Why Does Alcohol Cause Headaches?
One of the main problems facing those who struggle with alcohol is the alcohol headache. Alcohol headaches are not only subject to those who have a history of misuse or abuse of alcohol. These types of headaches can hit anyone of any age and background. An alcohol headache may fall into many categories, and while they are painful and unpleasant, some things can be done to relieve the alcoholism symptoms.
Alcohol has long been connected with the development of headaches, with about one-third of individuals with migraine noting alcohol as a trigger. Studies suggest that red wine, but not white and sparkling wines, trigger headaches independent of how much a person drinks in less than 30% of people. Lower quality wines may cause headaches due to the presence of molecules known as phenolic flavonoid radicals, which may interfere with serotonin, a signaling molecule in the brain involved in migraines.
In one study, the odds of a person citing red wine as a trigger of headache were over three times greater than the odds of indicating beer as a headache trigger. In addition, in some studies, it was observed that spirits and sparkling wines were associated with migraines significantly more frequently than other alcoholic beverages.
Besides hangover headaches and alcohol headaches, alcohol has also been reported as a trigger in primary headaches, most notably migraine and cluster headaches, followed by tension headaches (although the evidence is not as robust). The means through which alcohol can activate these particular headaches is not well understood. While the acute widening of blood vessels in the brain (called vasodilation) may explain the alcohol headache, this is likely not the mechanism for hangover headaches (when alcohol levels in the blood have declined to zero). Experts believe that nerve chemicals involved in central pain control, like serotonin, are likely responsible for an alcohol hangover headache, also called a delayed alcohol headache.
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Types of Alcohol Headaches
Immediate Alcohol-Induced Headaches
This type of alcohol headache is known as the ‘cocktail headache’ and comes on shortly after taking an alcoholic drink. This type of headache is less common, but many people may notice the symptoms developing within 3 hours of drinking. However, the headache is known to clear after 72 hours of abstinence.
Those suffering from an immediate alcohol headache will likely feel a pulsating sensation, usually on both sides of the head. They will also find that the headache increases in intensity when any physical activity is taken.
Delayed Alcohol-Induced Headaches
The most common type of alcohol headache is the delayed headache, which is seen to occur around 12 hours after drinking alcohol. It is frequently referred to as the ‘hangover’ headache. While similar symptoms to the immediate alcohol headache are experienced, this type of alcohol headache is usually a more dull, throbbing pain.
How Alcohol Triggers Headaches
There have been several proposed explanations for how alcohol causes headaches.:
- Red wine is the type of alcohol most often reported as a headache trigger. Tannin, a component in red wine, has been long considered the culprit. In addition to red wine, other alcoholic beverages, including beer, white wine, and liqueur, have also been reported as headache triggers.
- Substances such as sulfites, histamine, and tyramines are found in alcohol and may contribute to headaches as well. It has also been proposed that alcohol triggers an inflammatory response that can lead to a headache. Alcohol not only contains a chemical called histamine, but it also spurs your immune system to make more. This boosts inflammation throughout your body.
- Alcohol’s exact role in triggering headaches isn’t fully known. Many things are probably at play. For example, alcohol byproducts called congeners have been connected to headaches. Dark-colored alcohols like red wine, brandy, and whiskey may contain more of them.
- A chemical called ethanol is alcohol’s main ingredient. Once it gets into your system, it is converted into a chemical that triggers migraine. Ethanol is also a natural diuretic. That means it makes you pee more than normal. All of these things can set you up for a migraine.
Alcohol as a Migraine Trigger
Headaches cause pain in the head, face, or upper neck, and can vary in frequency and intensity. A migraine is an extremely painful primary headache disorder. Migraines usually produce symptoms that are more intense and debilitating than headaches. Many people with migraine find that certain factors trigger their symptoms. Drinking alcohol is a trigger for some people with migraine. Alcohol is a diuretic – it acts on your kidneys to make you pee more fluid than you’re taking in. Losing fluid from your body like this can lead to dehydration, which can cause headaches. So if you’re prone to migraines, you might get one if you drink to excess.
A phenomenon called glutamate rebound is an additional contributor. Glutamate is one of our body’s main excitatory chemicals, meaning it makes neurons more likely to fire (and thus increases activity at different locales inside the brain). Alcohol initially dampens glutamate activity, which reduces neural activity. But as it’s processed by our bodies and its inhibitory effects subside, we experience a glutamate rebound—an upsurge in glutamate activity resulting in increased neuronal activity. This increased activity can trigger headaches by activating pain receptors along various cranial nerves—especially for folks predisposed to migraines, who have been found to have naturally higher glutamate concentrations in their cortexes than folks who don’t tend to get frequent headaches.
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Alcohol Withdrawal Headache & Types Of Alcohol Withdrawal Syndrome
Headaches are one of the most common physical symptoms of alcohol withdrawal. Headaches can initiate only 6 hours after your last drink and may last anywhere between 3 days to over a year. A person’s alcohol withdrawal timeline depends on a number of factors, including the severity of alcohol dependence, the presence of other health problems, additional substance abuse, and others. Headaches are fairly consistent across withdrawal types. The combination of headaches with other symptoms can tell you how serious the withdrawal will likely be.
Alcohol is a depressant that affects the central nervous system. The effects of alcohol can spread through the entire body, and the same can be true when alcohol is taken away from the body. Alcohol withdrawal types can vary depending on your drinking habits and your body’s natural tolerance to alcohol.
Acute Alcohol Withdrawal Syndrome (AWS)
A patient can develop alcohol dependence from consistently high alcohol consumption over a long period of time. Once this happens, they may experience alcohol withdrawal when they try to quit. Alcohol withdrawal syndrome, or AWS, can start only 6 hours after your last drink.
Headaches are only one symptom of alcohol withdrawal syndrome. Other common symptoms of alcohol withdrawal include tremors, anxiety, stomachaches, and palpitations. Headaches caused by AWS tend to last for about 1 to 2 weeks. If headaches last for longer, this can be a sign that you’ll have more severe withdrawal symptoms. You may want to seek medical care if you feel like your headaches are not going away.
Post-Acute Withdrawal Syndrome (PAWS)
Withdrawal symptoms can appear suddenly after the acute withdrawal period has ended. This is known as post-acute withdrawal syndrome, or PAWS. During PAWS, many withdrawal symptoms such as sweating, tremors, sleeping problems, and alcohol headaches can come back without warning.
Symptoms of PAWS can go on for months or even years after you stop drinking. Headaches during PAWS can range from mild to severe. People suffering from PAWS may be tempted to go back to drinking just to make the alcohol headaches and other symptoms stop.
Prolonged withdrawal, also known as protracted withdrawal syndrome, is an acute withdrawal that lasts for up to a year, instead of a short-term two-week withdrawal timeline. You may be experiencing painful alcohol headaches for an entire year under prolonged withdrawal. Prolonged or protracted withdrawal can be hard to overcome without medical care or a stay at an inpatient treatment facility. The constant toll on your physical and mental health may increase your chances of relapsing.
Delirium Tremens (DTs)
Delirium Tremens, or DTs, is the most severe form of alcohol withdrawal. The first signs of DTs can come up 48 hours after your last drink, and about 42 hours after headaches have started. Side effects of DTs include visual and auditory hallucinations, increased body temperature, increased heart rate, increased body temperature, high blood pressure, and sweating. Headaches may not feel as intense compared to some of these symptoms. DTs can be life-threatening for some experiencing alcohol withdrawal, especially if medical attention is not given.
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Headache After Drinking Alcohol
Headaches after drinking alcohol, commonly known as hangovers, can last up to 72 hours after drinking, but most are shorter in duration. Again it depends on how much was consumed, how dehydrated you became, nutritional status, ethnicity, gender, the state of your liver, medications, etc.
It’s well known that drinking too much alcohol can cause a variety of symptoms the next day. A headache is just one of them. It’s easy to find tons of purported hangover headache “cures” that you can make at home and even buy in stores. But most of them have no reliable scientific research that proves they work .
How to Stop Alcohol Headaches
The best way to avoid a hangover headache is to limit how much alcohol you drink in one sitting. Still, we’ve also got some tips that can help you reduce your chances of having a headache, and a few to ease your pain in case you’ve already got one.
The following may help reduce the symptoms:
- Drinking water: Alcohol makes a person urinate more frequently, often leading to dehydration, in which case it is crucial to rehydrate the body.
- Eating nutritious foods: Healthful foods give the body fuel, nutrients, and antioxidants, which can aid recovery.
- Eating bland foods: When a hangover involves stomach trouble, try bland foods that raise blood sugar levels, such as bread.
- Eating fruit: The fructose in fruit may help the body break down alcohol.
- Resting: Sleep can help speed up recovery.
- Taking medication: NSAIDs, antacids, and some pain relief medications can relieve hangover symptoms.
A person with a hangover should not take pain relief medications or any other drugs that contain acetaminophen. This ingredient can strain the liver — like alcohol — so it is important to avoid combining the two.
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What’s the Treatment?
If alcohol is a headache trigger for you, think before you drink. In other words, the best treatment for a cocktail headache is actually preventing one in the first place. Before consuming a cocktail, ask yourself if it is worth developing a headache over and ruining your celebration or holiday.
If alcohol only occasionally causes you a headache, then moderation or striking that balance (as opposed to abstinence), maybe a more reasonable approach. If you do develop an occasional cocktail headache, soothe your discomfort with rest, a tall glass of water, and an over-the-counter painkiller.
If you are experiencing headache as one of the many symptoms of alcohol withdrawal, then you need professional help. Management of alcohol withdrawal headaches is likely best served as part of a treatment program. A person suffering from severe or prolonged withdrawal may need relief from headaches and other symptoms .
Alcohol headaches, when combined with other side effects, can make alcohol withdrawal very uncomfortable, painful, and sometimes deadly. It can be challenging to fight withdrawal on your own, but setting up a treatment plan with an inpatient rehab facility can put you in a situation to recover. Treatment options vary depending on the person’s needs but often start with a medical detox before moving into psychotherapy, management of withdrawal symptoms, and contacting support groups.
Start the healing process of alcohol headache and all the other symptoms of alcohol withdrawal. We Level Up NJ has amenities, therapies, and activities with customized recovery plans in place. During the treatment program, clients learn how to handle triggers, prevent urges to drink, and other tools to help maintain sobriety.
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 NCBI – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4821937/
 NIAAA – https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers#:~:text=As%20a%20result%2C%20alcohol%20increases,tend%20to%20wake%20up%20earlier.
 SAMHSA – https://www.samhsa.gov/medication-assisted-treatment/medications-counseling-related-conditions