Can Opioids Cause Hangovers?

October 10, 2022

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Opioids cannot cause hangovers definitionally because “hangovers” specifically refer to a set of symptoms caused by alcohol use. However, opioids can cause a number of uncomfortable symptoms that one might call a hangover, even if the term isn’t quite correct. With prolonged use, opioids can cause a withdrawal syndrome that might be described as similar to a severe hangover. Learn more here. 

What is a “Hangover”?

“Hangover” is not a medical term. It is used colloquially to refer to symptoms experienced the morning or day after using alcohol. [1] However, opioid use can still cause a number of unpleasant effects the day after use that could be considered similar to a “hangover” from alcohol. Moreover, prolonged use of opioids can lead to a physical dependence and withdrawal symptoms that can be likened to the symptoms of a “hangover”. 

Symptoms That Follow Opioid Use

Regardless of what one calls it, many negative symptoms can follow a period of opioid use, especially opioid misuse.[2] Opioids can cause drowsiness, mental fog, nausea, and constipation. They also affect breathing, which is generally their most dangerous effect when amplified with excessive use or if one combines opioids with other drugs that have a similar sedating effect. After opioids leave the body even after a single use, patients can have any number of non-specific symptoms including headache, fatigue, malaise, stomach upset, tremors, weakness, etc.

With prolonged use of opioids, patients may begin to experience a more formal syndrome of “withdrawal” hours to days after last use, which is very similar to a flu-like illness that some patients may describe as feeling similar to a severe “hangover”. 

Identifying the Signs of Opioid Withdrawal

Opioid withdrawal is different that the symptoms described thus far, and it is often described as “flu-like.”[4] These symptoms aren’t usually life-threatening, but they can be very uncomfortable, with symptoms including the following:

  • Agitation
  • Anxiety
  • Difficulty sleeping
  • Heavy sweating
  • Muscle aches
  • Runny nose
  • Teary eyes
  • Yawning
  • Abdominal cramps
  • Diarrhea
  • Goosebumps
  • Nausea or vomiting
  • Pupil dilation

If a person is experiencing opioid withdrawal symptoms, it is usually a sign they have a problem with opioid use, or if they’ve only taken opioids as prescribed, it’s a sign that their prescription may need adjusting. In either case, an individual experiencing these symptoms should see a doctor and talk about their options.

What Is Happening in the Body With Opioid Withdrawal?

Opioids have a mechanism of action in which they bind to opioid receptors on cells in the brain and stimulate them. [5] Opioid receptor stimulation blocks pain signals being sent from the brain and releases dopamine, a substance that is a key part of what makes us feel relaxed and happy. This is the way in which they work to both treat pain but also to create “euphoric” or happy feelings.

However, opioids involve a lot more than just pain signaling in the brain. These receptors are found in the gut and GI tract, the skin, and almost every other organ system in the body. Therefore, when the body withdraws from opioids, there are many other systemic effects on those same organs, not just the brain itself.

For example, when a person is using opioids, this turns on opioid receptors in the gut that cause abdominal slowing and constipation. When withdrawal occurs, the opposite symptoms of abdominal cramping and diarrhea can occur.

In the skin, opioid stimulation causes vasoconstriction. In contrast, during withdrawal the under-stimulation of these receptors can lead to vasodilation and sweating. 

Treatment for Opioid Withdrawal 

If you’re experiencing withdrawal from opioids, whether you are taking them as prescribed or illicit, you should talk to a medical professional. There are many evidence-based treatments for opioid withdrawal that can be used both short term to treat withdrawal symptoms and even more long term to prevent cravings and return to opioid use. Reach out to your doctor for more information.

Medically Reviewed By Elena Hill, MD, MPH

Elena Hill, MD; MPH received her MD and Masters of Public Health degrees at Tufts Medical School and completed her family medicine residency at Boston Medical Center. She is currently an attending physician at Bronxcare Health Systems in the Bronx, NY where she works as a primary care physician as well as part time in pain management and integrated health. Her clinical interests include underserved health care, chronic pain and integrated/alternative health.

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Citations

  1. Alcohol Hangover: A Critical Review of Explanatory Factors. Human Psychopharmacology. https://pubmed.ncbi.nlm.nih.gov/19347842/. June 2009. Accessed August 2022.
  2. Opioid Misuse and Addiction. MedlinePlus. https://medlineplus.gov/opioidmisuseandaddiction.html. April 2018. Accessed August 2022.
  3. Characterizing Opioid Use in a US population With Migraine. Neurology. https://n.neurology.org/content/95/5/e457. June 2020. Accessed August 2022.
  4. Opiate and Opioid Withdrawal. MedlinePlus. https://medlineplus.gov/ency/article/000949.htm. May 2020. Accessed August 2022.
  5. Prescription Opioids. National Institute on Drug Abuse. https://nida.nih.gov/publications/drugfacts/prescription-opioids. June 2021. Accessed August 2022.

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