Why do I still feel sick after drinking weeks ago?

Dear Social Drinker,   

As the stereotype goes, alcohol can be a prevalent part of the social scene on college campuses. In these settings it can be difficult to distinguish between occasional, social drinking and higher-risk drinking. However, it seems like you might be experiencing symptoms related to excessive alcohol consumption. Since drinking too much alcohol can often lead to harmful consequences, including alcohol use disorder and alcohol-related liver damage, consider consulting with a health care provider to discuss what you’re experiencing. Ultimately, it may be useful to wine down and reduce the amount of alcohol you drink. 

What are the recommended limits for drinking alcohol? 

The U.S. Centers for Disease Control and Prevention (CDC) advises people aged 21 and older who choose to drink to do so in moderation, if at all. Moderate drinking is defined as having one standard drink or less in a day for people assigned female at birth (AFAB) and two standard drinks or less in a day for people assigned male at birth (AMAB). A standard drink is a measurement, roughly equivalent to one can of beer, one shot of liquor, or one-fifth of a wine bottle. That said, alcoholic products may vary both within and across types of alcohol in the amount of alcohol they contain. Paying attention to the alcohol by volume (ABV) or percentage listed on the label may help you find drinks that are within the recommended range for the alcohol you choose to drink. 

How much do college students actually drink? 

Many college students drink more than the recommended amount. In a 2023 survey by the U.S. Department of Health and Human Services, around 29 percent of people aged 18 to 25 reported binge drinking in the past month. Binge drinking is defined as having four or more standard drinks in a day for people AFAB and five or more standard drinks in a day for people AMAB. Approximately seven percent of people in this age range said they binge drank five or more times in the past month—a higher proportion than in any other age group. Even if you aren’t binge drinking, or drinking at rates similar to other college students, doesn’t mean you might not be drinking more than your body can handle. 

How do you know if you’re dependent on alcohol? 

When you drink, alcohol acts on your brain and nervous system to cause pleasure and reduce stress and anxiety. However, if you drink in high amounts, the parts of your brain that control pleasure can become used to alcohol activating them. Over time, these parts of your brain can become dependent, requiring more alcohol to provide the same response. Sometimes, the brain might get to a point where it’s not able to function the same without it. This dependence and the behaviors it can cause are known as alcohol use disorder (AUD). 

People with AUD often feel the urge to drink alcohol—and increasing amounts of it. Without alcohol, people with AUD may experience symptoms such as irritability, pain, nausea, sweating, and shaking. These are known as withdrawal symptoms and occur because the pleasure pathways struggle to work without the alcohol they’ve become dependent on. 

Some other indicators of AUD include:    

• Losing control over when or how much you drink. 
• Feeling cravings to drink. 
• Needing to drink to feel “normal.” 
• Developing a “tolerance” to alcohol that makes you drink more to get the same effect. 
• Continuing to drink even when drinking negatively affects your life. 
• Experiencing emotional or physical withdrawal symptoms when you don’t or can’t drink. 

List adapted from Healthline 

What are the dangers of drinking too much alcohol? 

In addition to its effects on the brain, drinking excessive amounts of alcohol can affect your liver. The alcohol you drink moves to your liver to be broken down so that it can be removed from your body. If you drink more alcohol than your liver can process, your liver can become inflamed (known as alcoholic hepatitis). Your liver can also develop increased fat or scarring (known as alcoholic fatty liver syndrome and alcoholic cirrhosis, respectively). In fact, around 90 percent of people who drink heavily accumulate fat in their livers. Symptoms of alcohol-related liver damage can include: 

• Jaundice (your skin or eyes turning yellow) 
• Abdominal swelling and pain 
• Weight loss  
• Appetite loss 
• Fatigue and confusion 
• Nausea 
• Vomiting, especially vomiting blood 
• Passing blood in bowel movements 

List adapted from the U.K. National Health Service 

What do you do if you notice AUD symptoms? 

Alcohol consumption can impact the brain, behavior, and your body. Certain forms of liver damage can be difficult to treat and can lead to complications including infections and liver cancer. Therefore, if you begin to notice symptoms related to AUD, you might consider meeting with a health care provider. In most cases, the best route to alleviating symptoms is decreasing or stopping alcohol consumption. 

Where can you find support if you’re struggling with AUD? 

Stopping drinking can be challenging, so many people seek out the help of a mental health professional or recovery group, such as Alcoholics Anonymous. If you find that you’re using alcohol to overcome stress or anxiety, or that consuming alcohol is the only way you feel “normal,” these may be useful outlets to discuss and reflect on your drinking. 

The CDC’s “Check Your Drinking” Index can be a helpful way to assess the amount of alcohol you drink. Additionally, the National Institute on Alcohol Abuse and Alcoholism has useful resources for college students struggling with their alcohol consumption. To learn more about how you can modify your behaviors when it comes to drinking alcohol, consider checking out the Alcohol: Lowering Risk fact sheet. 

Hope this helps!