Hi, I have an high dose of benzos named Alprazolam (Xanax, Trankimazin)prescribed by my psychiatrist. Usually I combine it with wine to sleep faster for its synergic effects. Normally 5 mg and two glasses of wine and I go to sleep in 20 min. I have read that an high dose of Alprazolam and alcohol is letal in combination. Tomorrow I have to go to the pharmacy and I will have a total of 200 mg of Alprazolam in my possession. Do you think that if I take it all after a bottle or more of wine can achieve a peaceful death?
Unlikely. 10 mgs is only 20 times the maximum recommended daily dose (which is concerned about non-fatal issues like addiction and liver damage), so it's well below massive, fatal overdose territory. Would probably do a number on the liver, though.
hxxps://www.acsh.org/news/2019/04/24/can-xanax-kill-you-13974
Fatal "Xanax" overdoses usually involve combination with powerful opiates as well, which have an additive effect. (75% of benzodiazepine overdoses involve opiates, according to the below study.) Given the LD50 of Xanax alone (at over 300mgs per kg in lab rats), this is unsurprising.
hxxp://www.einstein.yu.edu/news/releases/1155/overdose-deaths-from-common-sedatives-have-surged-new-study-finds/
Alcohol and Xanax also have additive effects with each other, and can be fatal, but alcohol is a much weaker sedative than any prescription opiate, so I frankly don't see one bottle of wine and 200 mgs Xanax being enough to reliably kill. (Also, worth asking if it's Xanax or Xanax XR, as the extended release version is absorbed much more slowly, and would therefore result in a lower concentration in one's bloodstream.) That combination would very likely knock someone out for many hours, but I suspect higher doses or another factor (like going unconcious in a hot tub, Whitney Houston-style) would be necessary for reliable lethality. And, of course, the issue with higher doses of alcohol is that people almost always vomit before absorbing enough to be fatal, so that's a factor worth considering in combining any drug with alcohol.
The big risk with mixing alcohol and Xanax is actually the likelihood of liver damage, rather than death, FYI. For reference, there were 100,000 ER visits in the US for benzodiazepine overdoses in 2014 compared with 8,000 fatalities involving benzodiazepines in 2011 (almost all involving the presence of other drugs, and including stronger benzodiazepines than Xanax). Not odds I'd put money on.
hxxps://clinicalservicesri.com/prescription-drug-abuse/xanax/overdose/
Not saying it can't work, but overdoses are the suicide method with the lowest fatality rate for a reason, and I don't imagine anyone wanting to wake up intubated in a hospital with liver damage as a result of taking a damaging, non-fatal dose of alcohol and benzodiazepines.