Marcus Harrison drank so much cognac at a Memorial Day party a few years ago that when he tried to go to sleep, his bed started spinning. So he slept on the floor - and wasn't surprised when he felt terrible the next morning.
"I had a whole-day hangover," said Harrison, 38, a guest services employee at a Baltimore hotel.
Although he describes himself as only an occasional drinker, he has a preferred remedy for hangovers: one or two 10-ounce glasses of grapefruit or orange juice. He also quaffs Gatorade or some other sports drink, if he can find it.
"Always avoid coffee. Avoid anything with caffeine. It always dries you out," he says.
Good advice, it turns out. About two-thirds of us in the United States consume alcohol in some form, and with the New Year approaching tonight, some of us will do it to excess. As a result, millions will ring in 2005 tomorrow with personal remedies to treat the nausea, headache and upset stomach that inevitably follow.
"My cure is straight water and plenty of it, and drink it the night before, if you think of it, to dilute the impurities in the alcohol," advises Harrison's buddy, Michael Jackson, 32, who joined a discussion at the Midtown Yacht Club on a recent afternoon.
When he drinks, Jackson says, he sticks to beer because it minimizes the potential for a painful morning-after.
The basic cause of a hangover is well known: too much alcohol, consumed too quickly, drains the body of fluids.
"What a hangover is, primarily, is dehydration," said Siegfried Streufert, a psychologist at the State University of New York's Upstate Medical University in Syracuse and an expert on alcohol's effects.
An effective, over-the-counter cure remains elusive. And experts say the only reliable home remedy is the one that has worked since the dawn of fermentation - rest and gradual rehydration.
Quick cures are hard to find because the mechanisms that trigger hangover symptoms - from nausea to that incessant, pounding headache - remain a mystery. "The overall cause is too much alcohol, but other than that, nobody really knows what causes a hangover," said Dena Davidson, an associate professor of psychiatry at the Indiana University School of Medicine.
The lack of a sure hangover cure may not be such a bad thing. Some health experts view hangovers as nature's way of limiting alcohol consumption. "If we did have a cure, you'd see a whole lot more drinking, and that would mean more of the problems that go with it," said Linda C. Degutis, a researcher and public health expert at Yale University.
The medical term for a hangover is "veisalgia," a compound name taken from the Norwegian word kveis, meaning uneasiness after debauchery, and the Greek word algia, for pain.
Alcohol itself is a poison absorbed in the stomach and broken down by the liver. In the body, most of it enters the bloodstream directly, where it dilates blood vessels and depresses the nervous system, giving revelers a brief high or euphoria.
But as the alcohol wears off, its effects are all too familiar. They include:
Fatigue. The brain becomes more alert as the depressant effects of alcohol fade. That often means waking up in the middle of the night, or not getting enough of the precious, deep-level REM sleep the body needs.
"It's as if the brain is waking up and trying to shake off the effects of the alcohol," said Degutis. "That's why people will be tired the whole next day."
Dehydration. Because alcohol is a diuretic, the body tends to lose a lot of water. If you have four drinks, you will urinate up to a quart of water over the next several hours, according to a 1998 study Davidson co-authored.
Drinking plenty of water before bed can prevent some dehydration and wash some of the alcohol out of the brain. Davidson recommends taking water between alcoholic drinks to rehydrate and reduce the desire for more alcohol.
Stomach ache. Alcohol produces a buildup of acids, causing inflammation of the stomach lining and delaying the digestion of foods in the stomach. Eating food before or while drinking allows alcohol to be absorbed more slowly and reduces the pain from an upset stomach. Antacid tablets the next day also can help.
Headache. Alcohol's precise chemical effect on the brain remains a mystery, but it is known to affect neurotransmitters and hormones that act on the brain in ways that trigger headaches. Some drinks, such as red wine, somehow increase serotonin and histamine levels in the brain, which also trigger headaches.
Aspirin, ibuprofen or other pain relievers may help headaches, but they also can upset and damage a stomach already sensitized by too much alcohol.
The severity of a hangover depends on how much one drinks and how fast. Generally, the human body can process 1.5 ounces of alcohol an hour, whether it's in the form of a 12-ounce beer, a 5-ounce glass of wine or a mixed drink with 1.5 ounces of 80-proof whiskey.
Another thing that makes a universal hangover cure so difficult to find, experts say, is that symptoms vary from one victim to the next. And we're not all equally susceptible. "Some people get headaches, some get stomach aches or nausea, some get everything," Degutis says.
But recent research has disclosed a few patterns:
A 2003 survey of 1,230 students at the University of Missouri-Columbia found that women suffer worse hangovers than men, or at least women are more willing to report them. Of the 13 symptoms listed in the survey, thirst was the most common, followed by fatigue and headaches.
Women reported suffering from all three more often than men, and researchers attributed the difference to the fact that women have smaller bodies, which can accommodate less water.
Although imbibing can result in short-term memory loss, many people still go to work hung over - and manage to cope.
A Penn State University study found that 21 male managers who normally drink in moderation showed no measurable difference in performance the day after consuming enough screwdrivers to record a .10 percent blood alcohol level - which will snare a drunken-driving conviction in most states.
The volunteers, sent home in taxis, were asked to resolve conflicts that measured 25 skills, such as how broadly they approached problems and how quickly they made decisions.
"They complained of a headache, they were grumpy, unhappy, they didn't feel very good. But it didn't affect their work," said Streufert, who conducted the study in 1995 before retiring from Penn State.
But 48 university students at the University of Utrecht in the Netherlands had a harder time trying to recall 15 words in a memory test the morning after they drank the alcoholic equivalent of eight to 10 beers.
"The whole brain becomes disregulated by the alcohol. As the tasks become more difficult, the ability to perform them drops off sharply," said lead researcher Joris C. Verster.
Some scientists believe that darker drinks trigger worse hangovers than lighter ones because they contain more biologically active compounds known as congeners. Along with the ethanol that gives alcoholic beverages their kick, congeners are produced during fermentation. Methanol, for example, is a congener found in brandy and red wine.
As congeners are digested and broken down, researchers believe, they release cytokines, proteins secreted by the immune system that help trigger inflammation and contribute to flulike aches and pains.
The darker the beverage, the more congeners it usually contains, which is why some believe that bourbon produces a more severe hangover than vodka and that red wine causes more pain than white. But the research is still inconclusive.
"We do see more congeners in red wine than white wine, but their effects are still largely unknown," Davidson said.
Harrison, the hotel worker, says his key to minimizing hangovers is to drink slowly and in moderation. He has no plans - ever again - to drink to the point where the bed is spinning.
"Something like that, you remember," he said.
Happy New Year.
Help for the hangover
Experts say the best way to minimize a hangover is to limit the amount you drink. You also should eat throughout the night, pace your drinking and take some water or other nonalcoholic beverage before bed.
That said, if you do wake up with a hangover ...
Some doctors recommend sports drinks, such as Gatorade, to replenish lost electrolytes. They also say that grapefruit, orange or tomato juice will help the body retain fluids.
Antacids may relieve nausea and stomach problems.
Aspirin and ibuprofen may reduce head and muscle aches, but can exacerbate upper abdominal pain and nausea. Researchers tell us to avoid acetaminophen, most commonly sold as Tylenol, because alcohol enhances its toxicity to the liver.
Health supplements include Chaser, a pill containing activated charcoal and calcium carbonate designed to be taken while drinking the night before, and Opuntia ficus, an extract of the prickly pear cactus in capsule form taken the morning after. Many health experts are skeptical of these remedies, and most studies evaluating their effectiveness have been funded by the firms that market them.
(In one independent study last year, British researchers found that an artichoke-based hangover extract, marketed in capsule form, failed to help 15 volunteers who got drunk twice as part of the evaluation. The researchers did note that none of their volunteers dropped out of the study.)
A remedy recommended by barflies everywhere is the "hair of the dog," meaning another drink or two. The phrase comes from an ancient practice of healing dog bites by binding hairs from a dog that has bitten someone to the victim's wound.
Don't do it, according to the experts. Alcohol may temporarily relieve some hangover symptoms, but it also can prolong the hangover, impair your ability to function and contribute to alcoholism.
Sources: Alcohol Health & Research World, Canadian Medical Association Journal, Facts on File Encyclopedia of Word and Phrase Origins, staff and patrons of the Midtown Yacht Club.
- Dennis O'Brien