• Kim May

So, what is a hangover?


Hangovers may be ubiquitous, but research around on the topic is not. Surprising, right? Apparently, the research is so scant, they have not even produced an agreed upon definition.


The National Institute on Alcohol Abuse and Alcoholism defines a hangover as “set of symptoms that occur as a consequence of drinking too much.” They then provide a list of symptoms so long it calls to mind the prescription drug commercials and their possible side effects. Oh, then they mention hangovers vary from person to person. Cool…so what is a hangover?


Apparently, no one is sure.


However, symptoms of a hangover may include fatigue, weakness, thirst, headache, muscle aches, nausea, tachycardia, stomach pain, vertigo, sensitivity to light and sound, anxiety, depression, irritability, sweating, and increased blood pressure.


While it is known definitively that alcohol is the primary cause of hangovers, it is believed that congeners and sulfites may contribute as well. Congeners are compounds produced during fermentation and are more likely to be found in darker spirits. Sulfites are added to wine and function as preservatives.


We can think of the hangover as the tax we pay for drinking.


Factors that contribute to hangovers


While scientists do not know the exact reason hangovers occur, they have identified a few likely factors. While not all of these are applicable to everyone, it is safe to say one or more of these are at play when experiencing a hangover.


According to The National Institute on Alcohol Abuse and Alcoholism these factors are:


  • Dehydration: Alcohol suppresses the release of vasopressin, a hormone produced by the brain that sends signals to the kidneys causing them to retain fluid. As a result, alcohol increases urination and excess loss of fluids.

  • Disrupted sleep: People may fall asleep faster after drinking alcohol, but they tend to have less REM sleep, and often wake up earlier. This contributes to fatigue, and in some people cognitive disruption.

  • Gastrointestinal irritation: Alcohol directly irritates the lining of the stomach and increases acid release. This can lead to nausea or even vomiting and diarrhea.

  • Inflammation: Alcohol increases inflammation in the body.

  • Acetaldehyde exposure: Alcohol metabolism creates the compound acetaldehyde, a toxic, short-lived byproduct, which contributes to inflammation in the liver, pancreas, brain, gastrointestinal tract, and other organs.

  • Mini withdrawal: While drinking, individuals may feel calmer, more relaxed, and even euphoric, but the brain quickly adjusts to those positive effects as it tries to maintain balance. As a result, when the buzz wears off, people can feel more restless and anxious than before they drank.

Are hangovers preventable?


Well, kind of. It depends on how much you drink and your physiology. Drinking less certainly helps. Some believe that rapid spikes in your blood alcohol level may contribute to hangovers. For example, you might be less likely to experience a hangover when you consume four drinks in four hours as opposed to four drinks in 30 minutes. There is no conclusive evidence for this, but it is probably not bad advice either way to avoid binge drinking.


Some people will experience a hangover even after just one drink and some people can drink all they want without ever experiencing the slightest discomfort the next day. (I do not have evidence to support this assertion, but I suspect those people might be robots.)


Others try pain relievers before going to bed to minimize hangovers, however the combination of alcohol and acetaminophen can be toxic to the liver. Like alcohol, certain over-the-counter pain relievers, including aspirin and ibuprofen, can increase acid release and irritate the lining of the stomach. Exercise caution when using these medications before or after consuming alcohol.


Being rested, hydrated, and properly nourished is an ideal start to drinking. It may not prevent a hangover, but it will certainly help you recover and stay in good health.


Is there a cure for hangovers?


Officially, no. Once you have one, there is not a lot to be done. There are currently no remedies that have been proven to be effective. Things like greasy food, drinking a sports drink, or taking a shower make some people feel better, but everyone is different.


Many people are fans of the ‘hair of the dog’ technique and indeed some people do feel a little better after. The downside of this approach as it may contribute to your current symptoms and delay the inevitable. Additionally, alcohol withdrawal syndrome is brought on by drinking many days in a row, so, if possible, this is a good pattern to avoid. (Fun fact: the origin of the 'hair of the dog that bit you' expression comes from the old belief that one could be cured of rabies by taking a potion that contained hair from the dog that infected you. Important fact: this is not acceptable rabies care.)


Hydrating, taking in a little salt, and very mild exercise like a short walk or stretching helps some individuals feel better and does not have much of a downside.


Sorry for the bummer news, but the only real cure for a hangover is time.


Changing your drinking


Though legal, alcohol is a psychoactive drug. Therefore, it has dangers and risks just like any drug. Alcohol use disorder is the diagnostic label for what usually called alcoholism. However, a person does not have to have the diagnosis to have concerns about their relationship with alcohol. If you want to reduce harm when drinking, practice moderation, or abstain, Substance Use Therapy is here to support you.


Whatever you are facing, you don’t have to face it alone.


Sources:

https://www.niaaa.nih.gov/publications/brochures-and-fact-sheets/hangovers

Anderson, K. (2010). How to Change Your Drinking. HAMS Harm Reduction Network.

https://www.lexico.com/explore/what-is-the-origin-of-the-phrase-hair-of-the-dog


About the Author:


Kimberly May, LPC-S, LMFT is a therapist at Substance Use Therapy in Austin, TX. Kimberly works with individuals, couples and families whose lives have been affected by substance use. By utilizing a harm reduction framework, Kimberly works effectively with people in any stage of use. In addition to substance use, she works with other issues such as anger, burn-out, anxiety and grief. Contact today to schedule a no-charge, 30 minute, in-person consultation. *Note: telephone and telehealth sessions are currently available.

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