Escaping a hangover gets trickier with age, as you might well know. While the latest data shows that many are choosing to cut down on their alcohol intake during the pandemic – assumedly in a bid to nix the feelings of anxiety that it can cause – others are dialling it up. Around one in five people who drink report sipping more units in lockdown, per Alcohol Change UK.

For clarity, NHS guidance states that you should drink no more than 14 units a week (that’s 10 small glasses of low-strength wine, or 14 single measures of 37.5% ABV spirit) and you should spread those over multiple days: do not store up your allowance for a single session. You should also know that a global study from 2018 indicated that there is no completely ‘safe’ level of alcohol consumption.

If you have, however, woken up this AM with the distinct feeling that your nausea, headache and general off-kilter vibe has stuck around two days after you last imbibed, know that you’re not alone. The two day hangover, as any over 30-year-old will tell you, is real.

Is it possible to have a 2-day hangover?

Yes. ‘Hangovers are a self-induced vicious cycle and poor management of alcohol intake can lead to the feeling that a hangover is lasting for 48 hours,’ says our GP Dr Chun Tang.

‘Examples of poor alcohol management include drinking for two consecutive nights, over-consuming or knocking back drinks too quickly, not drinking enough water between alcoholic beverages, mixing drinks and not getting enough quality sleep after a few nights out on the town.’

What goes on in the body, during a 2-day hangover?

‘This feeling is akin to jetlag but is from socialising rather than long distance travel. If you’re awake until 3am on a Saturday night your body clock struggles to readjust to a normal pattern over the following days,’ explains Dr Tang.

‘Plus, your body will be working overtime to handle the effects of drinking and the symptoms of a hangover. For example, the liver will be overworking to process alcohol, you’ll be tired from little and/or poor quality sleep, you’re likely to be urinating more as alcohol is a diuretic, leaving you dehydrated and headache-y – and any post-night out vomiting can irritate the stomach for several days.’

And what’s going on with the nausea that won’t go away?

‘Vomiting and feelings of nausea can persist as both inflame the stomach and both – plus a hangover – can lead to serious dehydration, which can be on-going if you don’t properly rehydrate yourself,’ details Dr Tang.

‘This dehydration may be worse for higher risk groups; these include the elderly, those with chronic illnesses such as diabetes, people taking medication that increases urine, endurance athletes and those living in hot climates. Also, sadly, some of us are genetically more likely to suffer from feeling sick – this could be down to a lack of the enzyme Aldehyde Dehydrogenase, which helps to break down the toxic metabolite found in alcohol.’

Is it true that hangovers get worse with age?

Dr Tang adds: ‘As well, older people are also more likely to have a greater proportion of body fat as opposed to younger people; as fat absorbs alcohol and keeps it in your system, the liver enzymes are then less effective at flushing it away.’

Okay. So how do I avoid a 2-day hangover?

‘Obviously try and not drink too much (14 units per week is the recommend limit) and, as the old wives’ tale goes, don’t drink on an empty stomach. Food slows absorption and protects the stomach from gastritis and make sure you’re drinking water between drinks and before bed.

Avoid darker drinks like rum and whiskey as they can especially irritate blood vessels and make a hangover worse. Fizzy drinks also worsen hangovers by increasing the absorption of alcohol into the body,’ Dr Tang advises. So, swerve those vodka and cokes.

After the fact: ‘take painkillers for headaches, antacids to settle your stomach and consider soup or dioralyte to rehydrate.’

What are the risks of drinking too much?

‘Alcohol causes many medical conditions including cancers of the gastrointestinal tract – especially colon cancer and liver disease. This can damage DNA, which is most likely how alcohol causes [the increased] risk of cancer. Plus, alcohol can also lead to the development of polyps (benign growths) in the colon that have the potential to turn into colorectal cancer,’ says Dr Tang.

Quitting booze comes with myriad benefits, from boosted mental health (remember, it’s a depressant) to finding it easier to hit your fitness goals. Follow this advice if you want to cut back.