Central nervous system (CNS) depressant substances like alcohol and sedative drugs have inherent health risks, even when used alone. However, some people double-up (or triple-up, etc.) when it comes to these and other types of substances—both prescription and illicit. Though deaths from taking benzodiazepines alone are rare, using them in combination with certain types of substances such as alcohol significantly increases the risk of severe health consequences—including coma and death.1
What is Klonopin?
Klonopin, which is also available as generic clonazepam, is a benzodiazepine prescribed to treat panic disorder and certain seizure disorders.2 Klonopin is one of the most widely prescribed benzodiazepines; perhaps unsurprisingly, it is also one of the most commonly diverted sedative medications for nonmedical misuse.3Benzos like clonazepam in combination with substances like alcohol and opioids are also frequently involved in emergency department visits; such combinations significantly increase the risks of serious outcomes such as the need for hospitalization, transfer to another medical facility for more-intensive care, or death.4
Risk of Combination Overdose
Overdose deaths, including those involving prescription benzodiazepines, have been on the rise in the United States.5 Though many of these overdose deaths involve a combination of benzodiazepines and opioid drugs, the combination of alcohol and benzodiazepines is also dangerous.2
Alcohol and benzodiazepines act similarly in terms of their inhibitory pharmacodynamic actions.6 As a result, the combined CNS depression that can be reached by drinking while using benzodiazepines can more easily lead to dangerous respiratory slowing.2,3 The resultant lack of oxygen delivery to the brain can lead to rapid cell death in the brain, resulting in anoxic brain injury, coma, and death. Additional risks of this synergized CNS depression include in profoundly altered mental status, decreased response time, marked incoordination and increased risk of falls/injury.1,6
Other potentially severe and/or dangerous symptoms of concurrent benzodiazepine and alcohol use include:2,6,7,9
- Drowsiness / over-sedation.
- Impaired motor skills.
- Profound memory deficits.
- Bradycardia or slowing of heart rate.
- Respiratory depression / respiratory arrest.
CNS depressant overdoses should be treated as medical emergencies. If you suspect that, after taking Klonopin, drinking alcohol, or both, you or someone else might be experiencing an overdose, call emergency medical services immediately.
Another serious health risk of concurrent, excessive use of alcohol and Klonopin is the fact that both substances are associated with physical dependence and potentially severe—and in some cases deadly—withdrawal symptoms. Anyone who develops significant concomitant dependence to both of these substances could experience a particularly challenging, and potentially-complicated combined withdrawal syndrome.1
The most dangerous symptoms are seizures, which can be lethal if they become severe. However, agitation, hallucinations, and delirium may also be associated with problematic behavior that can increase the likelihood of injury of the affected individual or anyone nearby.10
Other potential alcohol / Klonopin withdrawal symptoms include:2,8,11
- Difficulty concentrating.
- Abdominal cramps.
- Muscle pain and stiffness.
- Muscle cramps.
- Delirium tremens.
Detox and Treatment for Polysubstance Dependence
It’s never a good idea to mix substances. Having a thorough understanding of the risks involved may help people to make safer choices. One of the most important precautions a person can take in terms of reducing the potential harms of substance use is to ensure that overdose situations are avoided, such as those which are more likely to occur when combining CNS depressant substances like alcohol and benzodiazepines; additionally, should such a pattern of drug use be part of a larger substance use disorder or addiction, withdrawal management and other treatment options for polydrug dependence and addiction can help people embark on recovery.
Greenhouse Treatment Center has experienced and licensed treatment staff to help patients manage withdrawal and undergo treatment that meets their specific needs. If you find that you’re struggling with compulsive drinking, Klonopin use, or both, options are available. Together we can help you your long-term sobriety goals.
- Miller, S. C., Fiellin, D. A., Rosenthal, R. N., & Saitz, R. (2019). The ASAM Principles of Addiction Medicine, Sixth Edition. Philadelphia: Wolters Kluwer.
- S. Department of Health and Human Services—Food & Drug Administration. (2017). Labelling-Medication Guide: Klonopin.
- Drug Enforcement Administration—Diversion Control Division. (2019). Benzodiazepines.
- S. Department of Health and Human Services—Substance Abuse and Mental Health Services Administration. (2014). The DAWN Report—Benzodiazepines in Combination with Opioid Pain Relievers or Alcohol: Greater Risk of More Serious ED Visit Outcomes.
- National Institute on Drug Abuse. (2019). Overdose Death Rates.
- Weathermon, R., Crabb, D.W., (1999). Alcohol and Medication Interactions. Alcohol research & health: the journal of the National Institute on Alcohol Abuse and Alcoholism, 23(1), 40–54.
- University Health Service—University of Michigan. (2019). The Effects of Combining Alcohol with Other Drugs.
- (2018). Prescription CNS Depressants.
- (2019). Commonly Abused Drugs Charts.
- Soyka, M. (2017). Treatment of Benzodiazepine Dependence. New England Journal of Medicine; 2017; 376:1147-1157.
- Saitz, R. (1998). Introduction to Alcohol Withdrawal. Alcohol Research & Health: The Journal of the National Institute on Alcohol Abuse and Alcoholism, 22 (1): 5-12.