Is Xanax a narcotic (opioid) drug?
Xanax is not a narcotic. Xanax is a prescription medication in a class of drugs called benzodiazepines (benzos). While not a narcotic (opioid) itself, it’s possible it may be prescribed along with opioids, but this can be harmful.
Xanax is a controlled substance. The active ingredient alprazolam is a Schedule IV controlled substance, which is less likely to be abused than a Schedule III drug, but it still has the potential for abuse.
The drug can become addictive, and it’s especially dangerous when prescribed with opioids. Opioids are typically prescribed to relieve pain. A 2016 study in Pain Medicine found that overdose death rates among patients taking opioids and benzos together were 10 times higher than among those only taking opioids.
Because of the dangers of mixing these drugs, in 2020 the U.S. Food and Drug Administration began to require "black box" warnings on the labels of benzodiazepines and opioids that warn of the dangers of using these drugs together. The Centers for Disease Control and Prevention recommends that doctors avoid prescribing Xanax and other benzodiazepines with opioid pain medication.
- Ait-Daoud N, Hamby AS, Sharma S, Blevins D. A Review of Alprazolam Use, Misuse, and Withdrawal. J Addict Med. 2018;12(1):4-10. doi:10.1097/ADM.0000000000000350. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846112/
- Drug Enforcement Administration (DEA). Controlled Substance Schedules. Available at: https://www.deadiversion.usdoj.gov/schedules/. [Accessed June 3, 2021].
- National Institute on Drug Abuse (NIDA). Benzodiazepines and Opioids. February 3, 2021. Available at: https://www.drugabuse.gov/drug-topics/opioids/benzodiazepines-opioids. [Accessed June 1, 2021].
- Dasgupta N, Funk MJ, Proescholdbell S, et al. Cohort Study of the Impact of High-Dose Opioid Analgesics on Overdose Mortality. Pain Med. 2016;17(1):85-98. https://doi.org/10.1111/pme.12907
- U.S. Food and Drug Administration (FDA). FDA requiring Boxed Warning updated to improve safe use of benzodiazepine drug class. September 23, 2020. Available at: https://www.fda.gov/drugs/drug-safety-and-availability/fda-requiring-boxed-warning-updated-improve-safe-use-benzodiazepine-drug-class. [Accessed June 1, 2021].
- Centers for Disease Control and Prevention (CDC). CDC Guideline for Prescribing Opioids for Chronic Pain. Available at: https://www.cdc.gov/drugoverdose/pdf/guidelines_at-a-glance-a.pdf. [Accessed June 2, 2021].
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