Written by Roger McCredie | Photos by Anthony Harden
Being an examination of the facts and fiction of hangovers, together with solutions other than suicide.
Oh, you silly party-goer, you. You floated home in the wee hours of New Year’s morning on a lake of Harvey Wallbangers. (Or was it apple pie moonshine?) Now, in the cold light of New Year’s Day, you’re kneeling on the bathroom floor, praying to the porcelain throne, afraid you’re going to die and afraid you’re not. Or maybe you’re just staring at the Rose Bowl parade and trying to distinguish the thump-thump-thump of the marching bands from the pounding in your own head.You’re suffering from veisalgia, a pernicious set of symptoms that are the inevitable consequence of a bout of heavy drinking. In layman’s terms: You have a hangover.
Writing in the New York University Journal of Medicine, Dr. Anthony Tolisano recently called the hangover “a condition that is well recognized yet poorly understood.” Ah, but you understand all too well, right? You just feel like nine miles of bad road. Well, this article, cold comfort that it may be, is offered for your edification.
Note: In the interest of full disclosure, I should point out that I am eminently qualified to comment on this subject. I retired from the drinking classes some decades ago when I received a communication from the folks at the Smithsonian asking if I would be willing to bequeath them my liver (see below) as a matter of historical interest. But I am intimately acquainted with the hangover phenomenon; and anyway, the properties of alcohol—including its hangover-inducing capabilities—remain unchanged. So there.
Anatomy of a Hangover
The human body is a highly effective self-healing machine and it wastes no time. As soon as you leave off poisoning it with alcohol, whether by passing out on the couch or falling into bed, it begins repairing the damage you’ve done to it, all the while cursing you for your callous mistreatment of it. Indeed, while you’re still conscious and still drinking, it may decide to override the abuse by causing you to throw up. Failing that, it will start cleaning up the mess as soon as you lose consciousness. If you wake up before the process is completed, which is usually the case, that’s just tough. Maybe next time you’ll think twice before accepting a challenge to play beer pong.
In Of Time and the River, Thomas Wolfe describes how his youthful protagonist and alter ego, Eugene Gant, discovers a satchel full of various liquors brought home by one of his brothers and, through reckless experimentation, becomes hopelessly drunk while the other family members are out Christmas shopping. When they return and find the passed-out amateur, Eugene’s father, a battle-hardened tosspot, says with professional authority that the first order of business is “to get it off his stomach.” This has a sound basis in fact, as far as it goes. Certainly expelling unabsorbed alcohol from the stomach by inducing vomiting means there’ll be less of it for the body to have to deal with.
But whether or not you avoid further toxicity by preliminarily blowing your beans, all that ethanol you’ve ingested still has to be dealt with. It’s a complicated process.
You see, while you were in the act of consuming your very first drink of the evening, your system was already converting the ethanol your drink contained into a substance called acetaldehyde, which is actually 10 to 30 times more toxic than the ethanol itself. Acetaldehyde produces an instant chemical imbalance that translates into mild to moderate mental aberrations (hey, you’d probably look really cute in that lampshade) and inhibited motor function (hence the slurred speech and the blind staggers). But that’s just the beginning; acetaldehyde can stay in your system at an elevated level for hours after you stop ingesting booze. It’s the cornerstone of a hangover.
In addition, almost all alcoholic beverages contain congeners, which are chemical substances that are by-products of the distillation and fermentation process. These differ by amount and type according to the grains and other ingredients that make up the recipes of different types of beverages. Congeners aren’t necessarily toxic themselves, but they complicate things when it comes to metabolizing booze: The more congeners, generally speaking, the more the adverse effects of the ethanol are heightened or prolonged. “Brown,” or amber, liquors contain more congeners than the clear stuff, which means that a surfeit of Old Fashioneds is liable to give you a worse time the next morning than a comparable intake of vodka-and-tonics.
Alcohol is not a stimulant, despite all the literature and movies wherein folks take a slug of whiskey to fortify themselves against the cold or to bolster themselves against danger or hardship. Instead, it’s the exact opposite; it’s a depressant, which means that it actually slows the functions of the central nervous system (see acetaldehyde, above). Upon ingestion it neutralizes inhibitions and provides an insidious temporary euphoria that is the basis of its addictive properties: When the euphoria begins to fade, you want it back… so, another drink, more euphoria. Taken in moderate amounts over time, alcohol produces a euphoria level that translates to nothing more than conviviality and a feeling of warm well-being, and this accounts for its popularity as a social lubricant. More drinks, of course, attack deeper inhibitions. We’ve all seen the results, as when mousy Mary Jane from accounting sheds various garments, hops on the coffee table, and begins to belt out “I Gotta Be Me.” But then at some point the law of diminishing returns kicks in and your system begins to nudge you and say, “This isn’t fun anymore.”
Additionally, alcohol is an astringent. It dries things out. Doctors recommend that when you irrigate your ear canals to get rid of excess wax, you finish off with a drop of alcohol. That’s to dry out any remaining water that could cause inflammation or breed infection. Swab some on your forearm and blow on it, like mama used to do when the cat scratched you. Dries right up, doesn’t it? That’s what’s happening to your innards as the ethanol metabolizes, and the resultant dehydration, one of a hangover’s hallmark ingredients, is what makes your next-morning tongue feel swollen, your teeth feel like they’re all wearing little fuzzy sweaters, and you feeling overwhelmingly thirsty.
So way to go, pilgrim. You’ve put a massive amount of this toxic depressant/astringent fluid into your body and now it’s time to pay the piper—you know, the one that’s playing “Too Long in This Condition” in the middle of your frontal lobe. The good news is that you’re mostly detoxified by now. The hangover symptoms actually kick in when your body’s blood alcohol content approaches zero, thanks in large part to the heavy lifting of that indefatigable janitor and unsung hero, your liver. And now you’re left with a bouquet of unpleasant after-effects.
What to do? Surely there must be a way of mitigating this misery, right?
For as long as there have been hangovers, there have been seekers after a cure for them. Google “hangover remedies” and you’ll find more than a thousand right off the bat. They range from aspirin to raw oysters, from cold showers to hot compresses. Herewith is a random but annotated sampling of sworn-by remedies, some enshrined in folklore, some well kept secrets, some best forgotten:
Strong, black coffee has long been touted as a cure for drunkenness per se. That’s on account of its caffeine content, which supposedly clears an alcohol-fogged brain, though critics say it only leaves you drunk and wide awake. As a hangover remedy, though, coffee has no effectiveness; in fact, since coffee constricts blood vessels, thereby elevating blood pressure, coffee can make a hangover headache even worse. On the other hand, if you’re a habitual coffee drinker, by all means have a cup if you feel up to it; you wouldn’t want to add coffee withdrawal to your existing headache’s potency. So either drink it or don’t—but don’t expect it to “help” your hangover.
A big, greasy breakfast
As soon as you can keep it down, food is good in the sense that you need to eat. But there’s no indication that fried eggs, bacon, and buttered toast will have any more salutary effect than cereal and milk or a smoothie. And none of those will do anything to help right your metabolism’s upset equilibrium.
Hair of the dog
The idea of taking another drink to mitigate the effects of having taken too many drinks seems at first to make a weird kind of sense. If a hangover is essentially a mini-withdrawal, why not even things out with a Bloody Mary or a Screwdriver? Ingesting more alcohol may indeed make you feel temporarily better, but it’s easy to start the whole wretched mess all over again. Next thing you know you’re thoroughly buzzed, another hour of reckoning looms, and repeating the process yet again can put you on a merry-go-round that has no brass ring.
Seriously. The theory here is that the carbon from the charred bread filters out the hangover-causing impurities left in your system, letting them be passed off as waste instead of being absorbed. This is actually the principle involved in emergency room treatment of alcohol poisoning, where a carbon-rich slurry is pumped directly into the victim’s stomach. But that’s an intensive clinical procedure, doctors say, designed for an emergency situation; eating burnt toast to achieve a much more limited result is like, well, eating burnt toast.
For 85 years, Alka-Seltzer has held the high ground as king of the patent medicine (alleged) hangover remedies, thanks in part to some of the cleverest advertising in history. Alka-Seltzer contains plain old bicarbonate of soda, which is an effective neutralizer of excess stomach acid and can quell queasiness, but it also contains aspirin and citric acid, which can actually irritate your stomach lining and cause more harm than good. Trade nausea for heartburn? It’s your call.
So, out of the depths of your misery you cry, “Is there nothing to be done?” Well, actually, there are some steps you can take that won’t magically cure your hangover but that are definitely beneficial and will make you feel at least somewhat better:
Replenish all those fluids you’ve lost. Plain old water is the absolute best. Juices are okay and sports drinks, such as Gatorade, may help restore electrolyte balance. Avoid milk or milk-based drinks; they have to be digested and you don’t need that extra burden.
Attack the headache
There may not be an overall hangover cure, but there are plenty of proven headache remedies out there, so why suffer? Aspirin – in its unadulterated form – is fine if you take it with plenty of water to minimize its acidity. Ibuprofen is good and for that matter so is naproxen (Aleve), again with lots of water.
“Balm of hurt minds,” Shakespeare called sleep, and he could just have well added “and hangovers.” If you have the luxury of being able to sleep in, do it. This includes taking a sick day or half of one if you can get away with it; if your hangover is virulent, you won’t be any good at work anyway. Sleep and let your body do its work. Because, as you may have intuited by now, the only sure cure for a hangover is time.
For that matter, when it comes to preventing future hangovers the most obvious course is not to drink alcohol at all. Don’t squawk; I said that to make a point. You can’t get a hangover unless you’ve been drinking to excess. Moderation is the key. Know your limits. And if you find yourself repeating the hangover scenario very often, maybe it’s time to take a clear-eyed, next-day look at the role booze plays in your life.
Sort of like the guy who was sitting in his hotel room the morning after a particularly energetic drinking bout, listening to his head split open and gazing bleakly at a nearly full bottle of Old Scratch on the nightstand. “You’re killing me,” the victim intoned. “You’re making me miserable, and if this keeps up, you’re going to ruin my life. I’m not going to let you do it! I’m not, do you hear? I’m getting rid of you!”
And with that he seized the liquor, opened the window, and made to defenestrate his tormentor. When he cocked his arm to throw, the remaining booze in the bottle made a little gurgling sound. The man lowered his arm slowly and looked at the bottle.
“Did I hear you say you’re sorry?” he asked.
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