like SSRIs, it is usually not linked to addiction.
  • Buspirone: The drug works well for generalized anxiety disorder (GAD). Its main benefit is that it does not cause dependence. This makes it a great choice for people who need long-term treatment.
  • Beta-Blockers: Propranolol and similar drugs may help with physical signs of anxiety, like a fast heart rate. This is especially true in situations such as public speaking. Although they do not directly tackle the psychological dimensions of anxiety, they can be beneficial in mitigating acute physiological responses.
Natural Remedies and Lifestyle Changes

Some easy adjustments to your daily routine might help alleviate or avoid anxiety problems. Try implementing these changes if you want to feel better and become more resilient to the damaging effects of anxiety:

  • Exercising: Exercising regularly has been shown to promote mental health and decrease anxiety.
  • Diet: Eating a balanced diet rich in omega-3 fatty acids, vitamins, and antioxidants can help keep the brain healthy. It can also reduce anxiety.
  • Some people relieve anxiety by using herbal supplements, such as lemon balm, valerian root., chamomile, withania (Ashwagandha), and lavender.
  • Yoga, deep breathing exercises, mindfulness, and meditation are some mindfulness and relaxation practices shown to alleviate anxiety.
  • Anxiety levels can be significantly reduced by making proper sleep hygiene a top priority.

These alternatives can reliably alleviate anxiety while reducing the associated hazards of Xanax and narcotics. Before starting any new prescription or other treatment modalities, speaking with a healthcare provider is essential.

If you are struggling with drug use, the Rolling Hills Recovery Center (RHRC) can help. If you are having trouble with drug use, the Rolling Hills Recovery Center (RHRC) can help.

We assist people dealing with all kinds of substances. This includes opioids, alcohol, benzodiazepines like Xanax, and other illegal or prescription drugs.

Located in Chester, NJ, we offer various therapies and services for treating alcohol and drug addiction. Our goal is to help you reach your recovery objectives more effectively. Together, we can strive for a better future and an addiction-free life.

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Written By:

Geoffrey Andaria

Geoffrey Andaria mental health writer at rolling hills recovery center
Rolling Hills Recovery Center

Mental Health Writer

About Author:

Geoffrey Andaria is an experienced mental health content writer and editor. With a B.A. in English and Journalism, Geoffrey is highly educated in freelance articles and research. Having taken courses on social work, Geoffrey is adamant about providing valuable and educational information to individuals affected by mental health and the disease of addiction.

Medically Reviewed By:

Dr. Carl Williams Ph.D., LCADC

Carl Williams, medical content reviewer at rolling hills recovery center
Rolling Hills Recovery Center

Expert Contributor

About Reviewer:

Dr. Williams presently serves on the board of Directors for two non-profit service organizations. He holds a Master’s degree in Human Services from Lincoln University, Philadelphia, Pa, and a Ph.D. with a concentration in Clinical Psychology from Union Institute and University. In Cincinnati, Ohio. He is licensed to practice addictions counseling in both New Jersey and Connecticut and has a pending application as a practicing Psychologist in New Jersey.

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