The Hangover

Dr. Daniel Spogen examines patient Stephanie Reinhardt.

Dr. Daniel Spogen examines patient Stephanie Reinhardt.

Photo/eric marks

What’s the best way to cure a hangover?

Some people, like those who don’t drink alcohol for health reasons or religious reasons or whatever, go their whole lives without ever suffering a debilitating hangover. They don’t know what they’re missing. Other people might drink to excess a time or two during their wild youth, wake up feeling terrible and then decide the whole binge drinking thing just isn’t for them. Other people might only endure a bad hangover or two a couple of times a year, after their birthday, maybe, or on New Year’s Day.

For some of us, hangovers are a regular part of life. Maybe you work in a bar and your customers are always buying you drinks in the hope of seducing you or just because you’re damned likable. Maybe you’re a sommelier who doesn’t like to spit. Maybe, like me, you’re the host of a weekly drinking game at a local bar, and you always end up drinking more than any of the actual players. Or maybe you just like to drink.

For the uninitiated, a hangover is the uncomfortable feeling that accompanies the morning after a night of heavy drinking. Symptoms include lightheaded-ness, nausea, fatigue, slowed down cognition and memory, and overall weakness.

So, yeah, maybe you wake up with a hangover on a semi-regular basis. For me, it’s about two or three times a month. Hell, we’ll just call it once a week. Which is fine by me. My inner werewolf needs to be taken out for a walk about once a week. That, for me, is the ideal cycle of the ancient saying, attributed to various sources, and sometimes called Petronius’ paradox: “Moderation in all things, including moderation.” I can impersonate a normal person for about five days a week, do all my grownup stuff and behave relatively civilly, but then once a week or so I need to cut loose, get buck wild, and make some bad decisions.

That means that then, the next morning, on the seventh day, I have a hangover day, or, what some deities call it, a day of rest. I actually see some value in hangovers. I’m a busy guy, and usually have about 30 projects in the works, and am rarely able to find time for quiet reflection, to just sit there and vegetate. Hangovers can prompt personal reflection on some of life’s big questions—like, why did I drink so much last night? Is there some suppressed, deep-down personal misery that I’m trying to run away from? Where did I leave my wallet? Who is this person sleeping next to me? When I run into the bathroom, like I’m going to need to do here in a minute, should I kneel before the porcelain altar so I can vomit comfortably or should I sit on the toilet in case I get diarrhea, and just puke into the bathtub?

I recently asked Daniel R. Spogen, the chair of the Department of Family and Community Medicine at the University of Nevada, Reno’s medical school and a director on the American Academy of Physicians board of directors, to explain the cause of hangover symptoms.

“Alcohol is a diuretic, and as you drink alcohol, you lose fluid volume,” he said. “This affects the hydration in the brain area, so basically the brain gets dehydrated. The symptoms that you get the day after are really caused by lack of hydration of the brain.”

Spogen said that there’s a lot of genetic variation in the effects of hangovers.

“There are a group of people who do not get hangovers, and the next day, they feel pretty good,” he said. “Whether or not their body can tolerate that amount of dehydration, it’s not quite understood, but one of the thoughts is that those are people who are more likely to become alcoholics because they don’t pay for it the next day.”

This is why some people get hangovers after one drink, and other people can drink 10 drinks and feel fine. It’s still not clear why some of us have been known to drink like the hangover was a goal rather than a side effect of the endeavor.

There are many schools of thought about the best ways to cure a hangover. Although I’m only 34, I’ve already done about 20 years of research on this subject. Here are my findings on the effectiveness of some of the most prevalent techniques for curing a hangover.

Hangover 10

1. More alcohol

Sometimes this is called, in one of the more bizarre and disturbing idioms still in common use, drinking “a hair of the dog that bit you,” having a little bit of alcohol in the morning to ward off the hangover. The Bloody Mary is the classic hangover cure cocktail, I think just because it has vegetables in it, so it seems healthy or something. I’ve never been particularly fond of hair-of-the-dog hangover cures. It always just feels like postponing the inevitable. You’ll get a little drunk in the morning and then need to take a nap at lunchtime.

2. Greasy food

Another common suggestion that’s never been particularly effective for me is eating greasy food, like tacos from the regional fast food chain Jimboy’s or plowing down on an Awful Awful burger from the Little Nugget, or hitting up one of the valley’s finer greasy spoon diners, like the Gold Dust West, Big Ed’s Alley Inn or the Gold N Silver during the hangover.

Spogen said he’s never seen much merit in these kinds of solutions either, and that it’s probably just a case of using food to occupy space in your stomach while your body metabolizes the alcohol. But, that being said, if you’re going to cram some food into yourself to keep it occupied while it processes the alcohol, you might as well eat whatever food you find most comforting.

3. Healthy food

According to Spogen—and my own life experience—there’s a bit more merit to eating healthy food to help cure a hangover, especially bananas and other fruits and vegetables high in potassium and other electrolytes.

“Whenever you have a diuretic, you’re going to lose all your electrolytes as well, so having just plain water, you could become deficient in one of your electrolytes,” Spogen said. “In fact, there are people who will significantly get low on potassium if they have too much to drink.”

He said that drinking electrolyte-enriched beverages like Pedialyte or Gatorade can also help by alleviating some of those deficiencies.

Joseph Rueckl is licensed as a doctor of oriental medicine in Nevada. He practices holistic medicine including acupuncture, herbal medicine, and therapeutic massage at his clinic, Symmetry Acupuncture. He recommends coconut water for restoring electrolytes.

4. Sex

“Exercise is good because it helps you metabolize alcohol,” said Spogen. “If you’re not too wasted—you don’t want to get injured—it can help metabolize the alcohol more quickly if you’re active.”

And, as everybody knows, sex is the best form of exercise. Of course, there are those who suggest sex as the solution for everything.

However, in some ways, masturbation might be even better than sex for curing a hangover, because, you’re less likely to get lightheaded or accidentally puke all over another person. But if you’ve got a sympathetic partner, you might as well go for it.

Spogen points out that alcohol has historically been known to help with sex, helping people drop inhibitions and get comfortable. Shakespeare, in Macbeth, has the best line on the relationship of alcohol to sex: “It provokes the desire, but it takes away the performance.”

One of the all-time great Simpsons quotes is “alcohol is the cause of, and the solution to, all of life’s problems.” But that might be even more true of sex.

5. Marijuana

Unfortunately, “hangovers” are not among the ailments covered by Nevada’s medical marijuana program, so as effective as this hangover cure might be—and I’m not saying I know for a fact from years of extensive personal research and experimentation that this is one of the most effective cures, but supposedly it works pretty well—the big problem is that it’s still illegal. We at the RN&R support total decriminalization of marijuana, but, in the meantime, the decision whether it’s worth breaking the law to break a hangover is between, you, your god, and the state of Nevada.

“It definitely works, but it slows down the rest of your day, also,” said Rueckl. “Taking it easy is a great hangover cure, and pot is a great way to take it easy.”

6. Other Drugs

Spogen says that ibuprofen can successfully help block some of the discomfort caused by dehydration, but he’s less enthusiastic about the effects of another drug often used to counteract alcohol: caffeine.

“People think that you’re drinking alcohol, which is a depressant, and caffeine is a stimulant, so they counteract each other, but it doesn’t work that way,” he said. “Basically, you get the worst effects of both. A lot of people, once they’ve had too much to drink, will brew a pot of coffee, so they’re not as drunk when they get back on the road, and the reality is you’re just using the coffee to occupy volume while your body is withdrawing from the alcohol. It really does not help you come out of it at all.”

7. Binge watching

I have a friend who always likes to go to a nice air conditioned movie theater whenever he’s hungover, buy a Cherry Coke and a giant tub of popcorn, and watch the most gruesome, disturbing horror movie available. There is something oddly cathartic about seeing people disemboweled when your own bowels are in turmoil. Like, “Ah man, my guts hurt but at least they’re not spilling out all over my clothes and getting gnawed by zombies or mutant hamsters or whatever. Sure, my skin feels slimy, but at least it’s not covered in pig’s blood or alien mucous.” Or maybe you just want to stay in bed and marathon through an entire season of Arrested Development or Archer or something else funny. I’ve also noticed that hangovers shut down some of the hyper-critical parts of my brain that prevent me from shamelessly enjoying maudlin entertainments like Barry Manilow albums, Meg Ryan movies, and Budweiser commercials. The problem with the binge-watching technique is that it’s pure escapism. You’re forgetting about your own horrible life for a minute to focus on somebody else’s, probably somebody imaginary. And, like the hair-of-the-dog approach, you’re often still hungover when the show ends, but now you feel even worse because you’ve just been sitting there for hours, staring at a screen. But sometimes this technique works well to complement another cure. It can be good to watch a movie, focus on something other than your own inner turmoil for a couple of hours, while pouring down the water, Gatorade and ibuprofen, and eating whatever comfort food works for you.

8. Holistic cures

“There’s an herb, ge hua. In English, we would call it the kudzu flower, but this actually treats alcohol toxicity and helps increase your metabolism of alcohol and relieve a hangover,” said Rueckl. “Part of the hangover is that your liver is just trying to get rid of this toxicity, and this helps to speed that process up. You drink it as a tea in the morning and once you’re done, your hangover is pretty much gone.”

Rueckl said he helped cure a lot of hangovers during a year he worked as acupuncturist on a cruise ship.

“There’s actually a point just at the tip of your nose, the part of your nose that sticks out the furthest, there’s a point right there that helps to increase your alcohol metabolism,” he said. “Rubbing on that helps, but makes you look silly. Acupuncture will get rid of a headache like that, 1-2-3. If you do come in with a hangover, that’s definitely something we could treat.”

9. Water

The best way to prevent a hangover is to drink water alongside the alcohol. Spogen suggests 8 oz. of water after every couple of cocktails.

“Keep ahead of your hydration, but realize that the more water you drink, the more you’re going to be using the bathroom because you’re taking a diuretic at the same time,” he said. “So it’s not exactly a replacement, but it helps. … It’s better to be proactive instead of reactive, so start thinking about hydrating the night before when you’re actually doing the drinking.”

But getting into water is also very helpful, if just to wash off that gross alcohol sweat. (Quick aside: As a nonsmoker, I’m so glad that most bars are nonsmoking now; hangovers are so much worse when my hair and clothes stink like cigarettes.) Take a long shower or bath, or, even better, take a quick sojourn out to some hot springs or your favorite swimming hole.

I recently asked my Facebook friends for their hangover cure recommendations. My buddy Ben Clyne won the thread with the most popular suggestion: “Go to Tahoe. Jump in the lake. Get out and drink a bloody beer. Go to T’s [Mesquite Rotisserie] and get a chicken burrito with guac. Eat that shit. Wash it down with beer No. 2. Take nap in sun. Wake up and be happy.”

10. Life change

Of course, the greatest of all hangover preventatives is to quit drinking. Kind of square, sure, but super effective. People who don’t drink rarely, if ever, get hangovers. And if they do, they call them “food poisoning” or “the flu.” The abstinence method has never been particularly successful for me, because, as outlined above, I enjoy drinking, and I’m only able to behave like a sane person the majority of the time if I’m able to go out and get crazy on a semi-regular basis. And yeah, I can appreciate good, clean fun, but I’m always a little bit suspicious of people who don’t drink. If you don’t trust yourself to lose control every now and then, it seems like you must be hiding something. But whatever, we can still be friends.

It seems like most regular drinkers like to employ some combination of these various cures, usually in a very specific order executed in a ritualistic way. So it might take some experimenting to find the combination that works best for you.

Find your personal threshold for hangovers, and be careful. As Spogen said, everybody’s metabolism is different and the quantity and quality of hangovers that might be acceptable to one person could be misery for somebody else. And, honestly, if this is a problem you’re dealing with on a daily basis, you might want to rexamine your lifestyle choices. Not that I’m one to judge. I realize that there are people out there who’ll say weekly hangovers are too many.

Drink up. Tip your bartenders. Enjoy your summer. Be safe. Don’t drink and drive. Try not to puke on anybody.