Hangover

What is a hangover?

A hangover is when you have unpleasant physical and mental symptoms after drinking too much alcohol the previous night.

How common are hangovers?

Hangovers are very common in people who consume too much alcohol. In one study, researchers found that about 75% of people who drank excessively the night before reported hangover symptoms. The researchers concluded that 25% to 30% of people who drink may be resistant to hangovers.

What are the symptoms of a hangover?

Symptoms of a hangover may include:

• Depression, anxiety or irritability.
• Disturbed sleep.
• Dizziness and vertigo (a sensation of moving when you’re not).
• Fatigue and weakness.
• Headache, red eyes and sensitivity to light and sound.
• Increased blood pressure.
• Rapid heartbeat.
• Muscle aches and weakness.
• Nausea, vomiting and stomach pain.
• Excessive sweating (diaphoresis).
• Extreme thirst (polydipsia).
• Essential tremor (shaking).

You’re also more likely to have memory, concentration and coordination issues when you have a hangover. In general, the severity of your symptoms depends on how much you drank and for how long. But your health and other factors also play a role. Some people get a hangover after even one drink. Other people who drink heavily don’t get symptoms.

What causes a hangover?

Alcohol causes hangovers — but it’s not simple. Drinking affects your body in several ways:

Direct effects of alcohol

• Dehydration: Alcohol is a diuretic. It causes you to pee more, so you lose a lot of fluid. (You can lose up to a quart of urine in the hours after having four drinks.) Alcohol also reduces the release of the hormone vasopressin. This hormone balances your body’s fluids. Dehydration causes thirst, fatigue and headaches.
• Electrolyte imbalances: Your body needs certain chemicals, called electrolytes, to perform at its best. Peeing a lot throws your electrolytes out of balance.
• Gastrointestinal diseases: Alcohol irritates the lining of your stomach and intestines. It slows the rate of digestion, increasing fatty substances in your liver, stomach and pancreas secretions. All these processes lead to an upset stomach and nausea.
• Inflammation: Alcohol increases inflammation throughout your body. It can contribute to the general unwell feeling of a hangover.
• Low blood sugar (hypoglycemia): This effect usually happens in people who have alcohol use disorder. They may binge drink and fail to eat properly over a few days. As your body processes alcohol, it produces lactic acid. Lactic acid reduces blood sugar production, resulting in fatigue, sweating, hunger and shakiness.
• Disruption of sleep and other processes: While alcohol is a sedative and can promote sleep, hangover symptoms usually interfere with sleep. You may have insomnia as your blood alcohol levels get lower, so you feel fatigued. Alcohol also makes it difficult for your body to regulate its temperature and interferes with hormone production.

Effects of alcohol withdrawal

A hangover is a milder form of alcohol withdrawal. Both have similar effects and symptoms. Drinking helps you feel calm, relaxed and even happy. Your nervous system adjusts to these effects. But when the alcohol wears off, your nervous system must readjust. You may end up feeling more restless, anxious and irritable than before you drank.

Effects of alcohol metabolites

When your body processes alcohol, one of the byproducts is acetaldehyde. This substance can cause a fast pulse, sweating and nausea. In most people, the body breaks down acetaldehyde before it causes problems. But it can cause inflammation in organs, leading to uncomfortable symptoms.

If you have alcohol intolerance, you may have a genetic inability to process the acetaldehyde fast enough. You may feel drunk after drinking even a small amount of alcohol.

Effects of factors other than alcohol:

• Congeners: These compounds contribute to how alcohol tastes, smells and looks. Researchers think they also contribute to the intoxicating effects of alcohol and a hangover’s severity.
• Using other drugs: Cigarettes, marijuana, cocaine and other drugs also produce intoxicating effects. Using them while consuming alcohol can make a hangover worse.
• Personal differences: Researchers found that feeling neurotic, angry, defensive or guilty over drinking can increase the hangover risk. If you have a family history of alcohol use disorder or are at high risk of developing it, you may also get more hangovers.

How much alcohol does it take to get a hangover?

Having more than one drink per hour can cause a hangover. Your body needs about an hour to metabolize (process) one drink. Below are some examples:

• One 12-ounce can of regular or light beer (5% alcohol).
• A half pint (8 to 9 ounces) of malt liquor or many types of craft beers (7% alcohol).
• One 5-ounce glass of table wine (12% alcohol).
• One shot (1.5 ounces) of liquor (40% alcohol).

How are hangovers diagnosed?

Most people who get hangovers can diagnose themselves based on their alcohol consumption and symptoms. If you feel sick after consuming alcohol, you most likely have a hangover.

What’s the best hangover cure?

Many hangover remedies claim to treat a hangover. But they’re often not based in science, and some can be dangerous. For example, drinking more alcohol (“hair of the dog”) won’t help a hangover. More alcohol just increases the toxicity of the alcohol already in your body.

Here are some hangover self-care tips:

• Eat bland foods with complex carbohydrates like toast or crackers. You’ll boost low blood sugar levels and reduce nausea.
• Drink lots of fluids, including water, electrolyte beverages (Gatorade® or Pedialyte®), broth and other non-alcoholic beverages to reduce dehydration. To be sure you’re getting enough hydration, drink fluids until your urine is clear.
• Get sleep to counteract fatigue.
• Take antacids to help settle your stomach.
• Try aspirin or other nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen or naproxen. NSAIDs are the best hangover medicine to ease aches and pains. But use them sparingly since they can upset your digestive system. Don’t take acetaminophen (Tylenol®) — it can be toxic to your liver when combined with alcohol.
• Be patient. Hangover symptoms tend to ease up over eight to 24 hours. Your body must clear the toxic byproducts of alcohol, rehydrate, heal tissue and restore functions and activity to normal.

Are there ways to get rid of a hangover fast?

While people may claim that coffee or a shower helps you recover faster, there’s no way to truly speed recovery. Your brain and body need time to recover and heal, and there’s no way to fast-track that.

How can I prevent a hangover (or reduce its severity)?

If you want to enjoy a drink without unpleasant hangover symptoms, you can try hangover prevention steps:

• Drink less. Symptoms are less likely if you drink small amounts of alcohol. Drink less than the amount it takes to make you feel intoxicated. Even if you do become intoxicated, drinking less can make hangover symptoms less severe.
• Sip carbonated beverages slowly. If you’re having carbonated beverages containing alcohol like champagne, drink them slowly. The carbon dioxide bubbles can speed up the rate of alcohol absorption in your bloodstream and compete with oxygen absorption.
• Choose wisely. Consume drinks with lower amounts of congeners. Lighter-colored drinks like vodka, gin, light beer and white wine typically result in less severe hangover symptoms. Darker-colored drinks with high levels of congeners, like bourbon, scotch, tequila, brandy, dark beers and red wine, cause more severe symptoms.
• Drink water. Alternate beverages containing alcohol with plain water. The water helps prevent dehydration.
• Eat. Food helps slow the absorption of alcohol. It’s best to eat before drinking, and a heavier meal can offset alcohol’s effects on your body. Even adding non-diet cola, ginger ale, fruit juice or punch to your drink can help slow absorption.
• Pace yourself. Limit consumption to one drink per hour. That’s about how much your body can process. You’ll help keep your blood alcohol levels from reaching the point of intoxication.

How long does a hangover last?

Typically, your symptoms are the worst when your blood alcohol level returns to zero. Symptoms can last about a day or possibly longer.

Are hangovers dangerous?

Hangovers can cause more than just unpleasant symptoms. With a hangover, you’re not thinking clearly. Alcohol impairs your attention, decision-making processes and muscle coordination. You might engage in risky behavior you wouldn’t ordinarily do. For example, driving during a hangover can be dangerous or deadly. People can also injure themselves at work.

How common are hangovers?

Hangovers are very common in people who consume too much alcohol. In one study, researchers found that about 75% of people who drank excessively the night before reported hangover symptoms. The researchers concluded that 25% to 30% of people who drink may be resistant to hangovers.

When should I see a healthcare provider?

Hangovers tend to go away on their own, even if you don’t do anything. As your body readjusts to the lack of alcohol, you start to feel better.

But talk to your provider if you have signs of alcohol use disorder. They can talk to you about treatment options. Symptoms include:

• Frequent episodes of heavy drinking.
• Severe alcohol withdrawal symptoms.
• Hangovers and drinking affecting your quality of life, including your relationships and your job.

What questions should I ask my healthcare provider?

If you’re worried about hangover symptoms, ask your provider:

• Do I have risk factors for alcohol use disorder?
• Do I have alcohol intolerance or alcohol allergy?
• What can I do to prevent or reduce hangover symptoms?
• How much alcohol is safe for me to drink?

When should I seek emergency care for a hangover?

Call 911 if you’re with someone who’s been drinking and shows any of these symptoms:

• Breathing that’s slow (fewer than eight breaths a minute) or irregular (if there’s a gap longer than 10 seconds between breaths).
• Cold to the touch (hypothermia).
• Confusion.
• Passing out (unconscious) or having trouble staying conscious.
• Seizures.
• Severe vomiting.
• Skin that’s pale or blue (in people with dark skin tones, check their gums and lips).