Hangovers: the dangers of drinking alcohol to excess

"Drinking alcohol in moderation can be enjoyable and one or two drinks may even have some small benefit for cardiovascular health. But excessive drinking can quickly become problematic for individuals, their health and their familles. Drink responsibly to help minimise the negative effects of alcohol. Stick to safe drinking practices such as substituting every alcoholic drink for a non-alcoholic one, not drinking on an empty stomach and designating a driver before you go out, which can make a big difference to how you feel the next day and your long term wellbeing." Dr Christine Bennett, MBF's Chief Medical Officer.

What is a hangover?

A hangover is the common term for the symptoms caused by excessive alcohol consumption. Symptoms range from headaches, nausea, vomiting and stomach upsets to tiredness, irritability and difficulty concentrating. Most of the time people that have consumed an excessive amount of alcohol end up with a degree of dehydration and many of the symptoms relate to that.

Drinking on an empty stomach, having a low percentage of body fat, or being small in size, can also make a hangover more likely. In the extreme, there is even the risk of death from alcohol poisoning if individuals drink too much too fast or ignore the symptoms of a hangover and continue drinking. ¹

Why is it important?

Alcohol is the most widely used social drug in Australia. While moderate use may have some small benefit to the heart for some people, it may not benefit all people. Heavy alcohol use or binge drinking actually damages the heart and can cause a number of serious health problems and is particularly a problem in young people.

How much is too much?

Alcohol use is not recommended for individuals who:

Are younger than the legal drinking age (18 years in Australia)
Are pregnant
Have a personal or strong family history of alcoholism
Have a personal or strong family history of breast cancer
Have had hemorrhagic stroke
Have liver or pancreatic disease
Have precancerous conditions of the digestive tract
Are operating potentially dangerous equipment or machinery (including cars, boats, or construction equipment) ²

Based on the most recent evidence, changes have been made to the advised maximum amount of alcohol recommended for a person to drink:

Men - no more than 4 standard drinks per day on average and no more than 6 drinks on one day with 1 to 2 alcohol free days per week
Women - no more than 2 standard drinks per day on average and no more than 4 drinks on one day with 1 or 2 alcohol free days per week ³

Moderate drinkers generally have lower mortality rates than abstainers or heavy drinkers however problem drinking reduces the quality of life for individuals and their families. ²

What are the effects of too much alcohol?

Alcohol dehydrates you: Even though you're drinking fluids, the alcohol makes your body lose more water than it takes in and is probably one of the causes of the headache.
You lose body salts: As your body loses water, out go valuable salts, such as sodium, potassium, calcium and magnesium, which upsets brain signals potentially disturbing your ability to think clearly. Eating salty food will make you want to drink more and should be avoided.
Your blood sugar's low: Alcohol can block your body's ability to produce glucose leaving you feeling weak.
Excessive alcohol is actually a poison: Alcoholic drinks contain ethanol, which your liver can break down. However, the smaller amounts of methanol that break down into acetaldehyde cause queasiness and nausea.
There are other toxins in alcoholic drinks: Other substances called congeners give alcoholic drinks their flavour, colour and aroma, and these also act as toxins. Dark-coloured drinks like rum, brandy and red wine tend to have more than lighter ones like vodka, gin or white wine, so they're more likely to cause the worst hangovers.
You haven't had enough sleep: Alcohol disrupts your sleep pattern and deprives you of deep, restful (REM) sleep.
Long term effects: Alcohol is one of the many causes of acquired brain injury because it has a toxic effect on the central nervous system, changes metabolism and heart function, may result in poor nutrition and lead to falls and accidents that injure the brain. ⁴

If I have had too much, what should I do?

There has been little effective research into hangover cures since this may encourage drinking alcohol. However since the main causes of a hangover are most likely to be dehydration and lack of sleep it is recommended that drinking plenty of water, preferably before going to sleep and then again when waking, as well as rest may help.

A mild analgesic such as two paracetamol may also reduce the severity of the headache.

Other widely touted remedies:

Mild analgesic : a couple of paracetamol either before going to bed or on waking may help the headache. Alcohol irritates the stomach lining so analgesics that irritate the stomach such as aspirin or ibuprofen are not recommended.
Hair of the dog that bit you: A quick drink may make you feel better for a while but it will only postpone the return of the symptoms - possibly coming back worse than before.
Multi-vitamins : There is minimal scientific evidence to show that vitamin B may help and while dehydration may mean that your body is low on vitamin B and C, it is uncertain whether taking supplements will help.
A fried breakfast : Eggs and other foods may provide salts and vitamins that have been lost but it shouldn't be a high fat fry-up.
Coffee : While the caffeine in tea and coffee may make you feel more awake, too much caffeine will dehydrate you further.
Exercise : If you can bear the thought of it, exercise will actually speed up the detoxification process and take your mind off feeling terrible. It is important that you drink plenty of water before, during and after exercising, and don't exercise if you're feeling too groggy, as it could put you at risk of an accident.

Practice safe drinking - some tips:

Never drink on an empty stomach - eat a substantial meal before you go out.
Have at least two alcohol free days each week.
Do not drink alcohol if you are taking medications (especially those that may enhance the effects of alcohol) such as antibiotics, anti-anxiety medications, barbiturates and sedatives.
Do not drink alcohol if you are pregnant or breastfeeding.
For every alcoholic drink, have a non-alcoholic one.
Drink plenty of water before you go out and when you get home.
Don't mix alcoholic drinks. Stick to the same one.
Organise a designated driver before you go out. Never drink and drive.

Where do I go for more information?

If you think you have a problem with alcohol, talk to your GP.

Australian Drug Foundation (www.adf.org.au)

Alcoholics Anonymous (www.alcoholicsanonymous.org.au)

Australian Government (www.alcohol.gov.au)

Sources:

University of Illinois
Uptodate
Australian Government (www.alcohol.gov.au)
Better Health Channel, Victorian Government

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