Of the miseries regularly inflicted on humankind, some are so minor and yet, while they last, so painful that one wonders how, after all this time, a remedy cannot have been found. If scientists do not have a cure for cancer, that makes sense. But the common cold, the menstrual cramp? The hangover is another condition of this kind. It is a preventable malady: don’t drink. Nevertheless, people throughout time have found what seemed to them good reason for recourse to alcohol. One attraction is alcohol’s power to disinhibit—to allow us, at last, to tell off our neighbor or make an improper suggestion to his wife. Alcohol may also persuade us that we have found the truth about life, a comforting experience rarely available in the sober hour. Through the lens of alcohol, the world seems nicer. (“I drink to make other people interesting,” the theatre critic George Jean Nathan used to say.) For all these reasons, drinking cheers people up. See Proverbs 31:6-7: “Give . . . wine unto those that be of heavy hearts. Let him drink, and forget his poverty, and remember his misery no more.” It works, but then, in the morning, a new misery presents itself.
A hangover peaks when alcohol that has been poured into the body is finally eliminated from it—that is, when the
But hangover symptoms are not just physical; they are cognitive as well. People with hangovers show delayed reaction times and difficulties with attention, concentration, and visual-spatial perception. A group of airplane pilots given simulated flight tests after a night’s drinking put in substandard performances. Similarly, automobile drivers, the morning after, get low marks on simulated road tests. Needless to say, this is a hazard, and not just for those at the wheel. There are laws against drunk driving, but not against driving with a hangover.
Hangovers also have an emotional component. Kingsley Amis, who was, in his own words, one of the foremost drunks of his time, and who wrote three books on drinking, described this phenomenon as “the metaphysical hangover”: “When that ineffable compound of depression, sadness (these two are not the same), anxiety, self-hatred, sense of failure and fear for the future begins to steal over you, start telling yourself that what you have is a hangover. . . . You have not suffered a minor brain lesion, you are not all that bad at your job, your family and friends are not leagued in a conspiracy of barely maintained silence about what a shit you are, you have not come at last to see life as it really is.” Some people are unable to convince themselves of this. Amis described the opening of Kafka’s “Metamorphosis,” with the hero discovering that he has been changed into a bug, as the best literary representation of a hangover.
The severity of a hangover depends, of course, on how much you drank the night before, but that is not the only determinant. What, besides alcohol, did you consume at that party? If you took other drugs as well, your hangover may be worse. And what kind of alcohol did you drink? In general, darker drinks, such as red wine and whiskey, have higher levels of congeners—impurities produced by the fermentation process, or added to enhance flavor—than do light-colored drinks such as white wine, gin, and vodka. The greater the congener content, the uglier the morning. Then there are your own characteristics—for example, your drinking pattern. Unjustly, habitually heavy drinkers seem to have milder hangovers. Your sex is also important. A woman who matches drinks with a man is going to get drunk faster than he, partly because she has less body water than he does, and less of the enzyme alcohol dehydrogenase, which breaks down alcohol. Apparently, your genes also have a vote, as does your gene pool. Almost forty per cent of East Asians have a variant, less efficient form of aldehyde dehydrogenase, another enzyme necessary for alcohol processing. Therefore, they start showing signs of trouble after just a few sips—they flush dramatically—and they get drunk fast. This is an inconvenience for some Japanese and Korean businessmen. They feel that they should drink with their Western colleagues. Then they crash to the floor and have to make awkward phone calls in the morning.
Hangovers are probably as old as alcohol use, which dates back to the Stone Age. Some anthropologists have proposed that alcohol production may have predated agriculture; in any case, it no doubt stimulated that development, because in many parts of the world the cereal harvest was largely given over to beer-making. Other prehistorians have speculated that alcohol intoxication may have been one of the baffling phenomena, like storms, dreams, and death, that propelled early societies toward organized religion. The ancient Egyptians, who, we are told, made seventeen varieties of beer, believed that their god Osiris invented this agreeable beverage. They buried their dead with supplies of beer for use in the afterlife.
Alcohol was also one of our ancestors’ foremost medicines. Berton Roueché, in a 1960 article on alcohol for The New Yorker, quoted a prominent fifteenth-century German physician, Hieronymus Brunschwig, on the range of physical ills curable by brandy: head sores, pallor, baldness, deafness, lethargy, toothache, mouth cankers, bad breath, swollen breasts, short-windedness, indigestion, flatulence, jaundice, dropsy, gout, bladder infections, kidney stones, fever, dog bites, and infestation with lice or fleas. Additionally, in many times and places, alcohol was one of the few safe things to drink. Water contamination is a very old problem.
Some words for hangover, like ours, refer prosaically to the cause: the Egyptians say they are “still drunk,” the Japanese “two days drunk,” the Chinese “drunk overnight.” The Swedes get “smacked from behind.” But it is in languages that describe the effects rather than the cause that we begin to see real poetic power. Salvadorans wake up “made of rubber,” the French with a “wooden mouth” or a “hair ache.” The Germans and the Dutch say they have a “tomcat,” presumably wailing. The Poles, reportedly, experience a “howling of kittens.” My favorites are the Danes, who get “carpenters in the forehead.” In keeping with the saying about the Eskimos’ nine words for snow, the Ukrainians have several words for hangover. And, in keeping with the Jews-don’t-drink rule, Hebrew didn’t even have one word until recently. Then the experts at the Academy of the Hebrew Language, in Tel Aviv, decided that such a term was needed, so they made one up: hamarmoret, derived from the word for fermentation. (Hamarmoret echoes a usage of Jeremiah’s, in Lamentations 1:20, which the King James Bible translates as “My bowels are troubled.”) There is a biochemical basis for Jewish abstinence. Many Jews—fifty per cent, in one estimate—carry a variant gene for alcohol dehydrogenase. Therefore, they, like the East Asians, have a low tolerance for alcohol.
As for hangover remedies, they are legion. There are certain unifying themes, however. When you ask people, worldwide, how to deal with a hangover, their first answer is usually the hair of the dog. The old faithful in this category is the Bloody Mary, but books on curing hangovers—I have read three, and that does not exhaust the list—describe more elaborate potions, often said to have been invented in places like Cap d’Antibes by bartenders with names like Jean-Marc. An English manual, Andrew Irving’s “How to Cure a Hangover” (2004), devotes almost a hundred pages to hair-of-the-dog recipes, including the Suffering Bastard (gin, brandy, lime juice, bitters, and ginger ale); the Corpse Reviver (Pernod, champagne, and lemon juice); and the Thomas Abercrombie (two Alka-Seltzers dropped into a double shot of tequila). Kingsley Amis suggests taking Underberg bitters, a highly alcoholic digestive: “The resulting mild convulsions and cries of shock are well worth witnessing. But thereafter a comforting glow supervenes.” Many people, however, simply drink some more of what they had the night before. My Ukrainian informant described his morning-after protocol for a vodka hangover as follows: “two shots of vodka, then a cigarette, then another shot of vodka.” A Japanese source suggested wearing a sake-soaked surgical mask.
Application of the hair of the dog may sound like nothing more than a way of getting yourself drunk enough so that you don’t notice you have a hangover, but, according to Wayne Jones, of the Swedish National Laboratory of Forensic Medicine, the biochemistry is probably more complicated than that. Jones’s theory is that the liver, in processing alcohol, first addresses itself to ethanol, which is the alcohol proper, and then moves on to methanol, a secondary ingredient of many wines and spirits. Because methanol breaks down into formic acid, which is highly toxic, it is during this second stage that the hangover is most crushing. If at that point you pour in more alcohol, the body will switch back to ethanol processing. This will not eliminate the hangover—the methanol (indeed, more of it now) is still waiting for you round the bend—but it delays the worst symptoms. It may also mitigate them somewhat. On the other hand, you are drunk again, which may create difficulty about going to work.
As for the non-alcoholic means of combatting hangover, these fall into three categories: before or while drinking, before bed, and the next morning. Many people advise you to eat a heavy meal, with lots of protein and fats, before or while drinking. If you can’t do that, at least drink a glass of milk. In Africa, the same purpose is served by eating peanut butter. The other most frequent before-and-during recommendation is water, lots of it. Proponents of this strategy tell you to ask for a glass of water with every drink you order, and then make yourself chug-a-lug the water before addressing the drink.
A recently favored antidote, both in Asia and in the West, is sports drinks, taken either the morning after or, more commonly, at the party itself. A fast-moving bar drink these days is Red Bull, an energy drink, mixed with vodka or with the herbal liqueur Jägermeister. (The latter cocktail is a Jag-bomb.) Some people say that the Red Bull holds the hangover at bay, but apparently its primary effect is to blunt the depressive force of alcohol—no surprise, since an eight-ounce serving of Red Bull contains more caffeine than two cans of Coke. According to fans, you can rock all night. According to Maria Lucia Souza-Formigoni, a psychobiology researcher at the Federal University of São Paolo, that’s true, and dangerous. After a few drinks with Red Bull, you’re drunk but you don’t know it, and therefore you may engage in high-risk behaviors—driving, going home with a questionable companion—rather than passing out quietly in your chair. Red Bull’s manufacturers have criticized the methodology of Souza-Formigoni’s study and have pointed out that they never condoned mixing their product with alcohol.
When you get home, is there anything you can do before going to bed? Those still able to consider such a question are advised, again, to consume buckets of water, and also to take some Vitamin C. Koreans drink a bowl of water with honey, presumably to head off the hypoglycemia. Among the young, one damage-control measure is the ancient Roman method, induced vomiting. Nic van Oudtshoorn’s “The Hangover Handbook” (1997) thoughtfully provides a recipe for an emetic: mix mustard powder with water. If you have “bed spins,” sleep with one foot on the floor.
Now to the sorrows of the morning. The list-topping recommendation, apart from another go at the water cure, is the greasy-meal cure. (An American philosophy professor: “Have breakfast at Denny’s.” An English teen-ager: “Eat two McDonald’s hamburgers. They have a secret ingredient for hangovers.”) Spicy foods, especially Mexican, are popular, along with eggs, as in the Denny’s breakfast. Another egg-based cure is the prairie oyster, which involves vinegar, Worcestershire sauce, and a raw egg yolk to be consumed whole. Sugar, some say, should be reapplied. A reporter at the Times: “Drink a six-pack of Coke.” Others suggest fruit juice. In Scotland, there is a soft drink called Irn-Bru, described to me by a local as tasting like melted plastic. Irn-Bru is advertised to the Scots as “Your Other National Drink.” Also widely employed are milk-based drinks. Teen-agers recommend milkshakes and smoothies. My contact in Calcutta said buttermilk. “You can also pour it over your head,” he added. “Very soothing.”
Elsewhere on the international front, many people in Asia and the Near East take strong tea. The Italians and the French prefer strong coffee. (Italian informant: add lemon. French informant: add salt. Alcohol researchers: stay away from coffee—it’s a diuretic and will make you more dehydrated.) Germans eat pickled herring; the Japanese turn to pickled plums; the Vietnamese drink a wax-gourd juice. Moroccans say to chew cumin seeds; Andeans, coca leaves. Russians swear by pickle brine. An ex-Soviet ballet dancer told me, “Pickle juice or a shot of vodka or pickle juice with a shot of vodka.”
Many folk cures for hangovers are soups: menudo in Mexico, mondongo in Puerto Rico, işkembe çorbasi in Turkey, patsa in Greece, khashi in Georgia. The fact that all of the above involve tripe may mean something. Hungarians favor a concoction of cabbage and smoked meats, sometimes forthrightly called “hangover soup.” The Russians’ morning-after soup, solyanka, is, of course, made with pickle juice. The Japanese have traditionally relied on miso soup, though a while ago there was a fashion for a vegetable soup invented and marketed by one Kazu Tateishi, who claimed that it cured cancer as well as hangovers.
I read this list of food cures to Manuela Neuman, a Canadian researcher on alcohol-induced liver damage, and she laughed at only one, the six-pack of Coke. Many of the cures probably work, she said, on the same distraction principle as the hair of the dog: “Take the spicy foods, for example. They divert the body’s attention away from coping with the alcohol to coping with the spices, which are also a toxin. So you have new problems—with your stomach, with your esophagus, with your respiration—rather than the problem with the headache, or that you are going to the washroom every five minutes.” The high-fat and high-protein meals operate in the same way, she said. The body turns to the food and forgets about the alcohol for the time being, thus delaying the hangover and possibly alleviating it. As for the differences among the many food recommendations, Neuman said that any country’s hangover cure, like the rest of its cultural practices, is an adaptation to the environment. Chilies are readily available in Mexico, peanut butter in Africa. People use what they have. Neuman also pointed out that local cures will reflect the properties of local brews. If Russians favor pickle juice, they are probably right to, because their drink is vodka: “Vodka is a very pure alcohol. It doesn’t have the congeners that you find, for example, in whiskey in North America. The congeners are also toxic, independent of alcohol, and will have their own effects. With vodka you are just going to have pure-alcohol effects, and one of the most important of those is dehydration. The Russians drink a lot of water with their vodka, and that combats the dehydration. The pickle brine will have the same effect. It’s salty, so they’ll drink more water, and that’s what they need.”
Many hangover cures—the soups, the greasy breakfast—are comfort foods, and that, apart from any sworn-by ingredients, may be their chief therapeutic property, but some other remedies sound as though they were devised by the witches in “Macbeth.” Kingsley Amis recommended a mixture of Bovril and vodka. There is also a burnt-toast cure. Such items suggest that what some hungover people are seeking is not so much relief as atonement. The same can be said of certain non-food recommendations, such as exercise. One source says that you should do a forty-minute workout, another that you should run six miles—activities that may have little attraction for the hung over. Additional procedures said to be effective are an intravenous saline drip and kidney dialysis, which, apart from their lack of appeal, are not readily available.
There are other non-ingested remedies. Amazon will sell you a refrigeratable eye mask, an aromatherapy inhaler, and a vinyl statue of St. Vivian, said to be the patron saint of the hung over. She comes with a stand and a special prayer.
The most widely used over-the-counter remedy is no doubt aspirin. Advil, or ibuprofen, and Alka-Seltzer—there is a special formula for hangovers, Alka-Seltzer Wake-Up Call—are probably close runners-up. (Tylenol, or acetaminophen, should not be used, because alcohol increases its toxicity to the liver.) Also commonly recommended are Vitamin C and B-complex vitamins. But those are almost home remedies. In recent years, pharmaceutical companies have come up with more specialized formulas: Chaser, NoHang, BoozEase, PartySmart, Sob’r-K HangoverStopper, Hangover Prevention Formula, and so on. In some of these, such as Sob’r-K and Chaser, the primary ingredient is carbon, which, according to the manufacturers, soaks up toxins. Others are herbal compounds, featuring such ingredients as ginseng, milk thistle, borage, and extracts of prickly pear, artichoke, and guava leaf. These and other O.T.C. remedies aim to boost biochemicals that help the body deal with toxins. A few remedies have scientific backing. Manuela Neuman, in lab tests, found that milk-thistle extract, which is an ingredient in NoHang and Hangover Helper, does protect cells from damage by alcohol. A research team headed by Jeffrey Wiese, of Tulane University, tested prickly-pear extract, the key ingredient in Hangover Prevention Formula, on human subjects and found significant improvement with the nausea, dry mouth, and food aversion but not with other, more common symptoms, such as headache.
Five years ago, there was a flurry in the press over a new O.T.C. remedy called RU-21 (i.e., Are you twenty-one?). According to the reports, this wonder drug was the product of twenty-five years of painstaking research by the Russian Academy of Sciences, which developed it for K.G.B. agents who wanted to stay sober while getting their contacts drunk and prying information out of them. During the Cold War, we were told, the formula was a state secret, but in 1999 it was declassified. Now it was ours! “HERE’S ONE COMMUNIST PLOT AMERICANS CAN REALLY GET BEHIND,” the headline in the Washington Post said. “BOTTOMS UP TO OUR BUDDIES IN RUSSIA,” the Cleveland Plain Dealer said. The literature on RU-21 was mysterious, however. If the formula was developed to keep your head clear, how come so many reports said that it didn’t suppress the effects of alcohol? Clearly, it couldn’t work both ways. When I put this question to Emil Chiaberi, a co-founder of RU-21’s manufacturer, Spirit Sciences, in California, he answered, “No, no, no. It is true that succinic acid”—a key ingredient of RU-21—“was tested at the Russian Academy of Sciences, including secret laboratories that worked for the K.G.B. But it didn’t do what they wanted. It didn’t keep people sober, and so it never made it with the K.G.B. men. Actually, it does improve your condition a little. In Russia, I’ve seen people falling under the table plenty of times—they drink differently over there—and if they took a few of these pills they were able to get up and walk around, and maybe have a couple more drinks. But no, what those scientists discovered, really by accident, was a way to prevent hangover.” (Like many other O.T.C. remedies, RU-21 is best taken before or while drinking, not the next morning.) Asians love the product, Chiaberi says. “It flies off the shelves there.” In the United States, it is big with the Hollywood set: “For every film festival—Sundance, the Toronto Film Festival—we get calls asking us to send them RU-21 for parties. So it has that glamour thing.”
Most cures for hangover—indeed, most statements about hangover—have not been tested. Jeffrey Wiese and his colleagues, in a 2000 article in Annals of Internal Medicine, reported that in the preceding thirty-five years more than forty-seven hundred articles on alcohol intoxication had been published, but that only a hundred and eight of these dealt with hangover. There may be more information on hangover cures in college newspapers—a rich source—than in the scientific literature. And the research that has been published is often weak. A team of scientists attempting to review the literature on hangover cures were able to assemble only fifteen articles, and then they had to throw out all but eight on methodological grounds. There have been more studies in recent years, but historically this is not a subject that has captured scientists’ hearts.
Which is curious, because anyone who discovered a widely effective hangover cure would make a great deal of money. Doing the research is hard, though. Lab tests with cell samples are relatively simple to conduct, as are tests with animals, some of which have been done. In one experiment, with a number of rats suffering from artificially induced hangovers, ninety per cent of the animals died, but in a group that was first given Vitamins B and C, together with cysteine, an amino acid contained in some O.T.C. remedies, there were no deaths. (Somehow this is not reassuring.) The acid test, however, is in clinical trials, with human beings, and these are complicated. Basically, what you have to do is give a group of people a lot to drink, apply the remedy in question, and then, the next morning, score them on a number of measures in comparison with people who consumed the same amount of alcohol without the remedy. But there are many factors that you have to control for: the sex of the subjects; their general health; their family history; their past experience with alcohol; the type of alcohol you give them; the amount of food and water they consume before, during, and after; and the circumstances under which they drink, among other variables. (Wiese and his colleagues, in their prickly-pear experiment, provided music so that the subjects could dance, as at a party.) Ideally, there should also be a large sample—many subjects.
All that costs money, and researchers do not pay out of pocket. They depend on funding institutions—typically, universities, government agencies, and foundations. With all those bodies, a grant has to be O.K.’d by an ethics committee, and such committees’ ethics may stop short of getting people drunk. For one thing, they are afraid that the subjects will hurt themselves. (All the studies I read specified that the subjects were sent home by taxi or limousine after their contribution to science.) Furthermore, many people believe that alcohol abusers should suffer the next morning—that this is a useful deterrent. Robert Lindsey, the president of the National Council on Alcoholism and Drug Dependence, told me that he wasn’t sure about that. His objection to hangover-cure research was simply that it was a misuse of resources: “Fifteen million people in this country are alcohol-dependent. That’s a staggering number! They need help: not with hangovers but with the cause of hangovers—alcohol addiction.” Robert Swift, an alcohol researcher who teaches at Brown University, counters that if scientists, through research, could provide the public with better information on the cognitive impairments involved in hangover, we might be able to prevent accidents. He compares the situation to the campaigns against distributing condoms, on the ground that this would increase promiscuity. In fact, the research has shown that free condoms did not have that effect. What they did was cut down on unwanted pregnancies and sexually transmitted disease.
Manufacturers of O.T.C. remedies are sensitive to the argument that they are enablers, and their literature often warns against heavy drinking. The message may be unashamedly mixed, however. The makers of NoHang, on their Web page, say what your mother would: “It is recommended that you drink moderately and responsibly.” At the same time, they tell you that with NoHang “you can drink the night away.” They list the different packages in which their product can be bought: the Bender (twelve tablets), the Party Animal (twenty-four), the It’s Noon Somewhere (forty-eight). Among the testimonials they publish is one by “Chad S,” from Chicago: “After getting torn up all day on Saturday, I woke up Sunday morning completely hangover-free. I must have had like twenty drinks.” Researchers address the moral issue less hypocritically. Wiese and his colleagues describe the damage done by hangovers—according to their figures, the cost to the U.S. economy, in absenteeism and poor job performance, is a hundred and forty-eight billion dollars a year (other estimates are far lower, but still substantial)—and they mention the tests with the airplane pilots, guaranteed to scare anyone. They also say that there is no experimental evidence indicating that hangover relief encourages further drinking. (Nor, they might have added, have there been any firm findings on this matter.) Manuela Neuman, more philosophically, says that some people, now and then, are going to drink too much, no matter what you tell them, and that we should try to relieve the suffering caused thereby. Such reasoning seems to have cut no ice with funding institutions. Of the meagre research I have read in support of various cures, all was paid for, at least in part, by pharmaceutical companies.
A truly successful hangover cure is probably going to be slow in coming. In the meantime, however, it is not easy to sympathize with the alcohol disciplinarians, so numerous, for example, in the United States. They seem to lack a sense of humor and, above all, the tragic sense of life. They appear not to know that many people have a lot that they’d like to forget. In the words of the English aphorist William Bolitho, “The shortest way out of Manchester is . . . a bottle of Gordon’s gin,” and if that relief is temporary the reformers would be hard put to offer a more lasting solution. Also questionable is the moral emphasis of the temperance folk, their belief that drinking is a lapse, a sin, as if getting to work on time, or living a hundred years, were the crown of life. They forget alcohol’s relationship to camaraderie, sharing, toasts. Those, too, are moral matters. Even hangovers are related to social comforts. Alcohol investigators describe the bad things that people do on the morning after. According to Genevieve Ames and her research team at the Prevention Research Center, in Berkeley, hungover assembly-line workers are more likely to be criticized by their supervisors, to have disagreements with their co-workers, and to feel lousy. Apart from telling us what we already know, such findings are incomplete, because they do not talk about the jokes around the water cooler—the fellowship, the badge of honor. Yes, there are safer ways of gaining honor, but how available are they to most people?
Outside the United States, there is less finger-wagging. British writers, if they recommend a cure, will occasionally say that it makes you feel good enough to go out and have another drink. They are also more likely to tell you about the health benefits of moderate drinking—how it lowers one’s risk of heart disease, Alzheimer’s, and so on. English fiction tends to portray drinking as a matter of getting through the day, often quite acceptably. In P. G. Wodehouse’s Jeeves and Wooster series, a hangover is the occasion of a happy event, Bertie’s hiring of Jeeves. Bertie, after “a late evening,” is lying on the couch in agony when Jeeves rings his doorbell. “ ‘I was sent by the agency, sir,’ he said. ‘I was given to understand that you required a valet.’ ” Bertie says he would have preferred a mortician. Jeeves takes one look at Bertie, brushes past him, and vanishes into the kitchen, from which he emerges a moment later with a glass on a tray. It contains a prairie oyster. Bertie continues, “I would have clutched at anything that looked like a life-line that morning. I swallowed the stuff. For a moment I felt as if somebody . . . was strolling down my throat with a lighted torch, and then everything seemed suddenly to get all right. The sun shone in through the window; birds twittered in the tree-tops; and, generally speaking, hope dawned once more. ‘You’re engaged,’ I said.” Here the hangover is a comedy, or at least a fact of life. So it has been, probably, since the Stone Age, and so it is likely to be for a while yet