We’ve all met them – the people who appear to be able to drink what they like without any of the consequences. While most people lie wilted and lifeless under their bedsheets, they spring to life as fresh as a daisy. You’d think they’d been bingeing on smoothies, not whisky.
Is hangover resistance due to good genes, choice of drink – or a magical cure?
These “hangover-resistant” people are not nearly as rare as you might think. According to recent studies, nearly a quarter of people appear to avoid punishment for a night of excess, even when they drink fairly heavily. Yet they seem to keep their secret well-guarded. Is it due to good genes, their choice of drink – or a magical cure?
Until around five years ago, scientists had largely chosen to turn a blind eye to these questions. “A hangover is seen as one of those things that stop people drinking – so a common view was ‘leave it well alone’,” explains Richard Stephens at Keele University. The unfortunate result is a huge amount of folklore, without much evidence. But with his Alcohol Hangover Research Group, Stephens hopes to remedy the situation.
The evidence to date suggests dehydration plays only a minor role in hangovers
Even the cause of the hangover had been somewhat mysterious. Until recently, the finger of blame had pointed at dehydration – alcohol was thought to make us pee more, so we lose fluids – yet the evidence to date suggests it plays only a minor role. Instead, it’s probably due to the chemistry of the drinks. Fermentation can result in toxic by-products called “congeners” that slightly poison our tissue. These chemicals often give the drink a darker colour, and it’s thought to be the reason that whisky can leave you feeling rougher than crystal clear vodka. (It may also explain why mixing your drinks is such a bad idea, since the more varieties of booze you try, the more varied the cocktail of congeners you are ingesting).
A few hours after a binge, the alcohol itself breaks down into acetaldehyde and, later, acetate. These slightly noxious “metabolites” trigger sickness, sweating, and a racing pulse. The alcohol and its by-products also play havoc with the immune system and provoke inflammation. “When we have a bad hangover, we have that puffy feeling – that’s to do with the inflammation,” says Stephens. In the brain, that inflammation could also contribute to a headache, and combined with low blood sugar and lack of sleep, it may lead to the listlessness and foul mood that often accompanies the physical pain.
23% of people claim to never suffer from hangovers, even when they drink very heavily
At least, that’s what seems to happen to most people. One of the big puzzles facing researchers like Stephens is why around 23% of people claim to never suffer from hangovers, even when they drink very heavily. They may well benefit from lucky genes; studies of twins suggest that the tendency runs in families. A constellation of genes may be involved, and the scientists have already identified some of the variants that appear to help flush the alcohol and its metabolites out of their blood, and damp down the inflammation that may result from intoxication.
Intriguingly, the suffering of a hangover may also hinge on certain personality traits; one study found that neurotic people are more likely to suffer from hangover than people who are more laid back. That doesn’t mean that the agony is necessarily “made-up” or exaggerated; emotions are known to modulate the experience of pain, meaning that feelings of guilt and anxiety might amplify, the real, physical distress.
Although genetic factors may play a role for some people, however, Stephens thinks that for many it’s simply a case of smart drinking. “It could be that it’s just the way they pace themselves.” He points to a recent survey that quizzed people in detail on the amount they had been drinking over the past month, and the severity of their hangovers. From this, the researchers concluded that although they had drunk the same volume, around 80% of the apparently “hangover-resistant” people had paced themselves so that their blood alcohol concentration never passed a peak of around 0.10%.
It’s commonly thought that we suffer worse hangovers as we get older, but there’s no evidence for the myth
Throughout his work, Stephens has been keen to bust a few of the other popular myths around drinking – including the idea that hangovers get worse with age. “It’s a very commonly held perception that we suffer worse hangovers as we get older, but there’s no evidence for it,” he says. “Hangovers are largely a young person’s problem.” One of his recent studies found that a 20-year-old is about seven times more likely than a 60-year-old to suffer a hangover after a period of heavy drinking. Again, he thinks this is down to pacing. “Also, they know what gives them a hangover and so they have learnt to drink well.”
As for the fabled cure, Stephens’ answer is perhaps predictable. There’s little evidence for more elaborate concoctions, such as the “prairie oyster” – the mix of vinegar, Worcester sauce, and raw egg that PG Wodehouse’s Bertie Wooster, among others, swears by. More than likely, the unusual and piquant flavours serve as a distraction and a placebo. Since dehydration plays only a minor role, drinking bucket-loads of water is unlikely to ease your pain either.
An ibuprofen will sort out the headache and a bit of the inflammation, and a greasy fry-up might restore glucose levels a bit - Richard Stephens
“The best way to avoid a hangover is just to drink moderately,” Stephens says. If it’s already a bit late for that, a little TLC can do no harm to mop up the damage. “An ibuprofen will sort out the headache and a bit of the inflammation, and a greasy fry-up might restore glucose levels a bit.”
But who knows – maybe a surprise cure will find its way into our medicine cabinet sooner or later; a few trials have looked at drugs that can help to counteract the effects of the alcohol’s nasty by-products, with a couple of minor successes. Sometimes the sources are surprising. A decade ago, one study found that an extract from the prickly pear cactus seemed to mop up the nastier effects of those toxic “congeners” found in whisky and other dark liquors, and reduces inflammation – although so far, no one has followed up the finding.
If you are feeling really desperate, you could also try eating the “edible stinkbug” – provided you can put your hands on one. Despite the rather unappetising name, they are something of a delicacy in Malawi and many swear by its abilities to cure a stonking hangover. (Just make sure you cook it correctly to remove its stench: according to one local source, “If you eat the unprepared one it will kill taste for a month”).Some scientists have started to investigate its nutritional properties, and it will be interesting to see if its reputation bears out in a clinical trial.
In general, Stephens tends to agree with the consensus view that a hangover may be a useful reminder of the potential damage we are doing our bodies, although he doesn’t want to be a party pooper. “Alcohol can be demonised, but we get a lot of pleasure from it, he says. “So it’s all about controlling what you drink.”
In other words, his advice is probably much the same as your parents’: have fun but drink slowly, drink carefully, and learn when enough is enough. Whether or not you are blessed with a magical constitution, you’ll thank yourself in the long run.
David Robson is BBC Future’s feature writer. He is @d_a_robson on Twitter.
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