Alcohol & Health
Treatment
Helping Alcoholics
Medically Reviewed by Dr P. E. Pancoast, MD
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Consuming alcoholic beverages is an enjoyable pastime for many, but it can also have lasting repercussions, like a two-day hangover.
A two-day hangover is essentially what it sounds like—a hangover lasting longer than the typical 24 hours. Various factors can cause it, so drinking responsibly, knowing the factors, employing preventative strategies, and seeking treatment can make the experience less frustrating.
Yes, it’s possible to have a two-day hangover.
Aside from poor alcohol management, the following can contribute to prolonged hangover symptoms and cause a self-induced harmful cycle:1
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Dehydration is a significant factor in experiencing a two-day hangover. Alcohol inhibits the production of vasopressin, a hormone that tells the kidneys to hold onto fluids.2
The lack of vasopressin leads to increased urination and fluid loss, resulting in headaches, fatigue, and thirst.
Alcohol can cause irritation and damage to the stomach lining, leading to a range of uncomfortable symptoms, such as:3
Additionally, alcohol can decrease appetite and increase acid release, further contributing to gastrointestinal tract distress.
When you drink alcohol—a toxin— your body naturally responds to it with inflammation. Higher levels of inflammatory biomarkers make a hangover worse.
Inflammatory mediators, such as IL-6, TNF-α, and CRP, and oxidative stress biomarkers increase immediately after consuming alcohol and stay elevated for over 12 hours. The elevated inflammatory response in your body causes these hangover symptoms:4
The symptoms of a two-day hangover can vary from person to person. However, they’re the same as those you’d experience after a typical 24-hour hangover. These side effects include:2
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There’s no scientifically proven hangover cure; the only true solution is time. The body needs to naturally eliminate the toxic byproducts of alcohol, return immune and brain function to normal, and heal damaged tissues.2
But if you’ve already overindulged, these remedies can help:5
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Yes, it’s normal to feel drunk two days after drinking. Alcohol can stay in your system for up to 24 hours, and the effects of a bad hangover can last for up to 48 hours, especially if you drink on an empty stomach.
However, if you experience any of the following prolonged severe symptoms, seek medical attention immediately:6
Research suggests that the severity of hangovers increases when they occur more frequently, potentially indicating a heightened risk for future AUD.7 Sensitization or reverse tolerance to this aspect of alcohol consumption may drive this.
This finding requires further investigation to fully understand the link between hangover frequency and severity for preventing AUD.
Yes, hangovers can be worse with liver damage. When heavy drinking damages the liver over time, it can’t metabolize alcohol as quickly. This change causes more toxins to build up in the body, which can lead to longer-lasting and more severe symptoms of a hangover.
In addition, alcohol can interfere with the absorption of nutrients from foods and cause deficiencies related to thiamine, folate, and vitamin B12.8 These deficiencies can also contribute to prolonged hangover symptoms.
It depends on the person and how much alcohol they consume. Generally, a hangover shouldn’t last longer than 24 hours. However, more severe hangovers can last up to 72 hours.
If your hangover lasts beyond this, it may indicate an underlying health issue or alcohol use disorder. You should discuss it with a doctor as soon as possible.
Alcohol heads straight to the liver after leaving the gastrointestinal tract. It travels through capillaries surrounding the stomach and intestines, leading to the liver via the portal vein.
Once inside the liver, ethanol diffuses into the hepatic cells, where enzymes work to convert it into inactive metabolites. This process, known as metabolism, detoxifies the ethanol and prevents bodily harm.9
To support metabolism, follow the tips on recovering from a two-day hangover mentioned earlier, such as drinking plenty of water and getting proper rest.
Yes, especially if you consumed a substantial amount of alcohol. As your blood alcohol concentration plummets, your brain undergoes sweeping modifications in certain neurotransmitter levels.
Alcohol imitates gamma-aminobutyric acid’s (GABA) effects, which induces a sense of decreased inhibition. This reaction corresponds to the amiable and relaxed mood you may feel when you drink alcohol. However, these consequences overturn during a hangover, resulting in a surge in anxiety.1
A two-day hangover can be uncomfortable, but it’s not necessarily an indication of a bigger problem. Hangovers occur when the body needs time to process and detoxify alcohol. Eating foods high in complex carbohydrates and electrolytes, taking pain relievers, and drinking plenty of water can all help recovery.
However, seek medical attention if your hangover lasts more than 48 hours and you experience severe symptoms or difficulty controlling your drinking.
Remember, the best way to avoid a two-day hangover is to prevent it by drinking responsibly.
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