According to the book The Benzodiazepines: Use, Overuse, Misuse, Abuse, Xanax (alprazolam) is a benzodiazepine medication that is most often prescribed for anxiety management, particularly the anxiety that occurs as a result of having a psychiatric disorder or medical condition. It may also be used as a sleep aid, for seizure control, or as a preanesthetic.
In some cases, the drug can be used to treat withdrawal symptoms associated with alcohol or the abuse of other benzodiazepines: however, typically long-acting benzodiazepines are used for that purpose.
Xanax was initially developed as an alternative to Valium (diazepam), which had become a significant drug of abuse. Xanax has a quicker onset of action and shorter half-life, so it was believed these qualities would make Xanax less likely to be abused.
However, sources such as the National Institute on Drug Abuse (NIDA) and the Substance Abuse and Mental Health Services Administration (SAMHSA) consistently report that Xanax is one of the most widely abused drugs in the country.
The mechanism of action of Xanax is to work through the neurotransmitter GABA (gamma-Aminobutyric acid), which slows down the firing rates of the neurons in the brain and spinal cord. The U.S. Drug Enforcement Administration (DEA) lists Xanax in the Schedule IV controlled substances category.
Heroin is an illicit drug that belongs to the class of opiate drugs. This substance was also developed as an alternative to another drug in the same class, morphine. However, heroin was found to be even more addictive than morphine, so it was eventually made illegal in the United States, although some countries still do allow its use.
Heroin works by attaching to the endogenous opiate receptors in the brain. Like Xanax, it slows down the functioning of the neurons in the brain and spinal cord but through this different mechanism. The DEA classifies heroin as a Schedule I controlled substance, meaning that the drug is considered to have no medical uses and cannot be prescribed.
Possession of the drug is a crime, and only organizations that have the approval to possess small amounts of the drug (most often for research purposes) can have it.
NIDA reports that benzodiazepines often are not primary drugs of abuse, but they are instead abused along with other drugs. The most common drugs that are abused with benzodiazepines are opiate drugs such as heroin, alcohol, and other benzodiazepines. The major mechanism of action of these drugs is to suppress the functioning of the neurons in the central nervous system (CNS).
When people combine CNS depressants, they are engaging in very dangerous behavior. According to the book Neuropathology of Drug Addictions and Substance Misuse Volume 3, the effects of CNS depressants can be serious, especially when combined.
The potential for a fatal overdose on either drug is significantly increased when Xanax and heroin are used in combination, even if they are used at low doses. An overdose on either drug can be potentially fatal.
Individuals who overdose on opiates can be treated with the drug Narcan (naloxone); however; Narcan is not effective to treat an overdose on benzodiazepines. Thus, an individual who has overdosed on a combination of these drugs may require a complicated treatment approach that may not be effective fast enough to counterbalance any potential dangers that may occur from too much of either of these drugs.
There are also some other concerns when central nervous system depressant drugs like heroin and Xanax are combined.
A combination of Xanax and heroin should not be taken under any circumstances. Individuals who combine any opiate drug and benzodiazepine are abusing these drugs, unless instructed to do so by a physician. Moreover, combining these drugs can be potentially dangerous even when they are combined in very small amounts because of the enhancement of their effects. Thus, there is no safe amount of Xanax and heroin that can be combined.
It is not safe to combine these drugs under any circumstances or in any amount. Anyone who combines Xanax and heroin is engaging in a serious form of drug abuse that could result in overdose and other long-term health issues.
(March 2018). Benzodiazepines and Opioids. National Institute on Drug Abuse. Retrieved January 2019 from https://www.drugabuse.gov/drugs-abuse/opioids/benzodiazepines-opioids
(October 2018). National Survey on Drug Use and Health: Detailed Tables. Substance Abuse and Mental Health Services Administration. Retrieved January 2019 from https://www.samhsa.gov/data/sites/default/files/cbhsq-reports/NSDUHDetailedTabs2017/NSDUHDetailedTabs2017.pdf
Drug Scheduling. Drug Enforcement Administration. Retrieved January 2019 from https://www.dea.gov/drug-scheduling
(2016). Neuropathology of Drug Addictions and Substance Misuse Volume 3: General Processes and Mechanisms, Prescription Medications, Caffeine and Areca, Polydrug Misuse, Emerging Addictions and Non-Drug Addictions. Academic Press. Retrieved January 2019 from https://books.google.com/books?id=Yu9eBwAAQBAJ&printsec=frontcover&dq=Neuropathology+of+Drug+Addictions+and+Substance+Misuse+Volume+3:+General+…&hl=en&sa=X&ved=0ahUKEwjk9N_MhtLfAhUQlawKHfU_CmAQ6AEILTAB#v=onepage&q=Neuropathology%20of%20Drug%20Addictions%
(April 2018). Opioid Overdose Reversal with Naloxone (Narcan, Evzio). National Institute on Drug Abuse, Retrieved January 2019 from from https://www.drugabuse.gov/related-topics/opioid-overdose-reversal-naloxone-narcan-evzio