Risk factors for hangover
Obviously, the primary risk factor associated with alcohol hangover is excessive drinking. The incidence and severity of symptoms increases with the amount of alcohol consumed. That’s why it is so important to remember the low-risk drinking guidelines: on special occasions, women can have three drinks and men, four.
Nonetheless, the incidence and intensity of hangover can vary from one person to the next, even if they drink exactly the same amount. The main risk factors identified to date are listed below.
1. Congeners and impurities
Separate episodes of alcohol abuse can have different consequences, even if the amount of alcohol is identical. The general consensus among researchers now is that the severity of hangover symptoms can be explained by congeners, i.e. chemical compounds found in alcoholic beverages, such as methanol, histamine or polyphenols.
Similarly, alcoholic drinks that contain high levels of impurities or preservatives may bring on hangover symptoms even when only moderate amounts are consumed. For example, zinc and other metals are sometimes added to alcoholic beverages as artificial sweeteners or to enhance flavour.
2. Psychological vulnerability
As noted above, about 25% of drinkers never suffer from hangover, no matter how much they drink. Why? Research on the subject is still in its infancy and the phenomenon is still very poorly understood. But one hypothesis is that this may be due to psychosocial factors. Studies by Harburg and his colleagues (1993) have shown a significant connection between drinkers’ psychosocial state and the severity of their hangover symptoms.
The incidence and intensity of hangover symptoms are not due solely to objective causes; they might also be explained by subjective factors distinct to the individual drinker at a particular moment. This may be another reason why researchers note such variations in hangover response from one drinker to the next.
3. Alcohol and tobacco
The association between episodic drinking and occasional smoking is well known. Many social or weekend smokers develop a sudden and strong urge to smoke when they drink excessively. Similarly, people who have quit smoking often start again during an evening of heavy drinking. These phenomena can be explained by the pharmacological interaction between alcohol and tobacco, which manifests as an intense physical need to smoke.
Consequences and remedies
A hangover is an obvious indication of an episode of abusive drinking. We can therefore conclude that people who report frequent hangovers are at risk for developing the disorders and diseases associated with abusive drinking, all of which are very well documented.
However, little is known as yet about the immediate and long term health effects of hangover. The Alcohol Hangover Research Group has noted the importance of developing methodologies that would eventually allow researchers to obtain reliable measurements of the effects of hangover on the health of drinkers.
Nonetheless, when it comes to reducing the unpleasant symptoms of alcohol hangover, a very specific warning can be issued. Headache is a symptom reported by almost 90% of people suffering from hangover16, but taking acetaminophen (Tylenol) for the pain is not advisable for everyone. Acetaminophen is tolerated by occasional drinkers who may drink too much on a particular occasion, but it is strictly contraindicated for people with an alcohol dependency (alcoholics) who have been diagnosed with liver problems. Clinical studies show that in such cases, the interaction between alcohol and acetaminophen significantly increases the risk of liver toxicity and may cause liver lesions, even when the medication is taken the next day. For some people, therefore, a hangover headache is a “punishment” they just have to live with.
Depending on individual sensitivity, combining alcohol with acetylsalicylic acid (Aspirin) or ibuprofen (Advil, Motrin) may also be a bad idea. Alcohol can cause irritation or even inflammation of the mucous lining of the stomach. In people who are prone to gastro-intestinal problems, these medications can exacerbate the irritating effects of alcohol.
In fact, the only safe way to treat the pain and discomfort of a hangover is to practice healthy living: exercise to increase oxygen supply, rehydrate by drinking plenty of water, and eat lightly. After that, only time will help.