How to Handle a Hangover

View PDF

Is there any cure for the morning after?

Pam Harrison

What can the average male expect after five or six cocktails, and a woman three to five? A hangover (not a trick question). “Surprisingly, there is no clear consensus on why we get hangovers, but the prevailing wisdom is that it’s because of acetaldehyde, a toxic by-product that comes from the liver’s breakdown of alcohol,” says Wende Wood, a pharmacist at Toronto’s Centre for Addiction and Mental Health and a pharmacy lecturer at the University of Toronto. Here’s the brutal truth about hangovers.

Photo: Masterfile

What they cost

In case you didn’t already know, these symptoms include a headache (usually pounding), fatigue, general malaise, diarrhea, nausea and the shakes. People often soldier on and work through such symptoms, but it’s estimated that the decreased productivity caused by hangovers cost the Canadian economy about $1.4 billion a year. Furthermore,  hungover workers are at an increased risk for injury and compromised job performance, according to a 2001 report in the Annals of Internal Medicine. Hangovers can affect driving skills and may increase the risk of cardiac death.

Paradoxically, hangovers are much more common in light and moderate drinkers than in heavy drinkers, perhaps because chronic heavy drinkers learn to adapt.
Some people report feeling exceptionally hungry the day after hoisting one too many. This may simply be because they didn’t eat enough while they were busy drinking. “But alcohol and hangovers also seem to affect several hormones, including insulin, and alcohol appears to inhibit the availability of blood glucose through an insulin-mediated mechanism,” says Wood.

Excess alcohol may also upset the body’s balance of electrolytes, soluble salts such as sodium, potassium, calcium and magnesium that carry electrical impulses.

What makes them worse

Photo: Masterfile

Dark spirits such as rye, scotch, bourbon, brandy and dark rum all contain impurities called congeners. These add flavour and colour and may contribute to hangovers. In one study, 33% of participants who consumed a lot of bourbon (a high-congener drink) reported hangovers compared with only 3% of subjects who consumed the same amount of vodka (a low-congener drink). This is one reason why colourless spirits such as vodka and gin are often the preferred choice of chronic heavy drinkers. Red wine can be problematic, too, because it contains tyramine, a chemical that triggers headaches in those prone to them. And if a bar doesn’t clean the hoses and taps that dispense draft beer, says Wood, the chemicals left behind by the beer can be rough on some people. The dehydration caused by alcohol and the poor quality of sleep that follows excess drinking also contribute to symptoms.

What about the added impact of carbonation (take the proverbial fit of the giggles after a single glass of champagne)? A recent small study found that carbonation increased alcohol absorption in two-thirds of the subjects tested, possibly because when the gas from the carbonation is released in the stomach, it triggers distention and gastric emptying into the small intestine, thereby making the alcohol more rapidly available for absorption. 

What prevents them

Short of abstinence, people should always avoid drinking on an empty stomach. Food slows down the absorption of alcohol, making it easier to tell when you’ve had too much to drink at a point when you’re more likely to stop. Another aid is water — before, during and especially after you’ve consumed alcohol. Water slows the rate of drinking while you’re at it, dilutes the alcohol you’ve consumed and helps rehydrate the body before sleep. Vitamin B₆ might help too: in one study, partygoers reported 50% fewer hangover symptoms when they took 1,200 milligrams of B₆ at the beginning, in the middle and at the end of one bash versus when they took no B₆ at a second party.

And an Ayurvedic herbal product called Liv.52 apparently reduced hangover symptoms more than a placebo in a manufacturer-sponsored study when taken with alcohol. The company suggests that the product blocks the liver’s breakdown of alcohol to acetaldehyde, the main culprit  in hangovers.

What cures them

In a word, nothing, although folk remedies abound. “Water, sleep, food and time all seem to help,” says Wood. If you’ve drunk as much water as you can hold and can’t go back to sleep, consider a mild painkiller such as ASA or an anti-inflammatory medication such as ibuprofen, both of which help to relieve the pounding head and general achiness.

Some people swear by sports drinks, which replace both fluids and electrolytes, others by fruit juices and others, still, by bananas. None of these remedies is supported by a shred of scientific evidence.

Finally, what about the old hair-of-the-dog approach, the proverbial eye-opener? “A hair of the dog can help at first since drinking more alcohol briefly blocks the liver from making acetaldehyde,” says Wood. “But ultimately, it only delays the inevitable and it can make your hangover worse.”