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Hangovers vs. Withdrawal: What’s the Difference?

Elena Hill, MD, MPH profile image
Medically Reviewed By Elena Hill, MD, MPH • Updated Oct 10, 2022 • 5 cited sources

“Hangovers” are a colloquial term used to refer to symptoms experienced the day after alcohol use. Hangovers are unpleasant but not usually medically concerning. In contrast, alcohol withdrawal is a sign a person has grown physically dependent on a drug and a more serious concern. 

What Is An Alcohol Related “Hangover”?

“Hangovers” are the experience of feeling ill the day after drinking, and can occur in anyone who drinks alcohol, particularly when they drink more heavily than they usually do. Hangovers are short lived, usually restricted to the morning or even the full day after drinking, but resolve on their own.

While all the science of a hangover is not completely understood, some contributing factors include the following:[1]

  • Mild dehydration
  • Disrupted sleep
  • Gastrointestinal irritation
  • Inflammation
  • Acetaldehyde exposure
  • Anxiety
  • Fatigue
  • Headache
  • Increased blood pressure
  • Irritability
  • Muscle aches
  • Nausea
  • Sensitivity to light and sound
  • Stomach pain
  • Sweating
  • Thirst
  • Vertigo
  • Weakness

Alcohol Withdrawal is entirely distinct from a hangover. Alcohol withdrawal occurs in patients who drink regularly, and often heavily. Withdrawal occurs when the body becomes physically dependent on alcohol. In the absence of alcohol, the brain begins to crave the alcohol, and a person can experience a number of unpleasant and sometimes even life-threatening symptoms as a result.

Should You Handle Hangovers & Withdrawal Differently?

Hangovers and withdrawal warrant very different reactions.

A hangover indicates that you may have drunk too much the previous night, but it doesn’t necessarily signal any major health concern. Heavy drinking can have serious health consequences. While it isn’t good to drink so much that you have a hangover, it isn’t necessarily a significant concern if you drink in moderation and only get them rarely.

Withdrawal symptoms, in contrast, signal that you have grown physically dependent on alcohol. It is often the sign that a person may have a more serious dependence on alcohol, or even meet criteria for an alcohol use disorder (AUD).

Common symptoms of mild alcohol withdrawal include:

  • Anxiety
  • Depression
  • Difficulty thinking clearly
  • Fatigue
  • Irritability
  • Shakiness
  • Mood swings
  • Nightmares

Severe alcohol withdrawal, called delirium tremens, can be dangerous and includes symptoms such as these:

  • Agitation or anger
  • Auditory and visual hallucinations
  • Fever
  • Seizures
  • Severe confusion[2]
  • respiratory depression
  • autonomic dysregulation, low blood pressure 
  • arrhythmias 
  • death

If you are noticing withdrawal symptoms when you stop drinking alcohol, you should see a medical professional. They can help you determine if you have a more serious problem with alcohol and offer you medications and other resources to help you safely discontinue alcohol use and maintain abstinence if that is one of your goals. 

Is Alcohol Withdrawal Dangerous?

Yes, it can be. Mild Withdrawal isn’t typically dangerous, however a small percentage of individuals can progress from mild symptoms to more severe symptoms. In very rare occasions, alcohol withdrawal can lead to a condition called delirium tremens which can result in seizures, autonomic dysregulation, low blood pressure and even death. It is therefore generally recommended that people who have any history of having more serious or severe withdrawal symptoms (hallucinations, altered mental status, seizures, admission to the ICU, etc.) should undergo alcohol withdrawal under the supervision of a medical provider.

Medication for Addiction Treatment (MAT) can be a vital part of recovery from AUD. There are several medications that can be taken to prevent relapse to alcohol use, including Disulfiram, Acamprosate, and Naltrexone. Talk to your doctor about managing alcohol withdrawal and next steps, with or without medications, for maintaining abstinence from alcohol.

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 ... Read More

  1. Hangovers. National Institute on Alcohol Abuse and Alcoholism. March 2021. Accessed August 2022.
  2. Alcohol Withdrawal. MedlinePlus. January 2021. Accessed August 2022.
  3. Opiate and Opioid Withdrawal. MedlinePlus. May 2020. Accessed August 2022.
  4. Handling Nicotine Withdrawal and Triggers When You Decide to Quit Tobacco. National Cancer Institute. January 2022. Accessed August 2022.
  5. The Cannabis Withdrawal Syndrome: Current Insights. Substance Abuse and Rehabilitation. April 2017. Accessed August 2022.
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