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Morning-After Science


The holidays are over, the presents are opened, New Year's resolutions are made, and we're all looking forward, filled with hope and optimism, to the year that has just begun. Yet for many of us, the outlook is colored--darkened--by feelings of regret, a lingering sense that all is not right with the world ... that perhaps we're not quite ready to turn over the calendar and move on to this next phase. Despite a generally positive outlook, one key question nags.

Just how, exactly, do you get rid of a hangover?

Maybe it's just me.

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Research shows repeatedly that college students are among the leaders in alcohol consumption and in the frequency and intensity of hangovers--though graduate students lag undergraduates by a wide margin. And science students in general, I'm guessing, are slackers in the drinking department compared with say, majors in economics and English lit. (Postdocs, who often have families to care for and to keep them honest, form the rearguard among science trainees when it comes to alcohol consumption; this observation is based on anecdotal evidence and on the fact that alcohol consumption, generally, tends to decline with age.)

Still, most postdocs, science students, and grad students drink sometimes--especially on holidays--and for students and postdocs who do drink heavily, a severe hangover is a very likely consequence. Real, hardened alcoholics, say scientists, those who dose themselves on a regular basis (the hardened alcoholics, that is, not the scientists) experience hangovers less often, and with less intensity, than their less experienced peers. In drinking as in science, it's the young, inexperienced folk who pay the highest price for indiscretion.

What exactly, is a hangover? The term typically is defined--even in the medical literature--by its cluster of symptoms rather than as a coherent syndrome. For most people those symptoms are all too familiar: headache, achiness, tremulousness, diarrhea, loss of appetite, fatigue, and nausea--all of these are cited by Jeffrey G. Wiese and colleagues in a 2000 metastudy on hangovers published in the Annals of Internal Medicine. There are also mental symptoms--depression and reduced cognitive and visual/spatial skill performance--and these often persist beyond the subsidence of the physical symptoms ... indeed, long after alcohol in the bloodstream has decreased to immeasurable levels.

Studies document decreased reaction times, worsened managerial skills, less ability to concentrate, and an increased risk for injury even when alcohol can no longer be detected in the blood ... all of which add up to major economic consequences. One study cited in the Wiese metaanalysis put the cost of hangovers to the U.S. economy alone as high as $148 billion; that's nearly 1.5% of the U.S. gross domestic product. Another researcher put the cost even higher, at $2000 per working adult.

Economic losses mirror hangover trends, in that it isn't the heaviest drinkers who do the most damage. 85% of economic losses come from light to moderate drinkers--you and me. That's mainly because there are more light-to-moderate drinkers than heavy drinkers, especially in the workforce. But it's also because light-to-moderate drinkers are more likely to develop hangover symptoms than their more experienced peers. Ever fail to get out of bed in the morning after a night's indulgence, or, worse, screw up an experiment the day after a night out? I have.

While I know of no data to support this claim, I'm confident that the cost of hangovers to science is at least on a par with their cost to society as a whole. Students drink more than average folk, do jobs that require greater concentration, and--let's be honest--many have research advisors whose orneriness drives them to drink.

Given the personal relevance of hangovers and hangover-related science to the everyday experiences of a major portion of the academic scientific workforce, you'd think that science would be all over this and might even have found a cure by now. But, though alcoholism has been studied extensively, hangovers haven't been studied as much as you might think. Wiese's metastudy examined 4700 articles on alcohol intoxication published since 1965; but Wiese found only 108 articles that addressed the hangover issue.

As mentioned, the research that does exist supports a general definition of hangover as a cluster of symptoms that follows alcohol consumption. Alcohol affects the body in different ways, depending on what you drink, how much, and on the individual's particular biochemistry. Light-to-moderate drinking (and heavy drinking) leads to dehydration, which is responsible for many hangover symptoms. The body may also, in its weakened state, be poisoned mildly (or in extreme cases, not so mildly) by impurities-- congenors in alcohol-research parlance--in alcoholic beverages and the mixers that accompany them.

A few preventive measures have won more or less qualified support--though not rigorous justification--from scientists. The most obvious and effective measure--one that just about everyone agrees on, is this one: don't drink.

A more practical measure: drink less. Unless you aim to become a serious, hardened heavy-drinking alcoholic--not recommended by alcohol researchers--drinking less will result in fewer, milder hangover symptoms.

Another, even more practical suggestion--though one that is likely to be less effective--is to drink clear stuff. Since congenors may increase hangover symptoms, your choice of beverage may have an impact on their intensity and duration. Clear beverages--white wine instead of red, vodka instead of dark rum--may make the aftermath less painful. Some say that malt beverages and sweet mixers can make things worse.

Three other hangover-prevention measures have been shown to have positive effects. Chief among these is hydration: Alcohol is a diuretic; it tends to dry out the body. Mixed drinks, beer, and wine, then, are better than more concentrated alcohol when it comes to preventing hangovers. But there's a potential downside: some of these beverages also have more congenors, which can make things worse instead of better. Water, then, is by far the best mixer when it comes to hangover mitigation. Drink a glass (or more) of water with every alcoholic drink and your hangover is likely to be milder.

Vitamin B6 has been shown to have a small effect on hangover in scientific studies, as have prostaglandin inhibitors, a class of drugs that includes aspirin and ibuprofen; for optimum effectiveness these should be taken while you are drinking, not the next morning, though they can also help the morning after. Finally, one study showed that an herbal preparation called Liv.52 might be helpful, though the validity of that study is not universally acknowledged.

A few other "folk" cures may have some scientific justification, though they seem to lack rigorous support and can even seem contradictory. Burnt toast--a traditional hangover cure--contains carbon, which, like the activated carbon slurries used to treat alcohol poisoning--may help to filter out impurities. Olive oil or another food-grade oil, taken by the tablespoon shortly before alcohol consumption, may help to slow the rate at which alcohol is absorbed, giving your body more time to adjust to its new blood chemistry. Greasy pizza works just as well, and tastes better ... though right about now the thought of eating greasy pizza might not be appealing.

Sugar, too, may help, but in the opposite way: instead of slowing alcohol absorption, it increases the rate of alcohol depletion. Though congenors in sweet drinks may make things worse, fructose itself may reduce hangovers by speeding alcohol metabolism. Since fructose is metabolized quickly, taking honey before you start drinking is unlikely to have much of a positive effect. So start by sucking down some olive oil, then, once you're into it, shoot some honey.

The general principle here--dramatically oversimplified--is this: just before, during, or after drinking heavily, eat something. Fats may help before drinking, sugars during...but any nutritious food--taken before, during, or after drinking--can help restore your electrolyte balance and hydrate your body.

So far we've only mentioned preventive measures. Hasn't the miracle of modern medicine developed a cure by now? In a word, no ... unless you consider the suggestion of writer Robert Benchley--who, though not a scientist in the strictest sense, is known to have performed many poorly controlled alcohol-related experiments on himself. The only cure for hangover, Benchley suggested, is death.

Benchley, by the way, said a lot of smart things that most graduate students can relate to. To whit: "Anyone can do any amount of work provided it isn't the work he is supposed to be doing at the moment." But I digress.

No discussion of hangover cures would be complete without consideration of the hair-of-the-dog approach. Drinking more alcohol the morning after your indulgence isn't recommended by scientists. Morning-after drinking may reduce the symptoms, but only by extending impairment--you'll feel the pain eventually. And hair-of-the-dog may be linked to alcoholism, which isn't a good thing. You have to sober up sooner or later, and when you do, it's going to hurt.

So there's no cure for hangover ... yet. Yet alcohol-related research is an active field with many research opportunities ... so maybe there will be one next year. There may not have been much hangover research, but alcohol and alcoholism research is a well-funded national priority. Research in this area spans several disciplines, from the biochemical study of basic mechanisms of alcohol metabolism, to the neuroscience of dependency, to demographic and clinical studies on at-risk populations.

As in most areas of science directly related to human health, the National Institutes of Health (NIH) are the major players, with the National Institute for Alcohol Abuse and Alcoholism (NIAAA) playing a dominant role. If you're interested in finding that hangover cure, look to NIH for support. NIAAA has 21 investigators in its intramural program, which covers a wide range of alcohol-related research. NIAAA sponsors 16 National Alcohol Research Centers and three alcohol-related institutional training programs. NIAAA's two extramural divisions, ( Basic Research and Clinical and Prevention Research), fund research in 34 topical areas related to alcohol and alcoholism. Overall, NIAAA funds more than 1000 research grants, career development awards, and training awards, and more than 300 fellowships.

Still looking for a hangover cure? The best bet is to get out there and find one yourself.