Alcohol-induced hangover, defined by a series of symptoms, is the most commonly reported consequence of excessive alcohol consumption. Alcohol hangovers contribute to workplace absenteeism, impaired job performance, reduced productivity, poor academic achievements, and may compromise potentially dangerous daily activities such as driving a car or operating heavy machinery.

These socioeconomic consequences and health risks of alcohol hangover are much higher when compared to various common diseases and other health risk factors. Nevertheless, unlike alcohol intoxication the hangover has received very little scientific attention.

What is a Hangover Exactly?

Alcohol hangover is the unpleasant next-day effect of an evening of excessive alcohol consumption. It is a puzzling phenomenon, since alcohol hangovers are most severe when alcohol has disappeared from the body or blood alcohol concentrations approaches zero.

Although some symptoms such as thirst and headache occur more frequently than others, it is hard to predict which combination of symptoms will occur after a drinking session. In addition to individual differences, the presence and severity of hangover-related symptoms also differ from occasion to occasion (I.e. within subjects). Although symptoms can be grouped because they seem related to a common construct such as mood, cognitive functioning, or dehydration, this has not led to a clear theory about the pathology of alcohol hanger.

The 10 most frequently experienced symptoms by 1516 Dutch students, the day following their last evening of excessive alcohol consumption.

Alcohol Hangover Pathology

The exact pathology is not yet fully understood but there are factors that correlate with hangover severity. After ingestion and absorption alcohol is metabolized. First, it is converted into acetaldehyde then it is further metabolized to acetate. Acetaldehyde is highly reactive and can cause tissue damage due to its toxic effects, which may lead to hangover-like symptoms such as nausea, sweating, rapid pulse and headache.

Subsequently there are the dehydration-related effects. Alcohol promotes urine production and subsequent dehydration can effect the electrolyte balance. Ingesting enough salt during alcohol consumption can counteract this effect and lower the overall water loss during the night.

Lastly there is inflammation. During alcohol consumption inflammation markers such as cytokines and CRP (c-reactive protein) are significantly increased. This implies that alcohol has an effect on the immune system, and that the subsequent presence and severity of hangover symptoms can probably be reduced by administration of strong and concentrated antioxidants.

Socioeconomic Consequences

The impact of alcohol hangover on daily activities can be profound. A survey among Dutch university students showed that more than half of them reported being unable to study when experiencing an alcohol hangover often or always. With an average hangover frequency of 2.7 days/month, 1 month a year is “lost”.

Alcohol hangovers are not limited to students and young adults. hangovers are also common in the workplace. A study showed 9.23% (11.6 million workers) of the US workforce reported to work with a hangover in the past year, making it the most common form of alcohol-related workplace impairment in the survey. There is a significant relationship between alcohol consumption and next-day absenteeism. A survey among 280 employees revelealed a two-fold increased likelihood of absenteeism the day after alcohol consumption.

Surprisingly, scientific evidence on the economic costs of alcohol hangover is scarce. A decade ago, Harwood estimated the annual costs of alcohol hangover in USA at 185 billion dollars, and although this amount was criticized for inaccuracy it gives an impression of the economic impact of hangovers on society.

Hangover Reflection and a Product to Keep an Eye on

The search for alcohol hangover cures is as old as alcohol itself. Many cures and prophylactic agents are available, but scientific evidence for their effectiveness is generally lacking. A possible explanation for the lack of scientific interest is that many physicians and researchers regard the alcohol hangover as an adequate punishment for unwanted behavior, i.e. excessive drinking. Alcohol is not a disease and can be easily prevented by moderating alcohol consumption. In their view, an effective hangover treatment is expected to promote binge drinking and thus would be hazardous to public health.

However I believe that social gathering, accompanied with a drink, is becoming even more important in a fast moving world where everything has to speed up, be more efficient causing more burnouts then ever before. It generates the perception that just doing nothing, relaxing and not being effective (at least not in an economical sense) is a bad thing.

“Social media” and its inseparable brother “the smart phone” even make real face-to-face social contact more difficult. Therefore going out with friends and people you care about is a MUST and should be uplifted even more in daily life. Alcohol consumption is not a must in these occasions but will weaken our daily (almost indoctrinated) restrains and sometimes helps us to forge new relations.

A new product concept named “FENIX Hangover Care” will launch on the 10th of October on Kickstarter and it shows very promising properties to be implemented in daily life through bars, disco’s and shops. It fights the right bad actors and replenishes the body with the right chemicals to reduce the overall hangover effect. There are not many anti-hangover care products available so hopefully this one will make it to the market. If you are interested you can check out www.fenixhangovercare.com.

Exaggerating is never good, but don’t forget to enjoy life.