This is the second part in a series about the myths and realities of alcohol consumption.
I pray thee let me and my fellow have
A hair of the dog that bit us last night—
And bitten were we both to the brain aright
- John Heywood
The idea that alcohol may itself be a cure for alcohol hangovers is something that most people would have heard. “Hair of the dog”. Could it have any truth to it?
It’s certainly popular: A glance at twitter shows that people all around the world are talking about needing some “hair of the dog” every minute of the day and a survey of college students revealed that 25% reported using alcohol as a hangover cure.
A google search reveals a lot of sites recommending “hair of the dog” — many of them supplying less than plausible explanations of how it might work.
Chiff very unconvincingly suggests that “adding more alcohol (ethanol) makes your body stop and concentrate on the new alcohol coming in.” (I find this kind of explanation interesting: It’s very common for people to psychologise their bodies, giving psychological explanations for non-psychological processes.)
Wikipedia explains that the newly consumed ethanol “dilutes” the metabolites (the things your body breaks the alcohol down to) of the earlier alcohol. The idea behind this is that the metabolites of alcohol are what give you the hangover. But how diluting them with more alcohol could make you feel better is not explained. Although wikipedia cites a research paper for this explanation, no such suggestion appears in that paper. (Someone should consider fixing the wikipedia page to reflect this.)
What the research says
The first thing worth mentioning here is that there hasn’t been an enormous amount of research into hangovers.
An editorial in the journal Current Drug Abuse Reviews outlined the state of the literature as follows.
Although the vast majority of excessive drinkers do experience alcohol hangovers, the scientific community has paid little attention to its pathology and possible treatment. This can be explained by the fact that physicians do not view hangover as a disease, but as a consequence of unwanted behavior. In fact, alcohol hangover can be easily prevented by moderating alcohol consumption. Moreover, finding a cure for hangovers might result in more excessive drinking episodes. This makes treating alcohol hangover a controversial topic.
That said, there has been some relevant work.
A recent review in a prominent journal considered the possibility that the hangover is an early stage of alcohol withdrawal. If that were the case, then hair of the dog would make sense. Consuming more alcohol would eleviate withdrawal the way that small doses of opiates eleviate opiate withdrawal, or having a cigarette relieves nicotine withdrawal.
Borrowed from The Annals of Internal Medicine.
But according to the reviewers this theory doesn’t seem to stack-up. Alcohol withdrawal and hangovers seem to differ in many ways, with some symptoms being quite the opposite in the two conditions. (See table, right.)
As far as I can tell, that’s the extent of the research directly relevant to the matter.
Systematic reviews have shown that no hangover cures have been proven to work — but that doesn’t mean they don’t. As I’ve said, very little research has been done and they usually focus on obviously bogus commercial “miracle” cures.
A priori, some explanations seem to make some sense. One simple one is that perhaps getting drunk simply makes you forget that you’ve got a hangover. The well-known analgesic effects of alcohol might help with some of the symptoms and the cognitive impairment might make you notice the other symptoms less.
Of course, this is a completely unsubstantiated claim. It’s also very plausible that hair of the dog simply doesn’t work and, as one editorialist suggested, is simply an excuse for early stage alcoholism.
What do the rest of you think?
(Stay tuned for the next installment in the series on the myths and realities of alcohol consumption.)
Jeffrey G. Wiese, MD; Michael G. Shlipak, MD, MPH; and Warren S. Browner, MD, MPH (2000). The Alcohol Hangover Annals of Internal Medicine, 152 (12), 897-902
Verster JC (2009). The “hair of the dog”: a useful hangover remedy or a predictor of future problem drinking? Current drug abuse reviews, 2 (1), 1-4 PMID: 19630732
Wiese JG, Shlipak MG, & Browner WS (2000). The alcohol hangover. Annals of internal medicine, 132 (11), 897-902 PMID: 10836917
Hi! I’ve been digging around through the alchol lit for a bit now myself, out of morbid interest, and I’m with the Wiese et al – this effect does not appear to be alcohol withdrawl. It’s too modulated by the presence of congeners for that to be a plausible explanation.
The editorial is incorrect in assuming that moderation would lead to fewer hangovers. Far from it, as Wiese et al mentioned later in the paper, light to moderate drinkers were more likely to feel the effects of a hangover! Hardly the effect one would use for a public health tool.
Yeah. They seem to be right.
RE moderation — I think they mean simply not drinking enough to experience a hangover. That’s certainly possible! :-)
Not drinking will solve all problems, I guess.
Um. No. Hangovers are caused mostly by dehydration and electrolyte loss.
http://alcoholism.about.com/od/hangovers/a/cures.htm
http://www.timesonline.co.uk/tol/life_and_style/health/article5370363.ece
1. Prevention is better than cure: switch to water before you get too drunk, and regardless, hydrate thoroughly before bed. If you can, take an advil to mitigate tissue swelling, and some electrolytes.
2. Failing that, or supplementing it if you way overdid teh booze, continue to hydrate throughout the hangover. Add electrolytes and food as needed. Rest.
Using this, I can recover rapidly from even a blackout-and-say-rude-things-you-don’t-remember night with minimal hangover symptoms. The emotional fallout from drunken gaffes.. well, there’s no cure for that. =P
I’m going to post about the idea that hangovers are (mostly) dehydration. A bunch of evidence seems to suggest otherwise.
Ah, sorry there Luxury. I guess I replied via the wrong link.
Okay his would be true in teh case of an alcoholic maybe but i can say through my experience as a responsible drinker the hair of the dog does actually work.
What i was taught is when you wake up the next day after a few too many with a splitting headache or you feel horrible you hae a glass of whatever you were drinking the night before and your fine for the day.
you continue the day, sleep and the following day effects are totally gone. Worked for me everytime. Even if there is psychological it bloody works. i dont believe its the early stages of Alcoholism.
I don’t know about the early stage alcoholism thing.
I started drinking when I was 13 years old and for the first 2 years I had drinking binges only occasionally and I never got a hangover. I remember I used to brag about it (stupid, needless to say). Nevertheless, I remember I almost religiously drank a Gatorade when I woke up. Later, when I was 15, I started to drink heavily more often (once or twice per week) and one day I suddenly woke up with a hangover. Now, drinking more alcohol works with the mild ones, but Gatorade doesn’t do anything except ridding you of a dry mouth. With the tough ones, only sleep gets you through. So, I find that when drinking more alcohol doesn’t work it is because nothing works. Nevertheless, I don’t know if irritated stomach/liver beats alcohol need in the body; meaning that I don’t know if I throw up the alcohol anyway because my stomach can’t stand anything or because it simply isn’t early stage alcoholism. I agree more with your theory. E.g. If your leg hurts and you start drinking you forget about it, people go out to forget their “heartaches”, etc. So, regardless of the no evidence situation, it makes sense.
From the research that I’ve read (I can’t locate a link online, unfortunately) hangovers are caused by the cogeners in the alcohol, which are the things like methanol and the like, which esentially add flavor to the alcohol. The ethanol (drining alcohol) itself has little impact on hangovers. As explained in the article, “hair of the dog” simply works the same way that pain killers do; you no longer feel the symptoms. There is no “cure” for a hangover, you can either treat the symptoms, or you can prevent it to begin with by avoiding alcohol heavy with cogeners. As strange as it seems, a colorless, flavorless alcohol like vodka or everclear is the least likely to cause a hangover. Also, higher quality alcohol (read as: more expensive) is less likely to cause hangovers because more of the cogeners can be drawn off and seperated since the company is less likely to be concerned about that small volume of liquid. That is, by no means, however, a garauntee that any alcohol will not cause a hangover, unless it is 100% cogener-free. Hope that helps everyone.
There was an interesting study recently about coffee withdrawal:
Coffee Consumption Unrelated to Alertness: Stimulating Effects May Be Illusion, Study Finds
It found that frequent consumers of coffee may feel alerted by coffee, but that this is actually merely the reversal of the fatiguing effects of acute caffeine withdrawal. I wonder whether something similar could be happening with alcohol?
Hey cool. Thanks — I’ll check out that research when I get a chance.
From what you say about the coffee research it seems to make a lot of sense.
I like your blog by the way, westius.
Ah! So cool you brought that up! I feel that is a similar explanation for the smoking habit.
People say it “relaxes them”, or otherwise puts them at ease, though in reality its simply a submission to the habit, or nicotine withdrawal.
I am a smoker so suffice to say, I’ve done my research. The body wasn’t born addicted to nicotine, nicotine was introduced into the body and the body learned. It learned to “whine”.
So basically, smoking a cigarette doesn’t relieve a smoker’s stress, it simply ceases the stressful sensations associated with wanting another cigarette.
As an (ashamedly) experienced alcoholic I recognize many of these ideas as effective “cures” for a hangover though some provide a better response from my own body. It’s important that the terms “cure” and “prevention” be properly defined as this allows for proper disambiguation of the physiological and psychological traumas one speaks out during a hangover.
Prevention: “Too much of anything is bad for you”. This quote is inarguable through its wording. “A lot of money” is different than “too much money” which implicates a problem BECAUSE of excess. Same with booze. Most people who have read this post (and others prior) already knew better and are likely looking for a “cure”.
Cure: The human body is a beautiful machine that is most resplendent when considering its healing properties. Even though our
systems have mended our broken bones, sealed sliced skin and even outmatched cancer, you have to keep time in perspective. Break a leg and you can understand 6 weeks of discomfort. Spend a night out overindulging and your next 8 hours may be the most horrific experience of your life.
We can’t cure hangovers; we treat them:
It’s been argued through previous posts, but many hangover symptoms occur due to an acute form of withdrawal. Why does another drink, or hair of the dog work for so many people? Because it puts you backwards. Closer to the “I feel great!” state you were in when you had the last shot you remember but before the infantile “I feel terrible, why me?” point in the morning. It’s like trying to drive the long way across your state with fumes in your tank and a five dollar bill in your pocket. Put $3 at the first gas station and you’re lucky if you make it to the second station. Either way, you’re going to run out of gas before you reach your destination. You’re simply better off without another nip.
Dehydration?
I believe dehydration is a constant threat and more so to the routine imbiber. Dry mouth? Aching in muscles you don’t even
remember using? Try over exaggerating a smile. Do your lips feel tight? Did you pee when you woke up? How much? What color was it?
Could you smell it distinctively? Sounds gross but I think these are sentiments most people can appreciate at some point in their lives. So we have to rehydrate, right?
Rehydration?
Rehydrating after a hangover isn’t about gulping down as much water as possible in the quicket fashion. For starters, our
stomaches’ have a certain rate of clearance and the rest of our system has a certain rate of absorbtion. The “drink to you pee clear” idea isn’t very substantial because you can drink a lot very quickly and it will be eliminated from your body in the same fashion. 8 ounces/30 minutes is what I feel is reasonable but not all drinks are the same.
Electrolytes!
One of the most critical elements of hangover treatments involves the reuptake of electrolytes. Consuming large amounts of water when you’re hungover isn’t simply inefficient but can be counterproductive: You’re encouraging the escretion of products already in great demand. Sodium. potassium and magnesium are important electrolytes and are found it most sport drinks. Personally, I mix 1 part gatorade with 4 parts water. The excessive sodium and caloric (sugar) content of regular gatorade is absurd.
Foooooood!
You can’t NOT eat. If you CAN’T eat (because you’re hungover) don’t expect to feel much better. You just spent the evening pissing out most of the vitamins and minerals your body holds dearly!
*DISCLAIMER
I’m not a doctor though I’ve done a good amount of “active” research. Nothing anyone else with half a brain (and twice the liver) could do equally and or oppositely. :)
I just thought this would be interesting, is what Alcohol Edu tells students about hangovers.
Causes of a Hangover
After a night of drinking, a person might experience what we call a hangover. With a hangover, a person usually suffers from nausea, fatigue, headaches, extreme thirst, and a sensitivity to light and loud sounds. Having a hangover can make paying attention in a morning class difficult and pretty unproductive.
One of the key causes of a hangover is dehydration, which is the source of a person’s headache. Drinking alcohol alters activity in a brain region called the hypothalamus and causes the body to get rid of more water than it should. Dehydration can also cause a person’s brain to slightly shrink away from its skull—which can cause a person to have a nasty headache.
Another cause of a hangover has to do with the breakdown of alcohol by the liver. When alcohol is metabolized, a toxin called acetaldehyde is produced. This toxin is responsible for a person feeling just plain old sick after drinking.
Dealing with a Hangover
Unfortunately, there isn’t a whole lot you can do to cure a hangover. Drinking water will help with the dehydration, but really all you can do is wait it out. Contrary to what you may have heard, drinking more alcohol won’t cure your hangover, but it will just make you all the more sick!
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Alcohol is initially converted to acetaldehyde, just as methanol is initially converted to formaldehyde. Both of these are toxic to the body and do cause inflammation, especially of nervous tissue.
Although I experienced daily hangovers in my twenties, I rarely suffered from any. For a short time I tried the hair-of-the-dog approach and found that it didn’t help nearly as much as a couple of tablets of the anti-inflammatory naproxen. I also developed a tolerance to the dehydrating effects of alcohol. One of my main tools was to take a tablet of vitamin B-1 (thiamine) before I passed out. Large quantitites of alcohol can cause a depletion of acetaldehyde dehydrogenase, causing the body to accumulate acetaldehyde. Thiamine help to keep quantities of acetaldehyde dehydrogenase high, so that alcohol can be completely converted to acetic acid, a normal metabolic by-product.
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I know for a fact that hair of the dog is an effective hangover cure. I’ve used it myself. Having a few beers or shots the next morning always alleviates the headache, the lethargy, etc. Then take a short nap, and you will be good as new. The key is to stop after a few drinks and not continue all day long again.
Oi! OK for sure, water is good for your body, your are 70% H2O. Drinking alcohol gets rid of a lot of it. Having a glass of water between each adult beverage helps keep you from dehydrating – and also can help you from assing out as quickly :-b Water before bed, water in the AM, with something like a wheat toast with peanut butter, banana slices and honey. there’s plenty of advice out there on how to Get Rid of a Hangover , you might just have to try around, until you find what works for you.
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im no expert and hair of the dog just makes me sicker and vomit from experience so is not for me but if it works for you great, i find i fill my glasses with ice now so i can hydrate while i drink and not have to worry about drinking water. if i drink to much still doesnt stop the hangovers but definitely minimises it to a more bearable level.
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