In Praise of Hangovers

Last Saturday, a friend cancelled his plans to meet up with me at the local roller derby bout, citing “a mild hangover” as the reason. “Mild” is a subjective term, but whatever he really meant by it, I don’t feel it very often anymore regardless. The key word there is “anymore.” 

Perhaps surprisingly given that it was the 1960s, I wasn’t much of an indulger of any kind in high school, so my first full-blown hangover wasn’t until the spring semester of my freshman year at GW. My misery was lawful, since the legal drinking age in the District of Columbia in those days was 18. The culprits were White Russians (vodka, Kalua, and cream) downed at a table with some friends in The Red Lion and copious wine in the dorm room of one of those friends afterward. (It seemed like a good idea at the time.) There were no other chemical enhancements in my bloodstream despite the year being 1971, still the psychedelic era. There didn’t need to be. 

Back in my own room, I decided to turn on the stereo and let it play the Melanie LP then on the turntable to the end when it would turn itself off. I don't know how long I lay there but sometime after 4 a.m. bed spin and nausea struck with a fury; opening my eyes did not make the nausea recede. I leapt out of bed, bolted out the door, and hurried down the hallway to the bathroom. You know what happened there. The heaves having passed but head still swimming, I returned my room. Playing on the stereo was the eponymous song on the Melanie album: Leftover Wine (no kidding), a song that to this day I cannot hear without queasiness. 

There are some things in life I don’t learn easily. So, despite that educational experience, there were many more like it before I began deliberately to avoid them. I even swung fully the other direction for a while. For several years I was a teetotaler. That is no longer the case but it has been a very long time since I’ve met the definition of a binge, which is 5 drinks at one sitting. The National Institutes of Health recommends limiting alcohol intake to no more than 4 drinks on any one day, and no more than 14 in any one week. (By definition one standard U.S. drink is 14 grams of pure alcohol; though alcohol percentage (ABV) varies by beverage brand, this is about the amount in one shot glass of whiskey, one glass of wine, or one can of beer.) In the past couple decades there have been entire years when I didn’t consume 14 drinks. The reason was not and is not virtue. Furthest thing from it. The reason is those mornings after the nights before. 

Oddly enough, despite alcohol being the most ancient, enduring, and well-studied of popular intoxicants, scientists don’t really know what causes hangovers. Most of the suppositions served up by popular publications are wrong. Dehydration, for instance. Alcohol is indeed a diuretic, but keeping properly hydrated will not prevent a hangover, except to the extent thirst itself counts as a symptom. The build-up of NADH and acetaldehyde (byproducts of alcohol metabolization) is also commonly cited, and these two substances do seem to contribute to the malaise, but the correlation is weak; hangovers typically are at their worst when acetaldehyde already has dropped to a low level. Sugary drinks make hangovers worse due to the formation of lactates from combining ethanol with glucose, but eliminating sugar will not eliminate the hangover, only marginally lessen the severity. The most promising idea is that hangovers are an inflammatory response – a type of immune system reaction. This hypothesis is supported by a high positive correlation of the production of cytokine (an immune system signaling molecule) with hangovers; injecting cytokines into sober subjects gives them the symptoms of a hangover without the benefit of the buzz. 

The cytokine hypothesis also helps explain why about 23% of the population claim not to get hangovers – or, at most, inconsequential ones. Apparently, they are not lying. Immune systems vary from person to person, largely for genetic reasons, and some seem not to react much to alcohol. The bad news: folks with this trait are at higher risk of alcohol abuse – though not alcoholism per se. This is hardly surprising. The penalty the other 77% must pay for a blood alcohol content of .08 is always a dissuasive factor in their consideration of whether to binge and how often. 

It seems my own system is quite a productive cytokine factory, for, in truth, I get hangovers even at the NIH-approved daily allowance. This is probably a good thing on balance, even if it does make me a “designated driver” more often than I care to be. As for the leftover wine, it can marinate dinner.

Melanie Safka Leftover Wine