Why Hangovers Can't Be Cured

David Vanderveen figures he should know better. But during a family party last Christmas, Vanderveen, 38, a normally temperate kind of guy, downed several glasses of champagne and Scotch before slurping some Boerenjongens, a Dutch concoction made from whisky and raisins. He spent the next morning on his couch, nursing a heaving stomach, headache and other assorted ills. "I felt like a monkey died in my mouth," says Vanderveen, cofounder of XS Energy Drinks, based in Laguna, Calif. "It wasn't pretty."

Vanderveen isn't alone in his holiday booze binging. The free flowing hooch at the endless round of parties during the month of December can turn a sipper into a chugger. According to the Distilled Spirits Council of the United States, the $58 billion distilled-spirits industry makes about 25 percent of its profits between Thanksgiving and New Year's. And though there are enough problems with lack of judgment the night of, the saga often continues the morning after with that smorgasbord of pain called the hangover. In medical terms, this full-body assault is called veisalgia.

While hangovers have plagued revelers since early hominids kicked back with some date-palm wine, science still doesn't have a good understanding of how your I-love-everybody yuletide cheer turns into such a biological bah-humbug. There are few studies that examine the hangover and the best way to cure it. But what science theorizes about the hangover may be enough to make any reveler skip the holiday binge.

The misery begins when blood alcohol levels start to fall. Some experts to believe the hangover is a "kind of mini withdrawal," says Robert Swift, professor of psychiatry and human behavior at Brown University and director of research at the Providence Veterans Adminstration Medical Center. Because alcohol is a sedative, your body reacts by releasing various neurochemicals to stimulate the brain. These chemicals cause a rapid pulse, nausea, tremors and light and sound sensitivity--the same symptoms that alcoholics experience when they stop drinking. The worst of the symptoms occur when blood alcohol levels reach zero, also known as "the morning after."

How fast it takes you get to that zero level depends on your liver, which processes nearly all the alcohol you imbibe. And it can metabolize only small amounts of liquor each hour, explains liver specialist Dr. William Carey, professor of medicine at the Cleveland Clinic Lerner College of Medicine. But "every person is going to metabolize alcohol differently," Carey says, with genetics and gender playing a role. On average, the liver metabolizes about one ounce of pure alcohol per hour. That's about 12 ounces of beer, a five-ounce glass of wine or one and a half ounces of liquor.

Which leads to another theory that puts the blame for the hangover on pure physiology. Alcohol is first broken down in the liver into a toxic substance called acetaldehyde. Acetaldehyde is then further broken down into a harmless substance called acetate. At high doses, acetaldehyde causes nausea, vomiting, sweating and other symptoms akin to the hangover. Although there is no acetaldehyde in your system when you have a zero blood-alcohol level, some of the after-effects of the toxin may persist the morning after.

Congeners, by-products of the distillation and fermentation process, may also play a role in making holiday partiers miserable. Darker-colored liquors such as brandies, bourbon and red wine contain more congeners than lighter colored alcoholic beverages like gin or vodka. The big-bad of the various congeners is methanol, which is broken down by the body into formaldehyde. In the vernacular, formaldehyde is embalming fluid. When living people have this in their circulation, the clinical term for how they feel is "rotten," Swift says.

Since alcohol is a diuretic, you'll wake up dehydrated. That dehydration explains some of the symptoms such as headaches and a dry mouth. Alcohol also plays havoc with the body's biorhythms, disturbing sleep patterns, despite it being a sedative. That lack of sleep contributes to the overall misery.

Oddly, "some people can get a hangover from one or two drinks," Swift says. "And it's usually the moderate or light social drinker who suffers the most." At particular risk, though, are women. Researchers at the University of Missouri, Columbia, found that women experience worse hangovers than men, despite the amount of alcohol consumed.
Though a drink-a-thon may make you feel merry, at least for a while, there are other health issues to think about. Binging, defined as four drinks per session for women and five for men, is a "serious public-health problem," according to Dr. Robert D. Brewer, alcohol team leader for the National Center for Chronic Disease Prevention and Health Promotion. Not only will your body most likely pay the price with a mother of a hangover, binging sets you up for a host of problems: car accidents, domestic and gun violence and sexual assault. There are also potential health issues that can be precipitated by a binge--acute pancreatitis, a painful and potentially life-threatening inflammation of the pancreas, or even "holiday heart syndrome," an irregular heart rhythm found in heart-healthy folks who have overindulged. "There's nothing funny, nothing good, about binging," Brewer says.

Binging isn't relegated to the problem drinker. Rather, studies at the Centers for Disease Control and Prevention show that binges are reported more often in moderate imbibers. And it's not the sole province of college kids either. According to the CDC, more than half of the alcohol consumed by adults in the United States is in the form of binge drinks, and 70 percent of binge drinking episodes involve adults over age 25.

The safest bet is of course to follow the rules. Current recommendations call for one drink a day for women and two a day for men. But if you can't resist the extra glass, there are ways to make your morning a little bit merrier. First, if you are drinking, don't drive--of course. A glass of water between drinks will both slow down your alcohol consumption and help with dehydration. Eat before drinking, and while you're at the party, keep grazing to slow alcohol absorption, suggests alcohol metabolism expert James Schaefer, a research professor at Union College in Schenectady, N.Y. Also avoid mixing drinks.

Don't waste your money on the many so-called hangover prevention remedies available in drugstores or online. Most don't have much, if any, science behind them. One study conducted by Tulane University researchers and published in the Annals of Internal Medicine did find that prickly pear extract prevented nausea and dry mouth and boosted appetite but didn't do much for other hangover symptoms.

So what can you do to help the morning after? Since alcohol messed up your sleep cycle, rest. To help your head, try aspirin or ibuprofen. Coffee can ease the pain, but it's also a mild diuretic. So drink plenty of water and juice. Exercise seems to help. Kim Donaldson, whose occasional downfall is holiday champagne, swears by walking or any type of light workout. "You may want to die at first, but you will feel better," says Donaldson, cofounder of Bottlenotes Inc., an online wine store.

And eat—even if you can barely stomach the thought. Brian Levy, a Dallas advertising executive, uses grease to help soothe symptoms during his sporadic forays into holiday overindulgence. But most experts say go bland with crackers, bread (burnt toast may help), bananas and other easy-to-digest foods.

And perhaps most important: don't fall for that myth about the-hair-of-the-dog-that-bit-you and have more alcohol. That trick may make you feel better in the short term, but it could lead you on a "very dangerous path" to alcohol dependence, Schaefer says. His advice: "Drink smart or don't drink. That way you'll be able to enjoy the holidays." Even the next day.