I Have A Hangover

Photo: Trunk Archive/Riccardo Tinelli

You know what a hangover feels like — jackhammers in your head, a mess in your stomach, aches all over. But what’s really happening? And more importantly, what can you do about it? Convinced there was a better answer than eating French fries, drinking coconut water, and streaming old episodes of The Wire, we asked someone who knows what they’re talking about.

David K Zich, MD, Assistant Professor in Emergency Medicine and Internal Medicine at Northwestern University Feinberg School of Medicine, says a big reason a hangover’s so painful is because it feeds itself. Alcohol is a diuretic, which means it makes you go to the bathroom more frequently, so you wake up dehydrated, which can contribute to nausea. Meanwhile, when your body tries to clear alcohol, the process causes even more nausea. And because alcohol is also a stomach irritant that can cause abdominal cramping and vomiting, a vicious cycle of — you guessed it! — nausea ensues. Basically, says Dr. Zich, “It’s one of the few imperfect systems in the body where it’s a downward spiral.”

Escaping hangover hell requires rest, hydration, and a return to regular blood sugar levels. (This advice applies to the occasional over-drinker, not for consistently heavy drinkers; if you think you may need help, visit the National Council on Alcoholism and Drug Dependence.) So, which purported cures can actually help a hangover, and which are hokum? Here’s what you need to know before your next drink.

DO NOT…

Drink Coffee

Think a hot cup of joe will perk you up? Not so fast. “Caffeine is a gut stimulant, so it will worsen nausea and cause diarrhea,” Dr. Zich says. If your body is hooked on caffeine, small amounts are fine, but it’s better to re-hydrate.

Indulge in Hair of the Dog

A Bloody Mary might seem to help, but it’s just boozy trickery. “Treating alcohol hangovers with alcohol can numb the situation and make you feel temporarily better,” Dr. Zich says, “but it’s just delaying the inevitable.” When your body metabolizes ethanol and methanol, two components of alcohol, it burns through ethanol first (which makes you feel sober again) before tackling methanol (which makes you feel terrible). But a funny thing happens if you add a new drink: your body, in the midst of a methanol-processing hangover, switches focus back to ethanol. So you do feel better for a minute, but then it’s back to the painful business of metabolizing methanol and there’s even more of it to plow through. “Adding alcohol on top of alcohol is just not a good idea,” Dr. Zich says.

Consume A Greasy Meal

“People say to eat a big, greasy meal and you’ll feel better,” Dr. Zich says. “It’s an old wives’ tale.” Heavy meals don’t sit well with an irritated stomach. Instead, eat gentle foods like toast, cereal, yogurt, or even some scrambled eggs — skip the bacon.

Invest In Herbal Supplements

Taken before or after drinking, a host of hangover-prevention supplements promise to eliminate or treat symptoms. “Unfortunately, a number of studies have looked at these ‘hangover helpers,’ and none of them have done better than placebo,” Dr. Zich notes.

DO…

Chug Sports Drinks

Increasing your water intake can help you feel better, but sports drinks can help, too. It’s the one time their sugar content is a good thing. “Go ahead and drink sports drinks,” Dr. Zich says. “You’ll re-hydrate, it’s a balanced electrolyte solution — which can’t hurt — and it can give you the sugar your body needs.”

Take Over-the-Counter Painkillers

“Tylenol, aspirin, ibuprofen, or Aleve can help you feel better,” says Dr. Zich, but there’s a caveat. “Alcohol is a stomach irritant, and the aspirin and ibuprofen can irritate the stomach.” Eat first, and unless you’re a heavy drink, go for Tylenol (it’s rough on the liver).

Get Ahead of the Hangover

Surprise, surprise: the best way to stop a hangover is to prevent one from happening. “Have a non-alcoholic drink before you go out, or make the first drink of the night non-alcoholic,” Dr. Zich advises. “Your stomach can hold only so much that it will limit the amount you take in.”

If you still wind up feeling the effects of last night’s drinking, Dr. Zich recommends hydrating, taking Pepto-Bismol for an upset stomach, replacing the sugar your body needs, and getting plenty of rest. “Still, the number-one thing is to prevent excessive alcohol to begin with,” he says. We’ll drink to that — or, on second thought, we’ll have a club soda.