If you’ve ever gotten drunk before, you have almost certainly had a hangover. You feel irritated, fatigued, slow to react, and slightly ill. You may feel regretful of your actions or down on yourself. Some people even experience a sense of existential despair. Hangovers are certainly not pleasant, but we expect them to last a day at most.
There is, however, an entirely different experience that some may confuse with a hangover. That is, alcohol withdrawal. Alcohol withdrawal is something that occurs only after an extended period of frequent alcohol use. It is connected to the body’s increasing dependence on alcohol to function. It is a lot more serious than a hangover, and the distinction therefore needs to be understood.
We’re going to discuss the difference between a hangover and alcohol withdrawal, including the causes and symptoms of each, as well as what kind of treatment is needed.
What is a Hangover?
A hangover is a temporary and unpleasant condition resulting from excessive alcohol consumption, usually following a night of heavy drinking. It is the body’s reaction to the toxic effects of alcohol and its byproducts, as well as dehydration and disrupted sleep. It is something almost everyone goes through regardless of how frequently they use alcohol, and can be managed without medical intervention.
What Causes a Hangover?
Hangovers are caused by excessive drinking, but what are the underlying factors that lead to the symptoms?
- Dehydration: Alcohol suppresses the hormone vasopressin, leading to increased urination and dehydration. Many symptoms of a hangover are symptoms of dehydration.
- Acetaldehyde Buildup: As the liver breaks down alcohol, it produces acetaldehyde, a toxic compound that contributes to nausea and headaches.
- Electrolyte Imbalance: Excessive drinking can deplete essential minerals like potassium and sodium, leading to fatigue and muscle weakness.
- Disrupted Sleep: Alcohol can interfere with deep REM sleep, leaving you feeling unrefreshed.
- Remaining Under the Influence: Depending on factors such as your metabolism and when you stopped drinking, you might still be somewhat under the influence of alcohol, leading to exacerbated symptoms.
Symptoms of a Hangover
- Headache
- Fatigue
- Nausea and vomiting
- Sensitivity to light and sound
- Dry mouth and thirst
- Dizziness
Duration: Hangovers typically last less than 24 hours and subside with hydration, rest, and over-the-counter remedies. Although you are not considered ‘under the influence’, it is important to avoid driving and performing other potentially dangerous tasks, as your reaction times and decision-making remain impaired.
What is Alcohol Withdrawal?
Alcohol withdrawal, on the other hand, is a severe medical condition that occurs when someone who is physically dependent on alcohol suddenly stops drinking or significantly reduces their intake. Unlike a hangover, alcohol withdrawal is not merely uncomfortable; it can be life-threatening without proper medical care.
Causes of Alcohol Withdrawal
Chronic alcohol consumption alters the brain’s chemistry. Alcohol increases the effects of gamma-aminobutyric acid (GABA), a neurotransmitter that calms the nervous system. Over time, the brain compensates by reducing its own natural GABA production and increasing excitatory neurotransmitters like glutamate. When alcohol is suddenly removed, this delicate balance is disrupted, leading to overexcitation of the nervous system.
Symptoms of Alcohol Withdrawal:
- Mild Symptoms: Anxiety, restlessness, sweating, tremors, insomnia.
- Moderate Symptoms: Elevated heart rate, high blood pressure, nausea, irritability.
- Severe Symptoms (Delirium Tremens or DTs): Hallucinations, seizures, confusion, fever.
Duration: Symptoms can begin within a few hours of the last drink and may persist for several days or weeks, depending on the severity of the dependency.
Key Differences Between Hangover and Alcohol Withdrawal
While hangovers and alcohol withdrawal can share some symptoms, such as nausea and fatigue, their underlying causes and consequences differ significantly.
1. Severity
- Hangover: Though uncomfortable, a hangover is not life-threatening.
- Alcohol Withdrawal: Can be life-threatening, particularly in cases involving seizures or delirium tremens.
2. Cause
- Hangover: Results from overconsumption of alcohol in a single instance.
- Alcohol Withdrawal: Arises from dependency due to long-term, excessive alcohol use.
3. Onset of Symptoms
- Hangover: Symptoms typically appear a few hours after drinking stops and peak the following morning.
- Alcohol Withdrawal: Symptoms can start within hours of the last drink and escalate over several days.
4. Duration
- Hangover: Symptoms resolve within 24 hours.
- Alcohol Withdrawal: Symptoms can persist for days or weeks, depending on the individual’s drinking history and level of dependency.
5. Treatment Approach:
- Hangover: Can be managed with hydration, rest, and over-the-counter remedies.
- Alcohol Withdrawal: Requires medical supervision, often including hospitalization and medication.
Why Does the Distinction Matter?
The distinction is not just a matter of semantics. Alcohol withdrawal cannot be approached in the same way as a hangover. It is a severe physical response and not understanding the distinction can be fatal. Here’s why.
Health Implications
Mistaking withdrawal symptoms for a severe hangover can delay essential medical care, putting the individual at risk of serious complications. For example, untreated delirium tremens can lead to seizures, heart failure, or death.
Reducing Stigma
People regularly refer to their symptoms after a night of drinking as being ‘just a hangover’. If alcohol withdrawal is confused with a hangover, many might not take it seriously, assuming the person is just overreacting to discomfort rather than going through a medical crisis.
When Would Someone Confuse Alcohol Withdrawal for a Hangover?
The symptoms of alcohol withdrawal are significantly more severe than those of a hangover. Furthermore, they come after an extended period of consistent alcohol use. Why would someone confuse alcohol withdrawal for a hangover?
One of the most common symptoms of substance use disorders is denial. The person explains away their problem as being normal. They ‘can stop any time’ or ‘don’t actually drink that often’. As such, they may tell themselves that withdrawal symptoms are nothing more than a bad hangover. If their loved ones haven’t recognized their alcohol use as addiction, they are likely to take the person’s word for it.
Conclusion
Hangovers and alcohol withdrawal might appear similar, but their differences are significant. While hangovers happen to everyone, are generally low in severity, and go away in mere hours, withdrawal is severe, lasts days or weeks, and can be life threatening.
If you or a loved one may be experiencing alcohol withdrawal, seek medical help immediately. Get in touch with Seasons in Malibu to learn more about how you can detox safely and begin your recovery journey.
