The incidence and severity of hangover the morning after moderate alcohol intoxication

Youth Alcohol Prevention Center, Boston University School of Public Health, Boston, MA 02118, USA.
Addiction (Impact Factor: 4.74). 06/2008; 103(5):758-65. DOI: 10.1111/j.1360-0443.2008.02181.x
Source: PubMed


To determine the incidence and covariates of hangover following a night of moderate alcohol consumption at a targeted breath alcohol level.
Data were combined from three randomized cross-over trials investigating the effects of heavy drinking on next-day performance. A total of 172 participants received either alcoholic beverage (mean=0.115 g% breath alcohol concentration) or placebo on one night and the other beverage a week later. The next day, participants completed a hangover scale.
Participants were 54 professional merchant mariners attending a recertification course at Kalmar Maritime Academy (Kalmar, Sweden) and 118 university students or recent graduates recruited from greater Boston.
One trial was conducted at Kalmar Maritime Academy (Sweden); the other two were conducted at the General Clinical Research Center at Boston Medical Center.
A nine-item scale assessed hangover.
Hangover was reported by 76% of participants. Neither alcoholic beverage type nor participant characteristics was associated with incidence of hangover.
Our findings on the propensity of hangover suggest that 25-30% of drinkers may be resistant to hangover.

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    • "Its common symptoms include headache, diarrhea, dysphoria, nausea, and tremulousness (Harburg et al., 1994; Howland et al., 2008; Wiese et al., 2000). Untreated alcohol hangover may have adverse influences on normal life (Harburg et al., 1994; Howland et al., 2008; Linkola et al., 1976; Meilman et al., 1990; Wiese et al., 2000). Persons with hangover tend to become more aggressive and violent (Brewer and Swahn, 2005). "
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    ABSTRACT: Background Alcohol consumption is influenced by heritable factors. The genetic influence on usual high-density drinking, including alcohol intoxication and hangover, is unknown. We aim to estimate the heritability of usual high-density drinking.MethodsA total of 13,511 male twins in this cross-sectional study were included from the National Academy of Sciences-National Research Council (NAS-NRC) Twin Registry. Data on the frequency of alcohol intoxication and alcohol hangover over the past year, that is, usual high-density drinking (phenotypes), were collected through a self-administered questionnaire when twins were middle-aged in 1972. Structural equation modeling was used to estimate the variance components of phenotypes.ResultsThe mean of the frequency of usual high-density drinking in the entire twin population was 0.16 times per month for intoxication and 0.18 times per month for hangover. The heritability of usual alcohol intoxication was 50.7% (95% confidence interval [CI] 46.2 to 55.0) before and 49.9% (95% CI 45.3 to 54.2) after the body mass index (BMI) adjustment. The heritability of usual hangover was 55.4% (95% CI 51.2 to 58.6) before and 54.8% (95% CI 50.6 to 58.8) after adjustment for BMI. Unshared environmental factors between co-twins explained the remaining variance in alcohol intoxication and in hangover.Conclusions Both genetic and unshared environmental factors have important influences on usual alcohol intoxication and hangover. These findings are important in understanding the occurrence of and developing interventions for usual high-density drinking.
    Full-text · Article · Aug 2014 · Alcoholism Clinical and Experimental Research
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    • "Notably, results from some laboratory challenge investigations contradict one derivative prediction—that familial alcoholism risk would be associated with decreased hangover sensitivity. Available evidence indicates either null fi ndings (Howland et al., 2008a) or enhanced hangover sensitivity among offspring of alcoholics (McCaul et al., 1991;Span and Earleywine, 1999). Exploratory analyses indicated that prediction of hangover was more consistent when examining SRE scores reported with reference to the heaviest period of drinking or the past 3 months compared with the fi rst fi ve lifetime alcohol-use occasions. "
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    ABSTRACT: The current investigation tested whether low sensitivity to alcohol, as measured by the Self-Rating of the Effects of Alcohol (SRE) form, is associated with hangover occurrence or resistance, two potentially important predictors of later problematic drinking outcomes. Drinkers who reported using alcohol at least four times in the past month (N = 402) completed the SRE at baseline and used ecological momentary assessment methods with an electronic diary to record drinking behaviors and related experiences over 21 days. Each morning, the diary assessed prior-night drinking behaviors and the presence of current hangover. After adjustments for sex, body weight, age, and smoking status, higher SRE scores (indicating lower alcohol sensitivity) predicted hangover occurrence on postdrinking mornings (odds ratio [OR] = 1.24 per interquartile range [IQR], p = .003). However, when the number of drinks consumed in the drinking episode was covaried, SRE scores were negatively associated with hangover (OR = 0.67 per IQR, p <.001). An interaction between SRE scores and the number of drinks consumed indicated that low-sensitivity drinkers tend to be differentially resistant to hangover at a given number of drinks. Higher SRE scores were associated with consuming more drinks on average (generalized estimating equations coefficient = 2.20 per IQR, p <.001). Individuals lower in alcohol sensitivity appear to be more resistant to hangovers per unit of alcohol. However, they are also more likely to engage in excessive drinking, and this may account for their increased odds of experiencing hangover during an arbitrary monitoring period. Heavy consumption, hangover resistance, and hangover frequency may each be manifestations of low sensitivity to alcohol, an established risk factor for alcohol use disorder.
    Full-text · Article · Oct 2012 · Journal of studies on alcohol and drugs
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    • "The AHS has proved valid and useful in a number of recent investigations (e.g., Hesse and Tutenges, 2010; Howland et al., 2008; Rohsenow et al., 2010) and has emerged as a preferred instrument for gauging immediate symptoms in experimental research and naturalistic studies of acute hangover. Techniques for assessing hangover in survey designs are less established. "
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    ABSTRACT: The Hangover Symptoms Scale (HSS) assesses the frequency of 13 symptoms experienced after drinking in the past year. Cross-sectional analyses in college drinkers showed preliminary evidence for the validity of the HSS (Slutske et al., 2003). The current investigation extended this work by examining the construct validity of the HSS in an ecological momentary assessment investigation. Frequent drinkers (N = 404) carried electronic diaries to track their daily experiences over 3 weeks. Each morning, the diary assessed prior-night drinking behaviors, the presence of current hangover, and intensity of current headache and nausea. Adjusting for sex and body mass, the HSS significantly predicted diary endorsement of hangover (OR = 2.11, 95% CI = 1.78 to 2.49, p < 0.001). Participants who endorsed the HSS headache and nausea items were especially likely to report the elevations of corresponding symptoms in diary records made the morning after drinking. HSS scores incrementally predicted hangover when the number of drinks consumed in the episode was covaried but did not moderate the relationship between the number of drinks and diary hangover reports. The HSS appears to be a valid tool for hangover research. Higher HSS scores identify individuals who complain of "real world" hangovers and who may be especially likely to display particular symptoms after a night of drinking. Past hangovers predicted future hangovers, suggesting hangovers do not necessarily discourage or inhibit future drinking, at least across the several-week time interval studied here. There is a need to develop and evaluate complementary measures that can more directly index individual differences in hangover susceptibility in survey designs.
    Full-text · Article · Jul 2011 · Alcoholism Clinical and Experimental Research
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