CBD and Xanax: Can You Take Them Together?

Xanax is one of the most commonly prescribed drugs for anxiety.

With the rising popularity of CBD, many people are now asking, “can I take CBD with Xanax?”.

The answer depends on your dose, the form of CBD you are taking, and your overall health. CBD can potentially interact with other drugs to cause serious health consequences.

Make sure you read this article before you attempt to mix Xanax and CBD.

What is Xanax?

Xanax, known by its proprietary name as alprazolam, is a prescription drug used to treat anxiety and panic disorders. Xanax belongs to a class of medications called benzodiazepines. It comes in immediate-release tablets, which are used for rapid calming effects. People with panic disorder are often prescribed extended-release tablets, which are slowly released into the bloodstream.

Xanax is meant to be prescribed as a short-term solution for anxiety, but many people end up taking it much longer than is recommended.

How Does Xanax Work?

Xanax attaches to two benzodiazepine receptors in your brain and a nervous system called BNZ1 and BNZ2.

The BNZ1 receptor regulates sleep, and BZN2 influences muscle relaxation, memory, anticonvulsant activity, and coordination.

The binding activity of Xanax causes a calming effect on the body by boosting the activity of a chemical called gamma-aminobutyric acid (GABA). GABA is an inhibitory neurotransmitter, which means it reduces activity in your central nervous system. This results in relaxed muscles reduced anxiety, and may also cause drowsiness.

Xanax is taken orally and metabolized in the liver by an enzyme called P4503A4.

Xanax Dosage

The recommended dosage varies depending on the person and the condition being treated. In general, the recommended dosage begins at 0.25 mg daily up to a maximum of 4 mg daily. Any daily dose of over 0.75 mg is associated with an increased risk of side effects and addiction.

Xanax and Benzodiazepine Addiction

Xanax is considered one of the most addictive benzodiazepines on the market. Approximately 40% of people who use benzodiazepines daily for a period of six weeks or more will become dependent on them.

This medication has a high potential for addiction and misuse due to its unique properties. It is extremely potent and rapidly metabolized with a short half-life. This means that people are more likely to get withdrawal symptoms and crave more of the drug.

Xanax also uniquely affects dopamine function and the brain’s reward system, similar to many stimulant drugs. As a result, people are more likely to seek out the drug for that surge of feel-good chemicals. This drug-seeking behavior is common among addictive substances.

CBD & Xanax

CBD, or cannabidiol, is a natural health-promoting compound. Among its many benefits, it has considerable potential to treat various anxiety disorders (4). Its benefits are primarily due to its interaction with the endocannabinoid system. Although CBD is considered a very safe drug, it can potentially cause problems when taken with Xanax due to its action on the P450 enzyme in the liver.

As a result, CBD and Xanax may not mix so well.

How Does CBD Interact with Xanax and Other Benzodiazepines?

CBD oil is a strong inhibitor of P450 enzymes, which are the main enzymes that break down benzodiazepines and other drugs. When you take CBD oil, it binds to these enzymes, which can interfere with the way the drugs are metabolized in your body. Simply put, CBD oil can prevent your body from effectively breaking down drugs like benzodiazepines.

The main result of this interference is an elevated level of the drugs in your system. As the amount of Xanax in your bloodstream goes up, it causes unwanted side effects like excessive drowsiness, disorientation, and an increased risk of addiction. These side effects get especially dangerous if you also add alcohol to the mix.

You should never mix alcohol with CBD and benzodiazepines.

What is a Safe CBD Dosage with Xanax?

There hasn’t been much research yet to determine what is considered a safe dose of CBD when taking it with drugs like Xanax. A 2013 clinical study using a CBD sublingual spray found that there were no interactions with liver enzymes with doses up to 40 mg (6). However, more work is needed to look at CBD in forms such as full-spectrum oil, vape, and smoked herbal flowers. All of these forms of administration are metabolized by the liver and therefore carry some risk of interactions.

You can safely use topical CBD with other drugs since topical CBD does not get in your bloodstream and will not inhibit P450 enzymes.

Taking CBD & Xanax Together

There is always a risk of increased side effects when you take CBD and Xanax together. You can reduce this risk by lowering your dosage or spacing out your dosing schedule (i.e., CBD in the morning and Xanax at night). The speed at which your body metabolizes CBD will vary depending on factors like the form of administration and dose. In general, you should wait at least three hours after taking CBD before taking a medication like Xanax.

CBD vs Xanax: Can CBD Replace Xanax?

Due to the high risk of addiction and multiple side effects of Xanax, you may be interested in replacing your Xanax prescription with CBD. Xanax is a very potent anti-anxiety medication that comes with a lot of risks. CBD has less dramatic effects on anxiety reduction but comes with many health-promoting benefits.

Benefits of Xanax

• Powerful calming effects
• Works rapidly

Side-Effects and Risks of Xanax

• Addictive
• Neurotoxic
• Tolerance-forming (you need a higher dose over time for the same benefits)
• Severe withdrawal (i.e., suicidal ideation, depression, hallucinations, confusion, seizures)
• Slurred speech
• Drowsiness and dizziness
• Impaired memory
• Poor balance and coordination
• Trouble focusing
• Diarrhea
• Very dangerous when mixed with alcohol
• Sleep disturbances (reduced slow-wave sleep)

Benefits of CBD

• Non-habit forming
• All-natural and plant-based
• Does not diminish performance
• Improves sleep
• Soothes pain
• Improves heart health (10)
• Neuroprotective
• Reduces inflammation
• Promotes overall wellness

Side-Effects and Risks of CBD

• Dry mouth
• Low blood pressure
• Drowsiness
• Diarrhea

How Does CBD Help With Anxiety?

CBD carries a host of anxiety-reducing benefits without interfering with your daily functioning. It helps manage issues like seizures, pain, acne, and anxiety. Additionally, it is neuroprotective, meaning CBD may help prevent age-related decline and improve brain functioning (13).

CBD works by influencing our endocannabinoid system, which helps us maintain a state of internal balance.

Ingesting CBD slows the rate at which your body absorbs an endocannabinoid known as anandamide. This compound, nicknamed “the bliss molecule,” has a calming effect on the nervous system (14).

Ongoing research has found that CBD may reduce anxiety by altering the blood flow in areas of the brain associated with fear and stress. CBD is also linked to serotonin levels by affecting how your brain responds to serotonin. Serotonin is a key neurotransmitter that regulates various functions, including mood.

CBD has been shown to have stress-reducing effects in various populations and across a wide range of health conditions (17).

CBD Dosage for Anxiety

The Federal Drug Administration does not regulate CBD, so you should always be diligent when selecting a source. Always buy your product from a reputable company that offers organic CBD. Look for companies that offer third-party testing to make sure that the product is accurately labeled and dosed. Start with 5–10 mg per day for anxiety reduction and increase your dose by 5 mg a day to find your sweet spot.

Can CBD Help with Xanax Addiction?

CBD is not only useful for anxiety; it may also help curb substance addiction.

A study done on mice displaying drug addiction showed that daily CBD reduced addictive behaviors for five months. These results are pretty exciting, but more work is needed to see how they translate to humans with addiction. Scientists believe that CBD can help people battle addiction by improving brain architecture and reducing symptoms of anxiety (19).

It remains to be seen how well CBD can help someone kick a Xanax addiction. Addiction is a complicated problem. What we do know is that CBD is a very safe alternative to Xanax and has many health benefits beyond anxiety reduction.

If you are interested in tapering off of your Xanax, you should always do so under the guidance of a medical professional.

Taking CBD & Xanax: Final Thoughts

Due to the many health benefits of CBD and the side-effects of Xanax, many people are considering switching to CBD to manage their anxiety. Talk to your doctor if you plan on making the switch so they can monitor any withdrawal symptoms.

Xanax is a popular medication, but it comes with a lot of risks. If you are considering mixing CBD and Xanax, you should avoid it due to potential drug interactions. In order to reduce unwanted side effects, try spacing out your doses so that your body has time to metabolize one drug before you consume the other.

CBD may be able to help people who struggle with addiction to Xanax, but we’ll have to wait and see what the research says.

References

1. Royal College of Psychiatrists (2015) Report on Benzodiazepines. https://www.rcpsych.ac.uk/mental-health/treatments-and-wellbeing/benzodiazepines
2. Juergens, S. (1991). Alprazolam and diazepam: addiction potential. Journal of substance abuse treatment, 8(1-2), 43–51.
3. Ait-Daoud, N., Hamby, A. S., Sharma, S., & Blevins, D. (2018). A Review of Alprazolam Use, Misuse, and Withdrawal. Journal of Addiction Medicine, 12(1), 4–10.
4. Blessing, E. M., Steenkamp, M.M., Manzanares, J., & Marmar, C.R. (2015). Cannabidiol as a Potential Treatment for Anxiety Disorders. Neurotherapeutics : the journal of the American Society for Experimental NeuroTherapeutics, 12(4), 825–836.
5. Alsherbiny, M.A. & Li, C.G. (2018) Medicinal Cannabis-Potential Drug Interactions. Medicines, 23(1), 3.
6. Serpell, M.G., Notcutt, W., & Collin, C. (2013) Sativex long-term use: an open-label trial in patients with spasticity due to multiple sclerosis. Journal of Neurology, 260, 285–295.
7. Huestis M.A. (2007). Human cannabinoid pharmacokinetics. Chemistry & biodiversity, 4(8), 1770–1804.
8. Ait-Daoud (n 3)
9. Moodley, P., Golombok, S., Shine, P., & Lader, M. (1993). Computed axial brain tomograms in long-term benzodiazepine users. Psychiatry Research, 48(2), 135–144.
10. Jadoon, K. A., Tan, G. D., & O’Sullivan, S. E. (2017). A single dose of cannabidiol reduces blood pressure in healthy volunteers in a randomized crossover study. JCI insight, 2(12), e93760.
11. Devinsky, O. et al. (2016) Cannabidiol in patients with treatment-resistant epilepsy: an open-label interventional trial. The Lancet. Neurology, 15(3), 270–278.
12. Oláh, A., Tóth, B. I., Borbíró, I., Sugawara, K., Szöllõsi, A. G., Czifra, G., Pál, B., Ambrus, L., Kloepper, J., Camera, E., Ludovici, M., Picardo, M., Voets, T., Zouboulis, C. C., Paus, R., & Bíró, T. (2014). Cannabidiol exerts sebostatic and antiinflammatory effects on human sebocytes. The Journal of clinical investigation, 124(9), 3713–3724.
13. Maroon, J., & Bost, J. (2018). Review of the neurological benefits of phytocannabinoids. Surgical neurology international, 9, 91.
14. Papagianni, E. P., & Stevenson, C. W. (2019). Cannabinoid Regulation of Fear and Anxiety: an Update. Current psychiatry reports, 21(6), 38.
15. Crippa, J. A., Zuardi, A. W., Garrido, G. E., Wichert-Ana, L., Guarnieri, R., Ferrari, L., Azevedo-Marques, P. M., Hallak, J. E., McGuire, P. K., & Filho Busatto, G. (2004). Effects of cannabidiol (CBD) on regional cerebral blood flow. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 29(2), 417–426.
16. De Gregorio, D., McLaughlin, R. J., Posa, L., Ochoa-Sanchez, R., Enns, J., Lopez-Canul, M., Aboud, M., Maione, S., Comai, S., & Gobbi, G. (2019). Cannabidiol modulates serotonergic transmission and reverses both allodynia and anxiety-like behavior in a model of neuropathic pain. Pain, 160(1), 136–150.
17. Crippa, J. A., Guimarães, F. S., Campos, A. C., & Zuardi, A. W. (2018). Translational Investigation of the Therapeutic Potential of Cannabidiol (CBD): Toward a New Age. Frontiers in immunology, 9, 2009.
18. Gonzalez-Cuevas, G., Martin-Fardon, R., Kerr, T. M., Stouffer, D. G., Parsons, L. H., Hammell, D. C., Banks, S. L., Stinchcomb, A. L., & Weiss, F. (2018). Unique treatment potential of cannabidiol for the prevention of relapse to drug use: preclinical proof of principle. Neuropsychopharmacology : official publication of the American College of Neuropsychopharmacology, 43(10), 2036–2045.
19. Calpe-López, C., García-Pardo, M. P., & Aguilar, M. A. (2019). Cannabidiol Treatment Might Promote Resilience to Cocaine and Methamphetamine Use Disorders: A Review of Possible Mechanisms. Molecules (Basel, Switzerland), 24(14), 2583.