Last Updated on by Dr. Ronaye Calvert-Conley
Your sitting next to your toilet after a night of excessive drinking—shivering and heaving the little food you could manage to swallow. The myriad of symptoms makes you feel like death warmed over. As your head pounds, heart races, and the room appears to spin, you might start to wonder; “Is this just a bad hangover or do I have alcohol poisoning?” At such a helpless moment, the line between hangover and alcohol poisoning can seem rather thin. For this reason, it’s important to differentiate between the symptoms of alcohol poisoning and a hangover.
In a simplified explanation, a hangover is the body’s way of punishing you for over-indulging in alcohol and overburdening your system with toxins – i.e., the body is working overtime but it can get the job done. The after-effects may make you feel like death is beckoning, but it’s not a life-threatening event.
On the other hand, alcohol poisoning occurs when your systems are overwhelmed – i.e., the toxins are too much for the body to eliminate. In such a case, you’re soaked in enough alcohol to affect critical body functions such as temperature regulation, heart rate, and breathing. Unlike a hangover, alcohol poisoning can be fatal. According to the Center for Disease Control and Prevention (CDC), 6 Americans (76% being men) die every day due to alcohol poisoning. Read for an in-depth explanation of the signs of alcohol poisoning and what to do in the case of an event.
What is a Hangover?
What does a hangover feel like—and how is it different from alcohol poisoning? If you’ve been drinking too much but the unpleasant feelings only appear at a later time, then you’re likely suffering from a hangover. The body’s process of metabolizing and expelling ethanol-related toxins is accompanied by unwanted psychological and physical effects – including decreased blood sugar, irritation of the stomach lining, dehydration, dilation of blood vessels, and inflammation. Collectively, these responses manifest as the physical symptoms that make every drinker regret the night before.
What Does a Hangover Feel Like? – Symptoms of a Hangover
Now that you have a good of what is a hangover, let’s look at what you feel—and why you feel that way. Ask anyone, “What does a hangover feel like?” and you’ll receive all kinds of answers that make it sound like the grim reaper came calling – and it’s understandable.
Contrary to common assumptions, alcohol is not a stimulant (at least officially). Although small quantities can “loosen you up,” it’s primarily classified as a depressant—meaning it inhibits the central nervous system. In high quantities, its depressant effects can wreak havoc on your entire body leading to symptoms of a hangover as shown below.
- Dehydration: As a diuretic, alcohol suppresses the production of ADH (antidiuretic hormone), increasing your rate of urination. So unless you counter this effect by hydrating constantly, alcohol depletes your fluid reserves. Coupled with other symptoms of a hangover such as sweating and diarrhea, you tend to feel dizzy, a dry mouth, fatigued, weak, and thirsty.
- Irritation of the gastrointestinal tract (GI): The characteristic nausea or vomiting from a hangover, is caused by an inflammation of the stomach lining and increased production of stomach acid.
- Dropping blood sugar: As the level of blood sugar drops, you may experience shakiness, irritability, fatigue, and weakness.
- Withdrawal: As you made merry chugging drinks the night before, the level of alcohol in your body gradually increased in the span of several hours. So when you suddenly cut the supply of alcohol, you’re likely to experience mildwithdrawal symptoms as the “buzz” wears off. You may feel anxious, sensitive to sensory inputs (sound, light, or even smell), shaking, a headache, and restlessness.
Health-wise, a one-night hangover isn’t such a huge deal—and as we will elaborate in the next section—it goes away all on its own. But if the symptoms are more severe such as irregular breathing, confusion, or seizures, it could indicate alcohol poisoning. Such an event demands immediate medical attention. You should also be concerned if the victim of a hangover has other medical conditions such as a history of diabetes or heart disease—which may exuberate the symptoms of a hangover.
How Long Does a Hangover Last?
If you’re suffering from a bad hangover, relief can’t come soon enough. You raid online resources (such as this one), ask for advice from friends, or even drag yourself to the nearest pharmacy – all in a desperate plea to experience some semblance of normalcy. Fortunately, hangovers last for around 24 hours—but it can feel like an eternity of mental and physical torment.
If your symptoms pass the 24-hour mark, it’s advisable to seek medical help. But please note that the question on “How long does a hangover last?” depends on several factors.
- Age: Ever wondered why college students seem to have a high tolerance for alcohol? As we get older, our bodies slowly lose their ability to expel toxins quickly. As a result, older people may experience hangovers for longer.
- Medication: Some pharmaceutical medications such as antibiotics, allergy medication, and antidepressants may affect how your body metabolizes alcohol.
- Level of hydration: The more dehydrated you are, the longer the hangover will last.
- Amount of alcohol consumed: It goes without saying that the more alcohol you consume, the more severe the symptoms of a hangover. It’s also worth noting that a study published in the Journal of Addiction Disorder and Rehabilitation, suggested that the number of drinks consumed does not affect the duration of a hangover.
- An empty stomach: Most of the alcohol you consume is absorbed in the small intestines. With this in mind, drinking on an empty stomach means that the alcohol will pass quickly to the small intestines and intensify the side effects of the ensuing hangover.
- Amount of sleep: Research shows that the severity of hangovers is inversely correlated to the amount of sleep. In other words, the less sleep you get after a night of heavy drinking, they lousier you’ll feel.
What are the Remedies for a Hangover?
The internet is crowded with supposed silver bullets to remedy hangovers—most of which are not substantiated by science. However, the only true cure for a hangover is time! Wait it out and give your body time to expel the toxins. You should feel a lot better before a day is over. But as you put your trust in your body’s ability to restore order, here are a few hangover remedies to ease your suffering:
- Eat something to replenish your depleted electrolytes. If you’re feeling nauseous, stick to toast or other bland foods.
- Get some sleep to help your body function more optimally. Plus, you’ll be oblivious of the hangover symptoms for a while.
- Sip on some juice or water to stay hydrated and ease symptoms such as a dry mouth, thirst, and weakness.
- Take some medication such as ibuprofen to dial down the muscle aches and headaches. Pepto-Bismol may also help with stomach distress.
Tips on How to Avoid a Hangover
- Avoid alcohol: The most fool-proof way to avoid a hangover is simply eliminating the main culprit from the equation.
- Drink in moderation: If you feel the first option is too drastic, then set a limit and drink in moderation. According to the most recent Dietary Guidelines by the Office of Disease Prevention and Health Promotion (ODPHP), “moderate drinking” means 2 drinks for males and one for females.
- Take it slow: Sipping your drink gives the body the much-needed time to process the alcohol—hence reducing the risk of a hangover.
- Eat before heading out for a drink
- Alternate alcohol with another non-alcoholic drink such as water.
When is it Alcohol Poisoning and Not a Hangover?
As explained earlier, the symptoms of a hangover appear when the level of alcohol in your blood drops—hence the reason you typically experience the effects the morning after a night out. On the other hand, signs of alcohol poisoning appear when there’s too much alcohol in your bloodstream to the point that it can’t be safely processed by the body. This typically happens when you binge drink – i.e., drinks a toxic amount of alcohol in a short time.
What are the Signs and Symptoms of Alcohol Poisoning?
Without immediate medical intervention, the symptoms of alcohol poisoning pose a serious health risk. Therefore, you should know how to spot the signs of someone with alcohol poisoning. Their lives might be hinged on your interpretation of the situation and speed of response.
If you notice someone with some of the symptoms below—especially after binge drinking—find emergency medical help as quickly as possible.
- Mental confusion
- Lack of coordination
- Irregular or slow breathing
- A state of near-unconsciousness or senselessness – i.e., they are conscious but unresponsive
- Passing out
- Chills and low body temperatures
- Blue-tinged fingertips or pale skin (signs of hypothermia)
- Profuse vomiting
- Loss of gag reflex
What are the Risks and Dangers of Alcohol Poisoning?
- Choking: When you lose your automatic gag reflex but your body keeps pushing the contents of your stomach up the food tract, the risk of choking is high – and it can be fatal.
- Severe dehydration, which could cause brain damage in extreme events
- Risk of severe hypothermia
- Increased risk of a heart attack
- Seizures that put you in danger of physical harm
- Loss of breathing and suffocation
What Leads to Alcohol Poisoning?
When you drink any alcoholic product—including accidental consumption of household products—the liver is mandated with the task of filtering out the toxins from your blood. Normally, the body can effectively process around one unit of alcohol every hour. But if you drink too much in a short time, the liver becomes overwhelmed and it can’t process the alcohol. This leads to a sharp increase in your BAC (blood alcohol concentration). Therefore, the risk of alcohol poisoning increases relative to the number of alcohol units consumed in a sitting.
Wondering exactly how much alcohol is too much? Below is a breakdown of the effects of binge drinking in relation to the number of alcohol units consumed.
- Up to 2 units: You tend to feel sociable and warm as your blood vessels expand and heart rate gradually increases.
- 4-6 units: The effects start impacting your nervous system. You may feel lightheaded, and reactions may get slower. You may also lose your inhibitions and decision-making ability, leading to recklessness.
- 8-9 units: Your vision gets blurry, speech slurred, and your reaction time is noticeably slower. At this stage, your liver is overburdened and the risk of a hangover is quite high.
- Up to 12 units: At 12 units of alcohol, the blood alcohol concentration is quickly approaching toxic levels. Your feet are unstable, you feel dizzy, and your coordination is significantly impaired—increasing the risk of accidents. You may also tend to frequent the washrooms are your body frantically tries to expel the alcohol.
- Over 12 units: Anything past 12 units puts you at a high risk of poisoning and losing consciousness. This can interfere with your gag reflex, heart rate, breathing, and other automatic bodily functions.
PS: A “unit” is measured based on the ABV (Alcohol by Volume) of a particular drink. For example, a single 25ml shot of spirits (40% ABV) and around 250 ml of lower-strength beer (3.6% ABV) both represent a unit of alcohol.
How to Help Someone with Alcohol Poisoning
When someone exhibits signs of alcohol poisoning—especially after binge drinking—it’s vital that they get help immediately. At the emergency department of a hospital, the medical practitioners will often insert a tube in their windpipe to help with breathing, fit an IV (intravenous tube) to top up the level of vitamins, blood sugar, and water in their bloodstream, and even pump their stomach (in extreme cases) to expel excess alcohol. But as you wait for the emergency medical services to arrive, here are a few things you can do to help.
- If possible, give the poisoned individual sips of water for hydration.
- Do your best to keep them awake and in a sitting position.
- If the person is unconscious place him/her on the side in a recovery position—and monitoring their breathing
- Keep them warm to counter the low body temperature.
- Keep an eye on them until emergency medical help arrives.
Things to AVOID When Someone Has Alcohol Poisoning
- Never tell someone to “sleep it off”when they have symptoms of alcohol poisoning. It may be a sound piece of advice for people with hangovers but it’s never a good idea in the event of alcohol poisoning. Why so? Even after someone stops drinking, the level of alcohol in the bloodstream may continue rising for up to 40 minutes as it passes from the gastrointestinal tract. This means that there is a risk that alcohol poisoning symptoms may become more severe over time.
- Don’t give the caffeine! Contrary to popular myths, giving coffee to someone with signs of alcohol poisoning is not advisable. Caffeine is a mild diuretic and it may worsen dehydration. Additionally, the CDC states that “Caffeine has no effect on the metabolism of alcohol by the liver and thus does not reduce breath or blood alcohol concentrations (it does not “sober you up”) or reduce impairment due to alcohol consumption.”
- Don’t give them drugs or more alcohol. Drugs can interact with alcohol and make the symptoms of alcohol poisoning worse. So unless you’re a qualified medical professional, it’s safer to steer clear of any medication.
- Do not feed them yet. Choking or suffocation is one of the causes of death in patients with alcohol poisoning. For this reason, you should avoid anything that can block their airway.
- Telling them to take a walk. Asking someone with impaired judgment and lack of coordination to “walk it off” is an obvious no-no.
- Taking a cold shower. You’ve probably heard suggestions that taking a cold shower helps you sober up – but keep in mind that one of the symptoms of alcohol poisoning is hypothermia. Therefore, a cold shower can cause temperatures to drop lower—increasing the risk of shock.
Treating Problematic Drinking – Do I Need Rehab?
If you find yourself continually binge drinking and always searching the internet for hangover remedies, then it might be time to review your drinking habits. Even if you’ve never experienced alcohol poisoning symptoms, it’s unwise to tempt fate. Below are a few questions to help you determine whether you may be struggling with an alcohol use disorder.
- Have your drinking habits forces you to withdraw socially?
- Do you have a seemingly irresistible craving for alcohol? Do you constantly obsess over the next drink?
- Do you experience prolonged withdrawal symptoms when you’re not drinking?
- Have you noticed an increase in your level of tolerance? Do you have to drink more to achieve the desired effects you crave?
- Is your drinking causing relationship problems with your loved ones or at work?
- Do you often experience memory loss or blackouts?
If you can relate to some of the questions above, you may need rehab for your problematic drinking. Alcohol treatment programs help examine your drinking motivations and behaviors in an attempt to identify your triggers and resolve underlying issues. Together with therapy and other medical interventions, the programs can help you get over your alcohol use disorder—leading to a healthier lifestyle
Dr. Ronaye Calvert-Conley is the CEO and Founder of Revive Detox, a Joint Commission Accredited and Legit Script Certified Addiction Treatment Center in Los Angeles, CA. She earned her Doctorate in Clinical Psychology from Alliant International University in Los Angeles in 2007 and has extensive experience working in the addiction and recovery field and the LGBT community. To learn more about Dr. Calvert-Conley click here.