Understanding Alcohol Induced Headaches

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Alcohol-induced headaches are pretty common. In general, alcohol is the identified migraine trigger in about 33% of migraine patients and a constant trigger in 10% of them. (1) This problem affects all alcohol drinkers, including those who consume alcohol in a harmful quantity.

Several studies have shown that more alcohol consumption is a common factor that can induce a primary headache, which is a headache that cannot result from other medical conditions.

To learn more about this condition, how it relates to alcohol use or misuse, its adverse effects, and how to treat it, read this article.

Types of Alcohol Consumption Triggered Headaches

Headaches caused by alcohol consumption are migraines, tension-type headaches or cluster headaches. They are all painful, often debilitating, and hampers the performance of daily activities. Each type has its characteristics.

1. Migraines Headaches

Migraines are typically throbbing pain that gets worse and is felt only on one side of the head. It comes with nausea, vomiting and sensitivity to light and noise. Some migraine patients get an “aura”, characterised by ringing in the ears, flashing lights or blind spots.

2. Tension Headaches

Tension headaches are the most common type. There is a dull, aching pain on the head and a tightening feeling on the sides, forehead, and back.

3. Cluster Headaches

Cluster headaches are so-called because of their cyclical patterns. Bouts may appear from 1 to 8 times a day, with attacks lasting from 15 minutes to few hours - 3 hours. Cluster headaches persist for weeks or months, after which they go into a remission period that could last months or years.

Cluster headaches are rare and not life-threatening, but the pain they bring on is very intense. Patients feel pain around one eye on one side of the head.

Onset of Alcohol-Induced Headaches

The onset of alcohol consumption headaches may be immediate or delayed. A quick alcohol-induced headache is also called a cocktail headache and is characterized by the following: (2)

  • Headache develops within 30 minutes to 3 hours of alcohol consumption.
  • Headache resolves spontaneously 72 hours after cessation of alcohol drinking.
  • Headache is of pulsating quality, is felt on both sides of the head, and worsens with physical activity.

On the other hand, a delayed hangover headache (DAIH) is the more common occurrence. It is known by its more popular name - hangover headache. This headache presents as:

  • Delayed alcohol induced headache can develop within 5-12 hours or usually, the morning after alcohol consumption.
  • The headache goes away without treatment within 72 hours.
  • Headache symptoms are similar to immediate alcohol-induced headache: pulsating sensation; bilateral; and worsening with physical activity.

What Causes Hangover Headache?

Alcohol as a headache trigger has been accepted, and various population studies back this theory. What is not scientifically proven is that some types of alcohol cause more headaches than others, with drinking red wine being singled out as a culprit.

Many people probably don’t know how consuming alcohol can lead to throbbing pain in the head and developing a headache.

How Delayed Alcohol-Induced Headache Occurs:

The main ingredient of alcoholic beverages is ethanol, a chemical compound that acts as a diuretic. Diuretics increase the urine output of the body, and the loss of water causes dehydration. This happens when a person drinks too much alcohol, whether beer, wine, or liquor.

The frequent urination that leads to dehydration causes the brain cells to contract temporarily, bringing on a headache. (3).  Another effect of ethanol is vasodilation, swelling of the blood vessels. When blood vessels expand, they stimulate specific brain nerves that result in a headache.

Alcoholic drinks contain congeners, biologically active compounds that contribute to a drink’s taste, smell, appearance, and the high probability of an alcohol-induced headache. These congeners are more abundant in red wine, whisky, and brandy, and in lesser amounts in gin and vodka.

Although there is no scientific basis that headaches are more frequent when red wine is imbibed, surveys of drinkers say that it does give them a headache more than other alcoholic beverages. Some agents in alcohol are responsible for increasing the body’s plasma serotonin and plasma histamine levels that, in susceptible people, can trigger alcohol-induced headaches.

How Much Alcohol Does it Take to Cause a Headache?

Many factors come into play when determining how much or how little alcohol one drinks can cause a headache. One person can drink several bottles of beer or glasses of white wine and not have a headache, while another may take only a tiny amount and get a pounding pain in the head when drinking red wine.

Or one can go on a binge one day and wake up without a hangover. Yet, that same person may have only a small glass at another time and then suffer from one.

1. Quality of Wine

The quality of wine can make a difference in its headache-producing capability. Low-quality wines have added sugar for sweetness and synthetic tannin for bitterness and an astringent taste. Sugar can deplete the B vitamins in the body, and tannins meddle with serotonin, all of which contribute to a hangover headache.

2. Type of Drink

Some drinks trigger headaches more than others, although there is no scientific basis. It is believed that congeners, the substances produced during fermentation, is the culprit.

Congeners add to the flavour and colour of an alcoholic drink. But they also compete with ethanol in the breaking down process. As a result, the alcohol does not break down faster and stays longer in the body. Another possible cause is the release of stress hormones. They include epinephrine and norepinephrine and retaliate to the presence of congeners.

These hormones trigger an inflammatory reaction that produces a headache. Dark coloured alcohol drinks like red wine, rum and brandy contain more congeners than clear drinks like vodka and gin, which is the probable reason people say red wines give them a hangover headache.

Why Do Some Get a Headache Quickly and Others Not?

Certain conditions influence whether alcohol intake will result in an alcohol-induced headache or not, and the amount of drink imbibed is only a tiny part of it. They include:

1. Bodyweight

A person who weighs 200 lbs will have less chance of getting an immediate headache than another person weighing 150 lbs if both drink the same amount of the same drink. A larger body mass will have more space for alcohol to spread out, which effectively lessens its concentration the changing hangover patterns.

2. Gender

Women consuming alcohol are generally more prone to hangover headaches than men due to the following differences:

  • The female body is 52% water while the male is 61% water. Hence, the woman’s ability to dilute alcohol is less than the man’s, making women more susceptible to having headaches after alcohol intake.
  • Dehydrogenase, the enzyme that breaks down alcohol, is smaller in the female body than in the male body. With more of this enzyme, men can drink more quantities than women without getting drunk. (4)
  • Women who are not yet menopausal undergo hormonal changes every month due to their menstrual cycle. They experience alcohol’s effects like a headache in certain months. Men do not have these hormonal changes.

3. Certain Ethnic Groups

The genetic composition of the Japanese is such that they are slower than other races in breaking down acetaldehyde, a primary by-product of alcohol. This trait is responsible for reddening their skin and getting a hangover after drinking a small amount of alcohol.

Some people are genetically prone to be migraine sufferers and tend to develop headaches when drinking, while regular alcohol drinkers do not have this issue. (5) But headaches aside, alcohol abuse leads to severe health conditions for both men and women.

Understanding Alcohol-induced Headaches

Which Types of Alcohol Cause Headaches?

All alcoholic beverages contain ethanol. Why does red wine result in more headaches than vodka or gin? The answer lies in the number of congeners a drink has. Congeners are complex molecules that are the by-product of the fermenting process.

Congeners add colour to alcoholic drinks. Thus, dark-coloured alcohol drinks like red wine, rum, and whiskey have higher Congeners than clear drinks such as vodka, white wine, and gin. Ergo, the chances of getting a headache from dark beverages are more significant than from light-coloured drinks. (6)

How to Avoid Alcohol-Induced Headache

An alcohol-induced headache, which is a component of a hangover, has many negative consequences. It is the reason for absenteeism and poor performance in the workplace. Yet, it puts the person in danger when driving or handling hazardous equipment. Besides, it leads to bad decision making, poor focus, and strained relationships.

The most obvious rural practice to avoid it is to stop drinking. If quitting is difficult, alcohol rehab is an option that has worked for many and changed lives.

Other Ways to Avoid Getting Headaches from Drinking:

Consume alcohol slowly. The body processes one drink (1.5 oz.)few hours, so drinking slower reduces blood alcohol levels in the system and may prevent a tension-type headache.

Eat before, during and after drinking. Food in the stomach slows down alcohol absorption in the body and maintains blood sugar levels. A low blood sugar level can cause a migraine headache, headache disorders, tension-type headache, nausea, and saps energy. Do you know that alcohol dehydrogenase two genotypes is one of the factors related to alcohol abuse in young adults?

Drink a glass or bottle of water with every drink. Doing this reduces alcohol ingestion while hydrating the body. Alcohol is a diuretic, making urination more frequent and resulting in a dehydrated body. Dehydration brings about a splitting headache attack.

Choose lighter coloured drinks over dark ones. White wine, red wine beer, vodka, or gin have fewer congeners in them. Congeners are the side products of fermentation and are higher in red wines, whiskey, and rum. They produce alcohol related-induced headaches.

When a Headache Results from Alcohol Withdrawal

Headaches also occur during alcohol detox, which is the initial phase of an alcohol recovery programme. The pain is one of the many withdrawal symptoms that start within 6 to 24 hours after the last drink. These symptoms can develop or change unexpectedly, and without medical assistance, they can be very unpleasant or even life-threatening, such as migraine attacks.

In an alcohol detox timeline, the first seven days are the most severe, although the severity can extend beyond the first week, depending on the length of time the alcohol misuse has been going on.

A professional inpatient rehab programme can be the best option because of the dangers of withdrawal from alcohol drinks and alcohol habits. Medical doctors, therapists, counsellors, and nurses will be on hand to help the patient get through the withdrawal symptoms and move on to the succeeding interventions to achieve a successful recovery.

A treatment course in an outpatient or inpatient rehab will use medications prescribed by physicians to reduce the withdrawal symptoms and make the patient more comfortable. The medications will help keep the system in balance and minimize the likelihood of a relapse.

How to Treat an Alcohol-Induced Headache

While drinking is associated with celebrations and merrymaking, the morning-after headache is nothing alarming. But, since alcohol is not an illicit substance and adults are not prohibited from buying and drinking alcoholic beverages, it’s easy to have one too many glasses or bottles or shots.

An alcohol-induced headache will generally resolve alone in 24 hours, although there have been reports of some lasting as long as 72 hours. But treating it will free the person from misery faster and resume normal activities. 

Here are suggested treatments for headaches from drinking alcohol:

  • Increase fluid intake. Fitness drinks like Gatorade will restore the body’s fluid and electrolyte balance. Since headaches result from dehydration, replacing the lost fluids will help in a faster cure.
  • Get enough sleep and rest. When a headache follows a night of drinking, take a pain reliever with a glass of water, and have uninterrupted sleep. The combination of staying up till late at night and drinking alcohol intensifies the headache.
  • Sleep and wake patterns get disrupted, causing a headache. Catching up on lost sleep restores the body and gets rid of the headache.
  • Eat nutritious foods. A healthy meal of proteins, carbs, and fats nourishes the body and aids in the speedy recovery of a hangover headache.
  • Eat fruits or drink fruit juices. Fruits contain fructose, a natural sugar that helps to break down alcohol in the body.
  • Take painkillers that belong to the NSAIDs (non-steroidal anti-inflammatory drugs). These include drugs that are ibuprofen, mefenamic acid, naproxen, diclofenac sodium, and coxib. Avoid acetaminophen and paracetamol (Tylenol, Excedrin) since alcohol does add to liver disease.


    Understanding how an alcoholic drink is a trigger factor of headache and headache disorder is a step towards preventing or treating them.

    More importantly, drinkers should be aware of the negative effects of alcohol on one’s physical and mental health, such as headache attacks, head pain, delayed headache, migraine-like headache, and cardiovascular disease its consequences on the family and personal life, occupation, social relations, and legal issues.

    Suppose you’re looking for professional treatment facilities in the UK that specialize in alcohol rehab. In that case, Gloucester is home to centres that have proven track records of success in treating substance addictions.

    About the author

    Peter Szczepanski

    Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.

    Peter has been on the GPhC register for 29 years. He holds a Clinical Diploma in Advanced Clinical Practice and he is a Clinical Lead in Alcohol and Substance Misuse for Abbeycare Gloucester and works as the Clinical Lead in Alcohol and Substance Use in Worcestershire. Find Peter on Respiratory Academy, Aston University graduates, University of Birmingham, Q, Pharmaceutical Journal, the Dudley Pharmaceutical Committee, Dudley Council, Twitter, and LinkedIn.