Hangovers Are No Holiday

Friday night in Hollywood, and the clientele of Bob’s Frolic Room II, as usual, is in full frolic mode. Blinking holiday lights festoon the long wooden bar. James Brown’s “Sex Machine” is blaring from the jukebox. A florid-faced middle-aged man is side-shuffle-dancing his way to the men’s room, while a gaggle of regulars clusters at the back of the bar, wailing along with the music.

It’s a lot of fun, a lot more alcohol--and a hangover from hell lined up for the morning. And this is just a regular old Friday. How many more feeble souls will soon be groaning and clutching their heads after reckless Christmas and New Year excesses?

Why, oh, why does alcohol do this to us? And if we drink too much this season--many of us will, whatever we swore the last time we did it--how do we avoid paying the piper? To get answers, we asked alcohol experts (and a few of Bob’s Frolic denizens) to weigh in with their wisdom.

Here, right up front, is something you can forget about: any big research push to come up with a hangover pill. Hangovers, after all, aren’t a big public health issue. Excessive drinking is. In that sense, the hangover’s a good thing.

“A hangover is a definitive cue for a person to control their drinking,” says Walter Hunt, a senior science advisor at the National Institute on Alcohol Abuse and Alcoholism. “One wouldn’t want to encourage finding a cure. It might encourage people to consume more alcohol than they would otherwise and risk damaging their liver. That’s not good medicine.”

(Tip 1, from the alcoholism institute, but not from anyone in the Frolic Room: “If you don’t want a hangover, don’t drink so much,” Hunt says. At the very least, drink slowly, so your liver can keep up with all that alcohol it has to metabolize. Eat a big dinner, preferably high in fat, to slow down the absorption of alcohol.)

But fear not: Science hasn’t totally ignored the hangover. A recent issue of the alcoholism institute’s glossy magazine, Alcohol Health and Research World, carried an entire review on the subject. There are studies in the literature on mouse and rat hangovers and on the performance of hung-over human pilots in flight simulator tests. And there are articles comparing brandy hangovers with bourbon hangovers with vodka hangovers, sometimes induced under “simulated party” conditions, “with encouragement of talking, singing and dancing.”

Despite these efforts, there’s no medical consensus on just what causes a hangover. Is it the alcohol? Other nasty chemicals in the drinks? Or--strangely--our shell-shocked neurons adjusting to a brain once again without booze?

“There’s evidence for each of these ideas, but none alone quite explains all the facts,” says Dr. Robert Swift, associate professor of psychiatry and human behavior at Brown University in Providence, R.I. “A hangover probably has a mixture of causes.”

The ironic thing about a hangover is that it reaches its ghastly zenith the next morning, when the alcohol’s mostly gone. You’d easily pass a Breathalyzer test. Yet you feel like death warmed over. Head a-pounding. Mouth like the bottom of a budgie’s cage. Stomach sending ominous messages to your consciousness, and what a miserable consciousness it is. Anxious, kinda guilty feeling, cringing from the sunlight and the gentle clatters of life as if they were searing spotlight and blaring siren.

*

The alcohol itself--meaning ethanol, the main alcohol present in adult beverages--is certainly to blame for some of these sensations. Ethanol stimulates urination, and all those trips to the bathroom dehydrate the body, producing a cotton wool mouth and maybe the headache as well. Low on water, the brain shrinks a tad, tugging on the membrane that secures it to the skull. The membrane senses pain when it’s tugged on. Yow.

And alcohol could trigger headaches in other ways, too, because it dilates arteries in the brain. This squashes nearby nerves, which send “Ow! Ow! Ow!” signals as the throb-throb-throb of blood flows past them.

(Tip 2: “Swear to god, it always works: three aspirin and a big jug of water before you go to bed,” offers Joe Basso, a Frolic bartender. Academic experts concur on the water, which helps the morning after too. But go easy on the aspirin: It can irritate a stomach already tenderized by alcohol. Avoid pain relievers that include acetaminophen because it can be toxic to the liver if you’ve been drinking.)

As if that’s not enough, the booze messes up your sleep. When the alcohol was in your body, it inhibited the REM, or dreaming, phase of your slumber. As the liver metabolized the alcohol away, your body went into REM overdrive to catch up. This helps explain those wild and crazy dreams drinkers have, as does all that waking up to go to the bathroom, which makes you more likely to remember what you dreamed.

The sleep disturbance could be one reason why some studies find that people who’ve drunk to legal intoxication the night before perform poorly in flight simulator tests, as well as in others that measure driving ability. Warning: You needn’t have an obvious hangover to perform subpar. Thus, the Federal Aviation Administration requires pilots go eight hours “from bottle to throttle” and recommends a more prudent 24 hours. Watch out: Swedish researchers are working on drug tests that would reveal recent drinking even after blood alcohol levels reach zero.

(Tip 3: Catch up on your sleep, agree all.

“People should be aware that after a night of heavy drinking, they’re going to be impaired the next morning. If they can, they should avoid driving, operating heavy machinery, anything dangerous to their fingers,” says Bud Perrine, a psychologist at the University of Vermont. Coffee, while it wakes you up and might help the headache, could make you extra-jittery.)

*

And if we’re feeling extra-languid and limp-wristed, that could be because alcohol sapped us of some blood sugar, too. (Tip 4: “Stack of silver-dollar pancakes with extra heavy syrup before bedtime,” suggests Frolic patron John. Alcohol experts, however, suggest partaking of complex carbohydrates the next day, which help replenish blood sugar and are easy on the suffering stomach. Honey or fruit help metabolize the alcohol and may lessen a hangover’s severity.

Still, the alcohol’s only one part of a hangover. A cornucopia of other chemicals are probably culprits as well, agree researchers. Such chemicals developed in the booze as it fermented and aged. As a rule, the darker the drink, the more of these extras it contains: You’ll find more in brandy, whiskey and red wine than in vodka, gin and white wine. You’ll even find methanol in there, a chemical that can strike us blind, even kill us, if we get too much of it in the wrong batch of home-made hooch. It’s there in small amounts in most alcoholic beverages.

Methanol in particular is a hangover biggie, reckons Wayne Jones, an alcohol researcher at the National Laboratory of Forensic Chemistry in Linkoping, Sweden. The ethanol may be gone when the hangover hits us, but the methanol is still hanging around. Our liver is busy metabolizing it into decidedly unpleasant substances like formaldehyde and formic acid, which could well be making our heads pound.

(Tip 5: Stick with drinks like white wine, vodka or gin, which contain less of these bonus chemicals.)

Still, there’s more to a hangover than impurities in booze. After all, people can get hangovers from pure alcohol, which is just that--pure. And don’t forget that a hangover strikes after the alcohol’s long gone from your body. Here’s where the other main hangover theory comes into play--that it’s not so much the presence of alcohol that’s making us feel bad as its absence.

*

Our system was taken by surprise by the alcohol we drank. It was messing with our brain, making it more sluggish, which explains all that poor judgment, slurred speech, staggering around and collapsing in corners (and death, might we add, when people drink enough to knock out brain regions controlling vital functions). But then the brain tried to adjust, turning up the dial on its “excitability” to counteract the depressive action of alcohol on its nerves.

Then the alcohol gets metabolized. And what’s left behind? A still-hyperactive brain and nervous system, explaining the anxiety, poor sleep, sweating and fever, plus all that cringing from noises and lights that seem oh-so-much brighter and louder than usual.

(Tip 6: “Hair of dog.” Of course. The strategy makes sense, because you’re returning your brain to the pickled state it’s now adapted to. But experts advise strongly against it. You’re putting off the inevitable. More seriously, making a habit of this kind of “cure” is not the best way to protect against developing a drinking problem.)

Down the centuries, people have concocted endless exotic “cures” for the hangover: everything from vinegar and raw eggs, heavily salted cucumber juice and bitter almonds mixed with raw eels. Few have been scientifically tested.

Nor, though it sounds pretty powerful, has this last offering from Frolic denizen Tod: “Roll back a can of anchovies. Dig out a big pinch of it. Then snort it up your nose like snuff.”

Try that if you wish.

Or you might prefer to do what the alcohol researchers suggest: Bide your time. Sleep it off. And don’t do it again!

(BEGIN TEXT OF INFOBOX / INFOGRAPHIC)

In Search of Relief?

Ancient Assyrians treated their hangovers with ground swallow beaks mixed with bitter myrrh. If your grocery store’s fresh out of beaks, consider these less exotic remedies:

Water: Drink lots of water the night before and morning after, because alcohol makes you urinate more than usual, which dehydrates the body.

Pain Relievers: Aspirin can ease your pounding head, but your stomach, already irritated by the alcohol, may object. Don’t use drugs with acetaminophen, which can be toxic to the liver when alcohol is present.

Coffee: Caffeine will help with hangover sleepiness and headache. But bear in mind that your body’s already more jittery than normal.

Hair of the Dog: A hangover, in essence, is a miniature alcohol withdrawal, so a little more alcohol will ease the symptoms. But in your state, should you really be drinking more?

Time: The only cure that really works.