Hangovers: beware of the dog.

It’s Saturday morning, bright and early: how are you feeling?

Headache? Yes.

Nausea? Yes.

Restlessness? Yes.

Sweating, irritability, vomiting? Yes, yes, yes.

No need to call the doctor. Given what you had to drink last night, your diagnosis is simple: veisalgia. That’s right, you’re hungover. Approximately, 20 million Americans regularly experience alcohol hangovers –these people are easy to recognize; they move sluggishly and can be heard mumbling phrases like, “I’m never drinking again.” But if hangovers are so aversive, why do people continue to drink? What causes hangovers? Do people who get more hangovers drink less often than those who don’t?

Alcohol researchers suggest that most hangover symptoms are due to the direct effect of alcohol on neurochemicals like GABA, serotonin, and glutamate. Bodily accumulation of alcohol metabolites (acetylaldehyde and acetate, e.g.), and the presence of congeners (taste and color ingredients, e.g.) in alcohol drinks also contribute to hangover intensity. Furthermore, drinking habits have a great deal of influence on hangovers by restricting sleep, diet, and hydration.

Many commercial products (so-called hangover pills) and home remedies exist for “curing” hangovers. Some individuals suggest eating greasy foods, raw eggs, and mounds of veggies. Meanwhile, others swear by exercise and sexual activity. While most are folk tails, some of these remedies have been empirically tested. For example, fruit juices can counter low blood sugar and reduce headaches and sweating, propranolol (a beta-adrenergic antagonist), and non-steroidal anti-inflammatory (NSAIDS) such as Ibuprofen can reduce headaches, and antiemetics and serotonergic antagonists may reduce nausea. Nonetheless, all of these treatments are only mildly effective at best. Thus, hangovers are here to stay, and maybe that’s a good thing. Because they are so aversive, hangovers serve to reduce problematic drinking, right? Do people with more hangovers drink less?

Alcohol researchers have found the opposite: the number of hangovers positively correlates with alcohol use disorders (AUDs). Specifically, the frequency of hangovers is  predictive of the development of AUDs. This is somewhat counterintuitive, given that hangovers are generally thought to curb drinking behavior. One of the most common misconceptions about drug use is that people use drugs because they enhance mood and produce euphoria (they’re positively reinforcing). Negative drug effects, however, are thought to decrease the likelihood of repeated drug use. But the reality is that these negative effects, like hangovers, can also actually prompt and sustain drug use. This concept is referred to as negative reinforcement, the idea that a behavior is increased when it serves to diminish negative experiences.

Evidence for negative reinforcement promoting alcohol use can be summed up with one concept: “the hair of the dog that bit you.” This is one of the most effective and notorious hangover treatments: more alcohol. Researchers hypothesize that the association between hangovers and AUDs may be hangover-sensitive individuals seeking the “hair of the dog.” Because people will do just about anything to reduce hangover symptoms, they may actually begin using alcohol more frequently. But before you reach for that Bloody Mary, just remember that taking the hair of the dog ain’t going to stop it from biting you again.

Piasecki, T., Sher, K., Slutske, W., & Jackson, K. (2005). Hangover Frequency and Risk for Alcohol Use Disorders: Evidence From a Longitudinal High-Risk Study. Journal of Abnormal Psychology, 114 (2), 223-234 DOI: 10.1037/0021-843X.114.2.223

Paulsen, F. (1961). A Hair of the Dog and Some Other Hangover Cures from Popular Tradition The Journal of American Folklore, 74 (292) DOI: 10.2307/537784