cover bar Title: Hangovers: An Ounce of Prevention
Author: Christina Dye
Publisher: Do It Now Foundation
Publication Date: March 2011
Catalog Number: 156

..Post-Party Blues

It's going to be one of those days.

You knew it the instant you woke up, your head pounding out paradiddles and your mouth as dry as a armadillo with heatstroke.

You've been here before -- swore, in fact, that you'd never be here again.

But, somehow, you're back again anyway, riding out the twists and turns and torments of a hangover. And it's all uphill from here.

No matter what else they may be, hangovers are more than just an unpleasant interlude for weekend party animals.

For one thing, morning-after miseries are a leading cause of workplace absenteeism and low productivity.

And heading back to the bottle for next-day relief (an anicient practice known as taking a "hair of the dog that bit you") only reinforces the tendency to drink more, more often.

So hangovers are more than just a headache, and a lot more than a cute cultural cliché.

Still, they're often passed over when research dollars are passed out -- one reason that science has been slow to investigate them fully.

Of course, hangovers are trivial compared to other alcohol-related problems, like drunk driving, fetal alcohol syndrome, and alcoholism.

People don't die from hangovers -- though they might wish that they could. And morning-after symptoms do disappear without treatment in a few hours or days.

Still, that doesn't make them any easier to take when they're happening to you.

And that's the whole point of this pamphlet.

In it, we'll talk about what hangovers are and where they come from. We'll discuss the basics of barroom pharmacology with the goal of helping you head off hangovers from here on out.

Because hangovers are more than just unnecessarily long and unnecessarily unpleasant -- they're unnecessary altogether.

..Signs & Symptoms

Where do we start in finding out about hangovers? We could begin with personal tales of My Most Miserable Morning After. Everybody's got one of those.

Or we could ask the experts. But if we did, we'd probably find a dozen different authorities with a dozen different answers.

Because the fact is that there's no single way to describe all the mornings after all the nights before.

While the most common complaints linked to hangovers center on thirst, body aches, and fatigue, over 30 different morning-after symptoms have been identified.

Following an evening of close consultation with the bottle, some awaken feeling dizzy or nauseous. Others are hit by headaches, dehydration, or heartburn. Some don't suffer much at all, while others pay for Saturday with a bleary fatigue that lingers from Sunday to Monday and beyond.

So much of what's drifted down through the years under the classification of "hangover" is probably better described as the "Morning After Syndrome," varying in severity and duration from one sufferer -- and one Sunday -- to the next.

What accounts for the variation?

Everything from attitude to atmosphere figures into the equation, but particularly important is the question of how fast your body metabolizes, or breaks down, alcohol.


Biologically, hangovers are linked to high levels of alcohol in the bloodstream.

About 95 percent of the alcohol content of a drink is broken down in the liver. What's left is excreted in the sweat, breath and urine.

But when intake outpaces output, blood alcohol level remains higher longer, and the likelihood of a hangover increases.

The maximum level at which the liver can metabolize alcohol is just under an ounce of liquor per hour-or the alcohol equivalent in a 12-ounce beer or a five-ounce glass of wine.

But age, sex and weight alter that rate, increasing the intensity of the alcohol high and the chances for a hangover low.

The intoxication threshold drops with increasing years and at lower body weights, while men, in general, tend to fare better than women.

Though the fate of alcohol in the body and bloodstream may differ slightly from drinker to drinker, the onset of hangovers is relatively fixed.

Morning-after aches and pains begin to make themselves felt as blood alcohol levels start to fall, generally an hour or so following the last drink of the night.

The worst symptoms strike 8-10 hours later, with the full recovery cycle spreading out hours beyond.

This prolonged rebound is believed to stem from the body's slow adjustment to the absence of alcohol.

In fact, some researchers think that hangovers represent a mild form of alcohol withdrawal.

Others argue that the hangover is only a response to the toxic effects of ethanol, liquor's psychoactive ingredient. Others blame congeners, the chemical by-products of alcohol's fermentation, distillation, and aging.

But while experts still debate the biochemical basis of the hangover, most sufferers instinctively know what to blame: booze -- too much too soon.

Too bad they don't remember till it's too late.

..Quick-Fixes & Quackery

Over the centuries, the hangover has inspired any number of home remedies -- from showers and saunas to coffee and cabbage-intended to ease the symptoms that go along with going too far.

Early Romans choked down raw owl's eggs and sheep lungs as an answer to the morning after. Assyrians favored ground swallow beaks and myrrh, while centuries later and half a world away, voodoo priests plunged needles in the corks of offending containers.

In America today, a range of organic extracts -- from primrose oil to herbal teas -- have been suggested, as have other disciplines and techniques, from acupuncture to biofeedback.

Among the newer concoctions to hit the hangover-helper market are preparations which claim to sober up drinkers by reversing the intoxicating effects of alcohol.

But according to the U.S. Food and Drug Administration, the mixtures -- generally blends of salts, sugars and vitamins -- don't work, at least not at turning around the effects of alcohol.

Probably the most familiar item in the unofficial pharmacy of folk remedies for hangovers is a drink or two more of the tonic of the night before.

That's often more than some people can stomach, hangover or not, but the practice does produce results by smoothing out -- at least temporarily -- a hangover's sharper twists and turns.

On the other hand, morning drinking also produces results of an entirely different order and often is considered an early sign of impending alcoholism.

According to most experts with a serious interest in the topic, most morning-after medications and emergency measures are no more than placebos, banking heavily on the power of belief and a hefty dose of wishful thinking.

"There are no true hangover remedies available," a spokesman for the Distilled Spirits Council of the United States says. "All so-called hangover cures have one thing in common: They don't work. The only real cure for a hangover is sobriety."

..Easy Does It

So what's the answer -- don't drink? That's sensible enough advice, but it's probably not for everyone.

Still, there are precautions that will help check the odds of a hangover. One involves slowing down the absorption of alcohol in the body by eating before you drink (and even while you're drinking) and by sipping your drinks slowly.

The safest bet of all is to practice moderation when drinking.

"We've found that if you want to avoid the whole hangover problem, use moderation," the DISCUS spokesman noted. "Moderation is healthy and painless. Drink enjoyably, but as part of a social event, not the goal."

Think about it. Because of all the medications, preparations and potions touted as remedies for hangovers through the ages, the only sure-fire way to spell relief the morning after the night before is (and always has been): M-O-D-E-R-A-T-I-O-N.



..Health & Hangovers

Probably the best-known sign that all's not well after a bout with a bottle is the hangover -- that miserable feeling that sets in the morning after the night before.

Hangovers, like the ingredients that go into them, differ from drinker to drinker.

Still, regardless of how (and in whom) hangovers happen, morning-after miseries represent the body's reaction to the short-term toxic effects of alcohol. And those effects begin to occur at low levels of drinking, even before a drinker feels what alcohol is famous for -- it's intoxicating effects.

Get the idea?

Even at moderate levels, alcohol is a poison, and at higher levels it's something of a liquid time bomb.

Still (and to balance out the picture) that doesn't automatically mean that it's "better" or healthier not to drink at all.

In fact, recent studies have shown that moderate drinkers have lower levels of heart disease than do tea-totalers, and statistics show that moderate drinkers tend to live longer and spend less time in hospitals than both abstainers and heavy drinkers.

Still, heavy drinking can lead to all sorts of health problems, and those problems have added up to what's been estimated in the U. S. as at least a $100 billion annual bill for otherwise-unnecessary health care expenses.

That doesn't even include all the aspirin and all the antacids to ease all the millions of hangovers. That only includes the "hidden" health problems linked to use of the drug.

And there are a lot of those. (See "Body Talk" box, below, for examples.)

..An Ounce of Prevention

Unfortunately, there's not a lot you can do to keep your body in perfect biochemical condition if you choose to drink.

That's because alcohol is a complex drug, the only one we know of that's both fat- and water-soluble, and one which affects all the organs and tissues of the body.

In fact, recent research has linked alcohol with a higher rate of tumors of the breast, liver, and mouth, along with an added susceptibility to high blood pressure.

And experts increasingly warn against drinking during pregnancy, since even one or two drinks per week have been linked with a higher risk of stillbirth and miscarriage.

The old adage has never seemed truer. Because an ounce of prevention really is worth a pound (or is it a gallon?) of cure.

Still, if you do drink (and you plan to keep on drinking) and you want to stay as healthy as possible, drink moderately.

Also, become aware of your diet and the way that foods (and drinking) affect your mood. Follow up by making a commitment to reduce your intake of junk food, fats, and excess sugar. And follow through by setting up (and sticking to) an exercise program.

That's the best way we know to have your cocktail and drink it, too -- hopefully, to a ripe old age.

..Parting Shots

Probably the best way to minimize the risk of problems is to simply be responsible about drinking -- by being aware that alcohol is a powerful drug and then treating it like one.

That means taking care if you're going to be taking a drink -- whether taking care takes the form of taking a cab when you're out on the town or simply taking it easy when a friend tries to insist on another round when you've had enough.

It also could mean passing on drinking altogether for some of us, particularly pregnant women and those taking prescribed medications -- which can produce deadly interactions when taken with alcohol.

It can mean a lot of things, because there are a lot of things we can do to take the danger out of drinking. But they all start with each of us. And they all end with being responsible.

Here's looking at you, kid.

..Sidebar | Mastering Moderation: How To Drink Responsibly

If you're a drinker and want to avoid hangovers, learn to drink responsibly. That means not drinking to escape -- problems or people -- and not drinking to get drunk. But that's onlly what it doesn't mean.

What it does mean is learning to see alcohol for what it is-a drug- and remembering to approach it with the healthy dose of caution it deserves.

Here are four ways to reduce your risk of problems:

  • Eat before drinking. Food slows the rate at which alcohol is absorbed, lowering peak blood alcohol levels. That means that if you want to avoid waking up in your own private hell, eat before drinking -- and snack on foods while drinking.
  • Drink slowly. Sip drinks rather than gulping them. Drinking too much often results from drinking too fast. And don't chug or "shotgun" your drinks. If you do, you might not have to worry about waking up with a hangover. You might not wake up at all.
  • Space your drinks. When you're drinking, switch off to soda or fruit juice from time to time.
  • Set a drinking limit. Know -- and respect -- your personal drinking limit. Notice how different amounts affect you. Then set a realistic limit on your own drinking -- and stick to it.

This is one in a series of publications on drugs, behavior, and health by Do It Now Foundation.
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