The Scientific Guide to Hangovers
“Let us eat drink and be merry for tomorrow we shall die”- The Thin Man
Now you’ve done it. The fatal glass of beer and the last drink have all caught up with you. A sensible person would say that moderating one’s self is the key to avoiding hangovers, but if you were sensible you wouldn’t be looking up hangover cures on the internet.
“A hangover is the toxic consequence of alcohol intake.”-Alcohol Hangovers: A Critical, Review of Explanatory Factors.
Ethanol, the active ingredient in everything from beer and brandy to vodka and vino, is a poison. A hangover happens when your Blood Alcohol Content (BAC) surpasses the amount of poison your body can process. Symptoms typically onset 6-8 hours after you stop drinking, but ill effects can be felt well before then and last for around 24 hours. Unfortunately there is no cure to a hangover, only treatment for its symptoms. By examining the physiological effects of alcohol we can craft a response to maximize recovery.
What Causes Hangovers:
There are a number of theories on what causes the symptoms of hangovers. The exact mechanisms aren’t known, but there are some good guesses. As mentioned above alcohol is a poison, but it isn’t quite that simple. It has several effects of its own on the body, as well as effects of the byproducts of breakdown. Different types of alcohol will have varying effects based on the chemicals present inside the beverage.
The Acetaldehyde Theory:
When alcohol enters the blood stream it heads to the liver. Once there it’s broken down by an enzyme called Alcohol Dehydrogenase into Acetaldehyde. Acetaldehyde Dehydrogenase breaks down Acetaldehyde to Acetate. Acetaldehyde will bind to proteins in the body. By binding to proteins it changes their shape, which in turn changes their function. Acetaldehyde interactions causes a wide variety of symptoms: racing heartbeat, flushing of the skin, nausea, and vomiting.
However, Acetaldehyde is quickly cleared of the blood stream and is rarely present the next day. While it is possible symptoms persist after the compound is processed. Many researchers feel the absence of Acetaldehyde during hangovers eliminate it as a possible cause.
Direct Effects of Alcohol:
Alcohol, when present in the brain, causes the pituitary gland to release a hormone called vasopressin. Vasopressin inhibits water retention and causes greater urine output, called diuresis. Diuresis will both dehydrate the body and expel electrolytes. Hangovers and dehydration share many symptoms: sluggishness, nausea, sweating, and diarrhea. The alleviation of hangover symptoms by drinking water supports the idea that dehydration is a major factor in hangovers.
Alcohol also has a direct effect on the lining of the stomach and intestines. Drinks with high alcohol content (whiskey, vodka, rum) will irritate the lining causing nausea, vomiting, and abdominal pain. Alcohol also increases the release of gastric acid, as well as pancreatic and intestinal secretions, all of which irritate the GI tract.
Another confusing aspect of alcohol is its effect on sleep. At first drinking can make you tired, indicating its beneficial to rest. But alcohol will disrupt the body’s normal processes. When your BAC falls back to zero this can lead to a rebound of hormones and wake you back up. The different sleep stages are also knocked off balance by the presence of alcohol. By interacting with circadian rhythm, the body’s internal clock, it will even throw your sleep schedule off for several days.
The Congener Effect:
It’s common wisdom among beer glass philosophers that clear liquor will leave you feeling much better the next day than dark liquor. As with most common wisdom I assumed that this was utter nonsense. But as it turns out I was wrong. Darker drinks like wine, bourbon, and tequila contain chemicals (congeners) that make hangovers worse.
Congeners are the chemical byproducts of fermentation. They arise from the process of making alcohol and are typically a combination and variation of several compounds: acetone, acetaldehyde (remember this from before), aldehydes, esters, methanol, and tannins. Several of these chemicals in large enough quantities have deleterious side effects and can be fatal. Unfortunately these compounds also give flavor and character to beverages.
A study of the effects of congeners showed that of a group that consumed 150 ml (a little more than 3 shots) of bourbon (dark liquor) 33% experienced hangovers. In another group that consumed the same amount of vodka (clear liquor) only 3% experienced hangover symptoms. This indicates that beverages like wine, rum, and brandy that are high in congeners will have worse hangovers than beverages with low congeners like vodka, gin, and brandy. So for once the talk in the pubs is right.
The Scientific Guide to Hangovers:
A few disclaimers before we start. Do not get drunk just to try these tips. If you or someone you are with cannot stand, cannot stay awake, or cannot stop throwing up then that person likely has alcohol poisoning and needs medical attention. Just because some of these tips might sober you up, they will not reverse the effects of alcohol. Do not drive or operate any vehicle if you have had more than the legal limit of alcohol.
With that out of the way I’ve broken down what I consider to be the five stages of the hangover. Go to the stage you are currently experiencing and follow the directions for that stage and all the subsequent stages. Two pieces of advice are present in all stages: STOP DRINKING ALCOHOL and START DRINKING WATER.
Height of the Night:
BAC is at its highest, decrease in social inhibition, increase in excitement and relaxation, impaired decision-making skills.
Winding Down:
BAC is decreasing. Tired, Dizziness, Still feeling positive effects, Start of negative effects.
Rise of the Hangover:
BAC is nearing zero. Nausea, dizziness, diarrhea, vomiting, severe headaches, and major discomfort.
Wakey Wakey:
BAC is zero, headache, photosensitivity, audiosensitivity, exhaustion, thirst, discomfort.
Never Again:
BAC is zero, sober, headache, residual sensitivity, lethargy, and malaise.
Stage 1, Height of The Night:
At this moment you aren’t hungover at all. In fact, you probably feel pretty rock and roll. If you’ve managed to realize that you are drunk, then steps can be taken to mitigate or avoid a hangover. First off, get yourself a great big glass of water. Alcohol dehydrates you; you’ll notice after a few drinks that you’ll be urinating a lot more. Even though the night is young you’ll still want to replenish and keep replenishing all the water you’ve lost.
Alcohol also depletes electrolytes. Typically you’ll get those from fruits and vegetables, but if you’re out at a bar or house party then you won’t have much access. Luckily fruit juices are common mixers for drinks. You can probably order tomato, orange, or cranberry juice at a bar. At a house party just go to where they keep the mixers. Pour yourself a cup of any juice they have, just remember it doesn’t work if you add more alcohol.
Now go back to having fun, if you’ve had enough drinks to get a hangover then you’ve had enough to ride the buzz for the rest of the night. Dancing is a great way to get your metabolism going and will help process the alcohol faster, but it will dehydrate you as well. Make sure to keep drinking water.
Stage 2,Winding Down:
The bar is closed; everyone is heading home, and the night is coming to an end. Alcohol will make you tired and you’ll probably want to just fall down somewhere comfy to sleep it off. Don’t listen to the temptation. This is a prime opportunity to stop the hangover in its tracks. If you’re out with people, then someone will probably have a hankering for a midnight snack. Have something to eat and drink lots of water. Just remember anyone whose been drinking shouldn’t be the driver. It’s common to feel sober after the festivities wind down. In reality the body takes hours to clear the alcohol in the bloodstream.
Now that you’re fed and hydrated brush your teeth. Alcohol is acidic and many drinks are high in sugar that will degrade your teeth. If you don’t have a toothbrush or toothpaste on hand just do your best to rinse thoroughly with water.
Find somewhere safe to sleep and go softly into that good night.
Stage 3, Rise of The Hangover:
Perhaps it creeps slowly like the waters of a flood, perhaps it surges all at once like a tidal wave, one way or another it will find you. Now you are really truly hungover. Don’t try and fight your body, if you’re going to vomit then resign yourself to it. If you have to use the bathroom then go find one. Remember if you or someone else can’t stop vomiting or stay conscious then get medical assistance.
If you are going to throw up a bucket or waste bin is preferable to the toilet. You might not have time but disinfect the toilet before you heave. Exhaustion, dehydration, and other side effects of alcohol will weaken your immune system. After you’ve thrown up make sure to clean up the mess. You might be a drunken slob, but you should always be a tidy drunken slob. It’s essential to rinse thoroughly and brush your teeth. Stomach acid is very corrosive and can damage your teeth. Toothpaste tends to have a neutral or slightly basic pH which will counteract the acid.
Drink water. If your stomach is too sensitive, suck on ice chips. Noncaffeinated soda like ginger ale is good as well. Sugar has anti-nausea effects and it’s a tasty way to hydrate. Try having some crackers or dry cereal. A little bit of food will go a long way. Now go back to sleep. Alcohol disrupts normal sleep patterns so even if you fell asleep you haven’t gotten any rest. It’s common to get feelings of great regret and sadness. Alcohol is a depressant and even though it has exciting initial effects it will bring you down eventually.
Stage 4, Wakey Wakey:
The chirping bird in the window sounds like a siren, and the thin shafts of morning sun feel like a spotlight. Your head hurts and your body aches. Your BAC is now at zero and you’re sober. What you need now is a hearty breakfast and lots of water. Your body was just put through the ringer and needs food and energy to recuperate. Make sure to get lots of fat and protein. Eggs and bacon are a great hangover fighter.
You’re also both dehydrated and depleted of electrolytes. Sports drinks, juices, and fruit will have lots of electrolytes. If you normally drink coffee in the morning, then don’t skip it. But Caffeine is a diuretic and you’ll have to drink more water to combat the effects. Coffee is also acidic and might upset your stomach further. It doesn’t sober you up. It just makes you more alert. A shower will also help you feel a lot better. You’d be surprised how much better you feel after taking care of yourself.
Stage 5, Never Again:
You’re blisteringly sober now. Aside from a mild headache, aversion to light, and sensitivity to sound the hangover is mostly over. That being said you’ll still feel down because of alcohols depressant effect. Exercise will boost your metabolism and help get your body back to normal. A run is a great way to get the heart rate going. Exercise also causes the release of endorphins that will combat that low feeling after a night of drinking. If you can’t workout, just go for a walk in the sun. The fresh air and activity will go a long way. Your next meal should have lots of vegetables to give you the vitamins and electrolytes you need. Try to avoid drinking alcohol even in small amounts for at least 24 hours. Also an early bedtime will help you to get the sleep you badly need.
Conclusion:
Little bit of personal advice: If your drinking habits interfere with your ability to live your life it’s very likely you have a problem with alcohol. If you find yourself intimately familiar with the advice written here through personal experience, then perhaps you should consider cutting back. Alcohol is a ton of fun. In my personal experience alcohol turns the volume up. But it doesn’t make the song any better. So if you’re happy, it’ll make you happier, if you’re sad, take a guess.
Drinking is very dangerous; the National Institute on Alcohol Abuse and Alcoholism estimates 88,000 people die each year due to alcohol. In the scientific community this is known as too damn high. If alcohol makes your life worse then get rid of it. If you think alcohol makes your life better, it doesn’t. You and the people you love make your life better, drinking just turns the volume up. And you don’t need it to make good things better, it just feels like it. Here is a link to a website where you can find help: https://www.samhsa.gov/find-help/national-helpline
With the serious stuff out of the way here’s some more bar room wisdom. Never drink on an empty stomach. Alternate each alcoholic beverage with a glass of water, it won’t hurt the buzz and you’ll keep yourself from going too far. When your body says you’ve had too much then listen. Peer pressure is a hell of a drug and it’ll cost you. If you’re not driving to your destination tie one off before you go, it will save you some money. If you’re going to have more than one drink, I’d avoid sugary and sweet cocktails. If you can’t taste the liquor, then you’re in danger, sugar is a killer. There’s a reason alcohol tastes like gasoline, its flammable and poisonous.
Now go have fun. Ask that cutie at the bar for his or her number and remember to keep hydrated.
References:
Prat G., Adan A., Sa´nchez-Turety M., Alcohol Hangover: a Critical Review of Explanatory Factors, University of Barcelon, 2009
Swift R., Davidson D., Alcohol hangover: mechanisms and mediators, Alcohol Health Research World, 1998
Mayo Clinic, Dehydration: Symptoms and Causes, mayoclinic.org, 2019
Milton E., Runbini I., Kleeman C.R., Lamdin E. Studies on Alcohol Diureses I. the Effect of Ethyl Alcohol Ingestion on Water, Electrolyte and Acid-Base Metablosm, Yale University School of Medicine, 1954
Rohsenow D., Howland J., Arnedt J., Almeida A., Greece J., Minsky S., Kempler C., Sales S., Alcoholism Intoxication with Bourbon Versus Vodka: Effects on Hangover, Sleep, and Next-Day Neurocognitive Performance in Young Adults, Clinical and Experimental Research, 2010