Adrenaline

Adrenaline, known in US medicine as epinephrine, is your body’s best-known stress hormone. It gets you ready to fight or run within seconds. Alcohol interferes with this system in several ways: while you drink, during a hangover, and especially during withdrawal. Many of the symptoms people know from that time are driven by adrenaline and its close relative, norepinephrine.

What Is Adrenaline? #

Adrenaline is a hormone. It’s made mainly in the adrenal medulla, the inner part of the small glands that sit on top of your kidneys. It’s produced there together with norepinephrine. Both belong to a group called catecholamines. In the brain, adrenaline plays only a minor role as a messenger. There, norepinephrine is the bigger player.

Your body makes adrenaline in several steps. It starts with the amino acids phenylalanine and tyrosine. These are turned into dopamine, then norepinephrine, and finally adrenaline. Along the way, your body needs helpers such as vitamin B6 and vitamin C. The last step is boosted by the stress hormone cortisol. That’s how your two stress systems work hand in hand.

Adrenaline is also an important medication. Emergency teams use it during cardiac arrest. People with severe allergies carry it as an auto-injector, such as an EpiPen, to stop anaphylaxis.

How Adrenaline Works in Your Body #

Adrenaline is the start button of the fight-or-flight response. Your heart beats faster and harder, and your blood pressure rises. Your airways open up so more air reaches your lungs. Blood flow to your muscles increases. At the same time, adrenaline pulls sugar out of storage in the liver and releases fat from fat tissue, so energy is available fast. Digestion slows down, your pupils widen, and you often start to sweat.

Adrenaline is released in response to danger and stress, but also during physical exertion, cold, and low blood sugar. Your body clears it within a few minutes. It becomes a problem when the system runs in overdrive all the time. Then your heart and blood vessels are under constant strain, and the risk of high blood pressure and heart disease goes up. Learn more in our entry on blood pressure and alcohol.

What Alcohol Does to Adrenaline #

Many people drink to unwind, and after a few drinks your mind does feel calmer. Your body tells a different story. Even while you’re drinking, catecholamine levels in your blood go up and your heart rate climbs. After heavy drinking, heart rhythm problems can occur, especially atrial fibrillation. Doctors call this holiday heart syndrome, because it often shows up after holidays and celebrations.

A second pathway runs through your blood sugar. While your liver is busy breaking down alcohol, it can barely produce new sugar. If you drink a lot and eat little, your blood sugar can easily drop too low. Your body responds with a surge of adrenaline. The result is shakiness, sweating, a pounding heart, and inner restlessness. This often happens at night or early in the morning.

On top of that, your brain fights back. Alcohol has a calming effect, and your brain pushes against it with stimulating systems. When alcohol wears off in the second half of the night, those stimulating forces suddenly take over. Many people wake up around 3 or 4 a.m. with a racing heart and can’t get back to sleep. The next day often brings a vague sense of dread known as hangxiety.

Adrenaline and Norepinephrine in Alcohol Withdrawal #

With regular drinking, your brain adjusts to alcohol’s calming effect. It turns up its stimulating systems so it can function normally. When alcohol is suddenly gone, the brakes are missing and the stress system goes into overdrive. Norepinephrine in the brain is especially active, backed up by adrenaline from the adrenal glands. For a closer look at what happens in your brain, read Alcohol Withdrawal – What Happens in Your Brain?

Many typical withdrawal symptoms come from this surge: shaking, sweating, a racing heart, high blood pressure, restlessness, anxiety, and insomnia. They usually peak one to three days after the last drink. In the worst case, they can progress to delirium tremens.

To treat withdrawal, doctors mainly use benzodiazepines. They temporarily replace the missing brakes in the brain and also protect against seizures and delirium. Beta-blockers or clonidine can additionally lower heart rate and blood pressure. On their own, though, they’re not enough. They only ease the effects on the heart and can hide important warning signs. That’s why quitting cold turkey without medical support is risky. Our Withdrawal Risk Self-Check can help you figure out whether home withdrawal is a safe option for you.

When Your Stress System Calms Down Again #

After acute withdrawal, your stress system needs time to find its balance again. In the first weeks and months, many people react more strongly to stress than they used to. Small annoyances feel bigger, sleep is restless, and sometimes panic attacks show up. This is part of recovery and is known as PAWS. It passes.

This phase comes with a trap. If you used to calm stress with alcohol, it’s easy to reach for a drink again. Read more about this in our entry on relaxation drinking. What helps more: exercise, regular meals to keep your blood sugar steady, and enough sleep. Slow, long exhales also noticeably calm your nervous system. Want to hear how others got through this phase? Join the conversation in our Bye Bye Booze community.

FAQ: Adrenaline and Alcohol #

---

---