The miserable mystery of the hangover.
Illustration by Michał Bednarski
The aching head. The cotton mouth. The wince at every noise. If you’ve ever tied on one too many, you know the suffering that comes in the aftermath: the hangover.
But physiologically speaking, what, exactly, is a hangover? Surprisingly, the answer is that we don’t really know. “At present, no theoretical model accounts for the pathology of alcohol hangover,” writes the Alcohol Hangover Research Group (which, no, is not a hard-partying drinking squad, but rather an international collaborative of sober-minded research scientists) in its “Consensus Statement on Best Practice in Alcohol Hangover Research.” While the symptoms of hangover—including nausea, fatigue, headache, and thirst—are well known, why exactly excess alcohol consumption produces a hangover remains, as one research paper on the subject puts it, “a puzzling phenomenon.”
It’s a common misconception that dehydration is responsible for hangover symptoms: It isn’t (although it may be a compounding factor). In fact, recent research, with heady scientific talk of cytokines and neuroinflammation, suggests that some kind of immune-system activation may be at work. And how drunk you have to get isn’t definitive either. In one study in which subjects drank to at least 0.10 percent blood alcohol content (well over the legal limit of intoxication), nearly a quarter of the participants reported no hangover symptoms at all. Beer before wine? Wine before beer? Science says the order will save you no pain. But on the other hand, drinking bourbon might result in more severe hangover symptoms than consuming vodka will, likely thanks to the presence of congeners—a complex of organic compounds in alcoholic beverages that are natural byproducts of fermentation and aging.
Why does a hangover hit on the morning after? Because, like a ravaged wasteland left in the wake of a retreating army, hangover symptoms become strongest as blood alcohol concentration nears zero. But as you blearily clutch your phone thumbing “hangover remedy” in Google search, science is here to tell you: Don’t bother. From pricey vitamin-infused IVs to greasy diner breakfasts to the dubious indulgence of hair-of-the-dog, “No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover,” reports a study in the British Medical Journal.
Of course, there is a 100 percent effective strategy for avoiding hangover: teetotaling. So far, it doesn’t seem to be catching on.
This article originally appeared in our Drink 2019 issue.
