HOW A HANGOVER WORKS

Human beings have been in search of a hangover cure ever since wine drinking began in Persia around 5,000 BCE. That first drop of alcohol (taken from a primitive spoon, perhaps) touched a lip, was sipped, savored, and swallowed. That spoon became a drinking vessel as the taste for it developed, then a bottle, and finally, a glass.

By the seventeenth century, rough French wine was being distilled into Cognac, port flowed into England via Portugal, the consumption of gin was ruining more than mothers, and ale and rum were slopping out of tankards (like a stein) throughout Britain and her myriad colonies.

Once the taste of alcohol had become appealing to humankind, the palate took a shine to its various incarnations. Initially, the only alcoholic drink anyone imbibed was limited to whatever foul brew that was developed by crude fermentation. As time marched on, this process became more sophisticated; the cactus gave up its nectar to produce Tequila, grains were transformed into beer, and the Greeks turned grapes into wine (which the Romans later perfected).

Alcohol became a habit, an integral part of a day in the life of anyone with access to a still or the contents thereof. And, as author and drinker F. Scott Fitzgerald noted in his book, My Lost City: “The hangover became a part of the day as well allowed for as the Spanish siesta.”

WHAT IS A HANGOVER?

While writing this book, I spent many hours wondering who first woke with a splitting headache, an upset stomach, and a mouth like the bottom of a dead parrot’s cage to utter those immortal words: “God, I’ve got a hangover.” We shall never know, but at least we can trace the history of the term itself.

The word “hangover” came into common usage at the turn of the twentieth century in the United States. Of course, other countries have their own versions. In Spain, you’d need to whisper resaca (originally “malady”) to get help; in Italy, malassere dopo una sbornia (“malady after a night of too much alcohol”). In Sweden, it’s baksmalla (after-effect); in Germany, they talk of having a Katzenjammer (literally, “the wailing of cats”); in France, it’s gueule de bois (“wooden throat”), while in the Netherlands, their word of choice is kater (“cat”).

Whatever the language, “hangover” has become the accepted term for any illness that is caused by too much drink. Physical symptoms include headache, nausea, thirst, fatigue, and sickness, plus an increased sensitivity to light and sound, bloodshot eyes, muscle aches, vomiting, and sleep disturbance. Blood pressure can be raised, and a rapid heartbeat, tremor, and sweating might also develop. Mental signs include dizziness, a sense of the room spinning, and mood disturbances, especially depression, anxiety, and irritability. These symptoms are universal, and they appear in both male and female sexes. Luckily, not all are present every time you overindulge, and their intensity usually manifests itself in proportion to the amount and type of drink consumed.

Throughout the centuries, many types of quack medicines have been hailed as hangover “cures.” At the start of the twenty-first century, there is no definitive cure—but that doesn’t mean there aren’t people claiming to have invented one. Finding a cure has become an obsession with some pharmaceutical companies. Whoever does invent a foolproof formula, whether it is a combination of natural or chemical ingredients, will have discovered the drinker’s Holy Grail. And they will never have to work again.

A hangover cure would change our society beyond all recognition. Absenteeism would drop dramatically. There would be no excuse not to turn up for work. Productivity levels would rise noticeably. Since ninety-two percent of men and eighty-six percent of women drink alcohol—how many hangovers is that a week? No one can put a figure on it, but it doesn’t take much imagination to know it’s quite a few.

If there were a cure, the problem of the hungover worker would disappear. You know the sort of thing: the office desks remain exactly the same throughout the day as when the workers arrived. All they’ve done is sleep in the storeroom, having put an almost illegible notice on the door declaring, “No Admittance: Stock-taking in Progress.” We all know what they’re taking stock of—the levels of toxicity in their blood!

On a more serious note, readers ought to bear in mind that alcohol is the most potent legal narcotic available. You need no prescription for it. Thus, there are some drinkers who have passed from social drinking into the physical disease of alcoholism. Such people, sadly, cannot be helped by this book.

WHAT IS THE EFFECT OF ALCOHOL?

In order to understand the science behind a hangover remedy, it is vital to comprehend exactly what alcohol does to the body. It is also important to understand that each of us reacts differently to alcohol, and we may even have inborn allergic reactions to alcohol.

The type of alcohol we drink is known as ethanol or ethyl alcohol. Initially, it acts as a mild anesthetic. When the first few sips of alcohol arrive in the stomach, gastric enzymes known as alcohol dehydrogenases (ADH) begin to break down the alcohol molecules even before they can be absorbed into the bloodstream. Men generally have a more active pre-absorption mechanism than women, but drinking quickly can bypass the mechanism altogether. Consequently, alcohol slips into the bloodstream and gets whisked away to the brain, where it delivers an initial sense of euphoria as it attacks the membranes of nerve cells known as neurons.

The body can absorb about one ounce of forty percent alcohol by volume (ABV) or eighty-proof spirit an hour. If your body takes in more than one ounce an hour, the brain’s motor facilities are upset (via the attack on the neurons), speech becomes slurred, and the muscle control is loosened. The more alcohol you drink, the worse it becomes. You can even fall into a drunken stupor and, if you drink far, far too much, a coma.

When alcohol gets into the bloodstream and enters the liver, the body’s “poison filter,” it is “metabolized”—meaning that more ADH transforms it into harmless acetic acid via a series of molecular transformations.

First, ADH converts the ethanol molecules into acetaldehyde. Then a second enzyme, known as aldehyde dehydrogenase (ALDH), converts acetaldehyde to acetate. Acetate is harmless, whereas acetaldehyde, a relative of formaldehyde, is extremely toxic.

If all this happens according to plan, about ninety percent of the alcohol you drink will have been metabolized, and the remaining ten percent will pass out of your body via urine and exhaled air. The result? You won’t experience any unpleasant effects. Drink more than your body can metabolize, however, and aldehydes, in the form of acetylaldehyde, build up in the body. This overload causes the flushing, nausea, headache, and general feeling of illness that goes hand in hand with drinking too much.

HOW TO READ THE SIGNS

Having waded through some chemistry, how will you know you have a hangover? This (unlike chemistry) is fairly simple. The first symptom is the headache, which is caused by dehydration. Alcohol is a diuretic, sucking moisture from the body’s cells, encouraging you to urinate, and thus making your kidneys work overtime. Therefore, you must drink copious amounts of water to replenish your lost stocks. Alcohol also lowers the levels of minerals and vitamins in the body. Calcium and magnesium go off and hide somewhere else, depleting blood levels, as do the essential salts potassium and sodium. Alcohol also affects levels of vitamins B1, B6, and C.

The second symptom is nausea, caused by too much acid building up in your stomach and irritating its lining. You have ingested a substance (alcohol) that’s disruptive to your body. Some of it is poisonous, and your body decides to cleanse itself, often unpleasantly, by making you throw up.

The third symptom is fatigue, caused by the loss of sugar in the form of glycogen, which is stored in the liver. When you drink, the glycogen turns into glucose and departs when you urinate. Your body has to work harder to do what it does normally.

And you were out late, and didn’t sleep well. Part of normal sleep is a dream-filled stage, known scientifically as rapid-eye movement, or REM sleep. This is the most important part of a sleep pattern and happens four to five times a night. For obscure reasons, alcohol inhibits REM sleep. As a consequence, you go to bed drunk yet you wake up early, can’t get back to sleep, and will be irritable and tired and not worth speaking to the next day.

HOW MUCH IS TOO MUCH?

The one question I am always asked is: How much wine and how many glasses of spirit can one drink without getting hungover? The answer is: How long is a piece of string? Put simply, it depends upon your physiology and your reaction to individual alcohols. We are all individuals and will react differently to different types of alcohol. I know one man who can drink Champagne all day and show no ill effects; another can drink whiskey by the bottle and still be upstanding. However, if I drink a whiskey or two, I know I will feel some ill effects because it is made of grain and I suffer from hay fever. At certain times of the menstrual cycle, alcohol has a greater effect on women than at others. They can drink one glass and have it “go right to their heads.”

There are a multitude of other factors to consider. For example, the stronger the wine, the more likely it will be to give you a hangover. The alcoholic content of wine ranges from around nine percent ABV to seventeen percent ABV for a fortified wine. The ABV differs from country to country, and region to region. If wine grapes have been grown on a dry hillside in a warm climate, less water has gone naturally into the grapes—therefore there will be less water in the final wine. I love a robust, deep, rich, red wine, but I know it will have a greater ABV percentage—and consequently a greater effect on my body.

Generally speaking, beer is about 99.9 percent water and has less alcohol by volume than wine or spirits. You can drink more beer than you can vodka and not fall over.

Spirits are usually forty percent ABV, which means they are much stronger than wine when taken neat. Liqueurs are between eighteen and thirty-three percent ABV, except absinthe, which ranges from sixty-eight to seventy-seven percent of pure spirit, and can be quite lethal.

The reason spirits have a more powerful effect is because they stay longer in the bloodstream. The best advice is to read the label of whatever you are about to drink because it will give you the percentage of alcohol and allow you to check your intake.

OTHER TOXIC INGREDIENTS

Just to confuse your body further, the alcohol we take into our systems isn’t pure. Many of these impurities, which are known as congeners, are toxic chemicals, either natural or synthetic, that are absorbed during the fermentation or distillation processes, and some spirits and wines have more of them than others. That little glass of sherry sipped before dinner or the teeny glass of port sipped after dinner are congener-rich.

Researchers into the effects of alcohol on the human body have found that the darker the drink, the worse the hangover; similarly, the more transparent your drinks, the fewer problems you will encounter next morning.

Other research has developed a list showing brandy, red wine, rum, and whiskey as the agents that cause the most painful mornings after the nights before. Thus, other facts to consider when “choosing your poison” include the following:

• Vodka has fewer congeners than gin.

• White rum, such as Bacardi, has fewer congeners than dark rum.

• Brandy, rum, and single-malt Scotch have about six times more congeners than gin.

• Bourbon-drinkers ingest eight times the amount of congeners as do gin-drinkers.

• Red wines contain more congeners than white wines.

• Fine wines usually have fewer toxins than cheap wines.

HOW HUNGOVER ARE YOU?

PLEASE, CAN I DIE NOW?

How it happens: Three gin martinis to start off. Red wine to excess. A large glass of Cognac, followed by a final martini. No food all night. OR: a Champagne cocktail that becomes a “bottle of Champagne.” Then a bowl of thin soup; no bread. Then six glasses of red wine, followed by a glass or three of port. Finish the night with three glasses of malt whiskey.

Solution: My heart bleeds for you, but rest assured the room will stop spinning. Eventually . . .

UNBEARABLE

How it happens: A Cosmopolitan to start the evening. Six glasses of white wine. Brandy and more brandy with no food.

OR: About eight glasses of some sort of cheap liquor. (Expensive brands undergo more extensive distillation, which lessens the number of congeners contained.) No food other than chips nibbled early on in the evening.

Solution: Try to remember that there is, in fact, an afterlife.

SUFFERING

How it happens: Two whiskey sours followed by several glasses of carbonated (or bubbly) drinks such as sparkling wine, or tonic and soda water in mixed drinks. One final whiskey sour as a nightcap. No food.

Solution: Make sure your drinking partner is ahead of you.

I’LL LIVE

How it happens: Three sweet drinks (Bailey’s and cream, piña coladas, and so on). Sweet flavors disguise the taste of alcohol, and you may not realize how much alcohol you are really consuming.

Solution: Eat a little early in the evening, but check that all your clothes are still in place.

HANGOVER? WHAT HANGOVER?

How it happens: Three vodka and tonics consumed with blinis and smoked salmon. Finally, a large glass of water. No problems!

Solution: Carry on. But watch out for the banana skins . . .