What causes hangovers, blackouts and ‘hangxiety’? Everything you need to know about alcohol these holidays



There’s no way to cure a hangover, even with ‘hair of the dog’.
Louis Hansel

Nicole Lee, Curtin University and Brigid Clancy, University of Newcastle

With the holiday season well underway and New Year’s Eve approaching, you might find yourself drinking more alcohol than usual.

So what actually happens to our body as we drink alcohol and wake up with a hangover?

What about memory blackouts and “hangxiety”, when you can’t remember what happened the night before or wake up with an awful feeling of anxiety?

Let’s look at what the science says – and bust some long-standing myths.

What happens when you drink alcohol?

It doesn’t matter what type of alcohol you drink – or even whether you mix drinks – the effects are basically the same with the same amount of alcohol.




Read more:
Do different drinks make you different drunk?


When you drink alcohol it goes into the stomach and passes into the small intestine where it’s quickly absorbed into the bloodstream.

If you have eaten something, it slows the absorption of alcohol so you don’t get drunk so quickly. That’s why it’s a good idea to eat before and during drinking.

It takes your body about an hour to metabolise 10g, or one standard drink, of alcohol.

(There are calculators that help you estimate your blood alcohol level but everybody breaks down alcohol at a different rate. So these calculators should only be used as a guide.)

What causes memory blackouts?

We all have that friend who has woken up after a big night out and not been able to remember half the night. That’s a “blackout”.

It’s different to “passing out” – you’re still conscious and able to carry out conversation, you just can’t remember it later.

The more alcohol you drink and the faster you drink it, the more likely you are to experience blackouts.

Once alcohol in your blood reaches a certain level, your brain simply stops forming new memories. If you think of your brain like a filing cabinet, files are going straight to the bin, so when you later try to look for them they are lost.

How do I sober up?

If you’ve had too much, there’s no way to sober up quickly. The only thing that can sober you up is time, so that the alcohol can be eliminated from your body.

The caffeine in coffee may make you feel more awake, but it doesn’t help break down alcohol. You will be just as intoxicated and impaired, even if you feel a little less drunk.

The same goes for cold showers, exercise, sweating it out, drinking water, and getting fresh air. These things might help you feel more alert, but they have no impact on your blood alcohol concentration or on the effects of alcohol.

What causes hangovers?

Researchers haven’t identified one single cause of hangovers, but there are a few possible culprits.

Alcohol is a diuretic, so it makes you urinate more often, which can lead to dehydration. This is especially the case if you’re in a hot, sweaty venue or dancing a lot. Dehydration can make you feel dizzy, sleepy and lethargic.

Alcohol can irritate your stomach lining, causing vomiting and diarrhoea, and electrolyte imbalance.

An imbalance of electrolytes (the minerals our body need to function properly) can make you feel tired, nauseated, and cause muscle weakness and cramps.

Hangovers can leave you tired, dehydrated, and with an irritated stomach.
Adrian Swancar/Unsplash

Too much alcohol can cause your blood vessels to dilate (expand), causing a headache. Electrolyte imbalance and dehydration can also contribute to that thumping head the next morning.

Alcohol also interferes with glucose production, resulting in low blood sugar. Not producing enough glucose can leave you feeling sluggish and weak.

Alcohol also disrupts sleep. It can make you feel sleepy at first but it interrupts the circadian cycle, sleep rhythms and REM (rapid eye movement) sleep, so later in the night you might wake up.

It can stop you from getting the quality of sleep you need to wake feeling refreshed.

Why ‘hair of the dog’ doesn’t work

There’s no way to cure a hangover, even with “hair of the dog” (having a drink the morning after). But drinking the next morning might delay the onset of symptoms, and therefore make you feel better temporarily.




Read more:
Monday’s medical myth: you can cure a hangover


Your body needs time to rest, metabolise the alcohol you have already had, and repair any damage from a heavy night of drinking. So it’s not a good idea.

If you drink regularly and you find yourself needing a drink the next morning, this may be a sign of alcohol dependence and you should talk with your GP.

Suffering from hangxiety?

Alcohol has many effects on the brain, including that warm, relaxed feeling after a couple of drinks. But if you’ve ever felt unusually anxious after a big night out you might have experienced “hangxiety”.

Over a night of drinking, alcohol stimulates the production of a chemical in the brain called GABA, which calms the brain, and blocks the production of glutamate, a chemical associated with anxiety. This combination is why you feel cheerful and relaxed on a night out.

Your brain likes to be in balance, so in response to drinking it produces more glutamate and blocks GABA. Cue that shaky feeling of anxious dread the next morning.

What can you do if you wake up with hangxiety?

To ease some of the symptoms, try some breathing exercises, some mindfulness practices and be gentle with yourself.

There are also effective treatments for anxiety available that can help. Talk to your GP or check out some resources online.

If you’re already an anxious person, drinking alcohol may help you feel more relaxed in a social situation, but there is an even greater risk that you will feel anxiety the next day.

Prevention is better than a cure

Have a drink of water between alcoholic drinks.
Marvin Meyer/Unsplash

If you choose to drink this holiday season, the best way to avoid hangovers, hangxiety, and blackouts is to stick within recommended limits.

The new draft Australian alcohol guidelines recommend no more than ten standard drinks a week and no more than four standard drinks on any one day.

(If you want to check what a standard drink looks like, use this handy reference.)




Read more:
Cap your alcohol at 10 drinks a week: new draft guidelines


As well as eating to slow the absorption of alcohol, and drinking water in between alcoholic drinks to reduce the negative effects, you can also:

  • set your limits early. Decide before you start the night how much you want to drink, then stick to it

  • count your drinks and avoid shouts

  • slow down, take sips rather than gulps and avoid having shots.

If you’re worried about your own or someone else’s drinking, call the National Alcohol and other Drug Hotline on 1800 250 015 to talk through options or check out resources online.The Conversation

Nicole Lee, Professor at the National Drug Research Institute (Melbourne), Curtin University and Brigid Clancy, PhD Candidate (Psychiatry) & Research Assistant, University of Newcastle

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Hangovers happen as your body tries to protect itself from alcohol’s toxic effects



A night of revelry can mean an uncomfortable day after.
Everett Collection/Shutterstock.com

Daryl Davies, University of Southern California; Joshua Silva, University of Southern California, and Terry David Church, University of Southern California

Debaucherous evening last night? You’re probably dealing with veisalgia right now.

More commonly known as a hangover, this unpleasant phenomenon has been dogging humanity since our ancestors first happened upon fermentation.

Those nasty vertigo-inducing, cold sweat-promoting and vomit-producing sensations after a raucous night out are all part of your body’s attempt to protect itself from injury after you overindulge in alcoholic beverages. Your liver is working to break down the alcohol you consumed so your kidneys can clear it out ASAP. But in the process, your body’s inflammatory and metabolic reactions are going to lay you low with a hangover.

As long as people have suffered from hangovers, they’ve searched in vain for a cure. Revelers have access to a variety of compounds, products and devices that purport to ease the pain. But there’s a lot of purporting and not a lot of proof. Most have not been backed up well by science in terms of usefulness for hangover treatment, and often their effects don’t seem like they’d match up with what scientists know about the biology of the hangover.

Drain enough cups of booze in one session and you know what’s bound to follow.
Laura buron/Unsplash, CC BY-ND

Working overtime to clear out the booze

Hangovers are virtually guaranteed when you drink too much. That amount varies from person to person based on genetic factors as well as whether there are other compounds that formed along with ethanol in the fermentation process.

Over the course of a night of heavy drinking, your blood alcohol level continues to rise. Your body labors to break down the alcohol – consumed as ethanol in beer, wine or spirits – forming damaging oxygen free radicals and acetaldehyde, itself a harmful compound. The longer ethanol and acetaldehyde stick around, the more damage they can do to your cellular membranes, proteins and DNA, so your body’s enzymes work quickly to metabolize acetaldehyde to a less toxic compound, acetate.

Over time, your ethanol levels drop through this natural metabolic process. Depending on how much you consumed, you’re likely to experience a hangover as the level of ethanol in your blood slowly returns to zero. Your body is withdrawing from high levels of circulating alcohol, while at the same time trying to protect itself from the effects of alcohol.

Scientists have limited knowledge of the leading causes of the hangover. But they do know that the body’s responses include changes in hormone levels to reduce dehydration and cellular stress. Alcohol consumption also affects a variety of neurotransmitter systems in the brain, including glutamate, dopamine and serotonin. Inflammation increases in the body’s tissues, and the healthy gut bacteria in your digestive system take a hit too, promoting leaky gut.

Altogether, the combination of all these reactions and protective mechanisms activated by your system gives rise to the experience of a hangover, which can last up to 48 hours.

Your misery likely has company

Drinking and socializing are cultural acts, and most hangovers do not happen in isolation. Human beings are social creatures, and there’s a high likelihood that at least one other individual feels the same as you the morning after the night before.

Each society has different rules regarding alcohol use, which can affect how people view alcohol consumption within those cultures. Drinking is often valued for its relaxing effect and for promoting sociability. So it’s common to see alcohol provided at celebratory events, social gatherings and holiday parties.

For many people, ‘partying’ is synonymous with ‘drinking.’
Lidya Nada/Unsplash, CC BY-ND

In the United States, drinking alcohol is largely embraced by mainstream culture, which may even promote behaviors involving excessive drinking. It should be no surprise that overindulgence goes hand in hand with these celebratory social events – and leads to hangover regrets a few hours later.

Your body’s reactions to high alcohol intake and the sobering-up period can influence mood, too. The combination of fatigue that you experience from sleep deprivation and hormonal stress reactions, in turn, affect your neurobiological responses and behavior. As your body is attempting to repair itself, you’re more likely to be easily irritated, exhausted and want nothing more than to be left alone. Of course, your work productivity takes a dramatic hit the day after an evening of heavy drinking.

When all is said and done, you’re the cause of your own hangover pain, and you’re the one who must pay for all the fun of the night before. But in short order, you’ll forget how excruciating your last hangover was. And you may very soon talk yourself into doing the things you swore you’d never do again.

Speeding up recovery

While pharmacologists like us understand a bit about how hangovers work, we still lack a true remedy.

Countless articles describe a variety of foods, caffeine, ion replenishment, energy drinks, herbal supplements including thyme and ginger, vitamins and the “hair of the dog” as ways to prevent and treat hangovers. But the evidence isn’t really there that any of these work effectively. They’re just not scientifically validated or well reproduced.

For example, Kudzu root (Pueraria lobata), a popular choice for hangover remedies, has primarily been investigated for its effects in reducing alcohol-mediated stress and hangover. But at the same time, Kudzu root appears to inhibit the enzymes that break down acetaldehyde – not good news since you want to clear that acetaldehyde from your system quickly.

To fill this knowledge gap, our lab is working with colleagues to see if we can find scientific evidence for or against potential hangover remedies. We’ve focused on the benefits of dihydromyricetin, a Chinese herbal medicine that is currently available and formulated as a dietary supplement for hangover reduction or prevention.

Dihydromyricetin appears to work its magic by enhancing alcohol metabolism and reducing its toxic byproduct, acetaldehyde. From our findings in mice models, we are collecting data that support the usefulness of dihydromyricetin in increasing the expression and activity of enzymes responsible for ethanol and acetaldehyde metabolism in the liver, where ethanol is primarily broken down. These findings explain one of the several ways dihydromyricetin protects the body against alcohol stress and hangover symptoms.

We are also studying how this enhancement of alcohol metabolism results in changes in alcohol drinking behaviors. Previously, dihydromyricetin was found to counteract the relaxation affect of drinking alcohol by interfering with particular neuroreceptors in the brain; rodents didn’t become as intoxicated and consequently reduced their ethanol intake. Through this combination of mechanisms, we hope to illustrate how DHM might reduce the downsides of excessive drinking beyond the temporary hangover, and potentially reduce drinking behavior and damage associated with heavy alcohol consumption.

Of course, limiting alcohol intake and substituting water for many of those drinks during an evening out is probably the best method to avoid a painful hangover. However, for those times when one alcoholic beverage leads to more than a few more, be sure to stay hydrated and catch up on rest. Your best bet for a smoother recovery is probably some combination of nonsteroidal anti-inflammatory drug like ibuprofen, Netflix and a little downtime.

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Daryl Davies, Professor of Clinical Pharmacy, University of Southern California; Joshua Silva, Ph.D. Candidate in Clinical and Experimental Therapeutics, University of Southern California, and Terry David Church, Assistant Professor of Regulatory and Quality Sciences, University of Southern California

This article is republished from The Conversation under a Creative Commons license. Read the original article.