A while ago I received a note from a lady who was planning a trip to Abaco. In anticipation of some heavy-duty party action, she inquired about the best way to treat a hangover. As we are coming up on the busy summer season, I thought it might be appropriate to open this issue up for consideration.
Right off the rip, let me firmly state that I don't condone the irresponsible consumption of alcohol, or any other intoxicating substance. This is especially true when one is faced with the eventuality of running a boat or even a golf cart. Vacations often imply a release from the responsibilities of our workaday existence, and we sometimes tend to forget that at least some of said responsibilities remain in force. Please drink responsibly in Abaco, and for that matter, everywhere else. And in anticipation that one of our more progressive readers may be tempted to point out that marijuana does not induce a hangover, I would simply state that it is illegal to import, distribute, possess, or consume pot in the Bahamas. There are numerous forums on the World Wide Web and elsewhere that would be more appropriate for such consideration.
Eons ago a gentle cave dweller named Ogg was making a batch of his popular corn soup. After he was finished, he realized that he had extra, so he poured it into a barrel-shaped wooden container he had fashioned from a tree stump. Ogg stuck it in the back of the cave, then got distracted and forgot about it. One day, a couple of years later, Mrs. Ogg was rearranging some furnishings and found the dusty barrel. She called to Ogg, who quickly recognized the long lost batch of corn soup. Figuring it had spoiled, Ogg took it down to the creek, opened it, and was just about it dump it when he noticed that the “soup” had taken on a rich, dark, golden color. He stuck his figure into the liquid and then tasted it. Ogg flinched as it burned his throat, but a moment later he felt a delightful, warm sensation in his stomach. He thought for a moment, then poured a little of the soup into a gourd, along with some chilly water from the creek. Ogg drank, considered the mixture for a moment, drank some more, and began to feel, well, happy, energetic, even elated. He made a larger batch of the diluted soup and shared it with the rest of his clan. What a wild night they had! They danced, sang, laughed, and had a marvelous time.
Until the next morning: no one got up until mid-day, and they all felt terrible. Some were vomiting, some had awful headaches, some couldn’t even move. It took them a few days to determine that their malady had been caused by the new soup, and they urged Ogg to throw it away. But Ogg and a couple of his friends just couldn’t let it go. They diluted the mix even more, they mixed it with food, they even drank it warm. And Ogg made a new batch of “soup,” this time from cactus.
Alcohol is a simple two-carbon molecule that can be made from an amazing variety of flora. From corn we get bourbon whiskey, cactus gives us tequila, sugar cane yields rum, grapes yield wine, hops and barley give us beer, etc. It’s a simple matter of grinding the plants and mixing the derived juices with a few other key ingredients such as yeast. Over time, a remarkable process called fermentation yields alcohol, and since the time when Ogg first made his discovery, humans have been getting high on various alcoholic mixtures. They, and we, have also suffered the consequences.
When we ingest alcohol, our liver identifies it as a toxin, and it goes to work trying to eliminate it. First, it changes it into acetic acid, better known as vinegar. Now, how many of you have ever consumed several ounces of vinegar over the course of an evening? You wouldn’t think of doing that, it would be very nasty. Turns out that’s exactly what you do each time you drink alcoholic beverages, at least in a metabolic sense. But it gets worse: your liver takes the vinegar and turns it into formaldehyde and some related chemicals, and they are WAY nastier than vinegar ever thought about being. Remember formaldehyde from high school biology? Same stuff, very, very nasty, a real poison. And it takes a while to clear this stuff, and, until it does, it makes you feel awful. Among other things, it disrupts your sleep rhythm, makes your head hurt, and makes you feel “jittery.”
Alcohol is also a diuretic; that is, it stimulates your kidneys to make urine. This is good in a sense, it helps you clear the nasty toxic metabolites. But, as most of you know, the more you drink, the more you pee, then you want even more to drink, and on and on. What’s worse, if you’re in a hot climate, you can actually become dehydrated, which is also an unpleasant sensation.
Alcohol can also cause your blood sugar level to drop. This is aggravated if you forget to eat, or if you’re vomiting, which also aggravates dehydration. Are you starting to see where this is going?
So, let’s assume you’ve been out in your rental boat all afternoon in the hot sun. You’ve had a few beers, you forgot to bring some fresh water to drink, and you didn’t bother with lunch. You decide to walk up to Nippers with some friends, and you sit down at the bar next to those big machines that dispense those wonderful orangey-pink frozen Nippers. That first sip is so good, but you can’t drink very fast because your throat gets “frozen.” However, it’s hot, and it doesn’t take long to melt, and you’re SO thirsty. In 15 minutes it’s gone, you’re laughing with your pals, singing along with a Barefoot Man CD, and you order another. Someone says something about dinner, but you were going to wait until you get up to Blue Water, so you put it off. Next thing you know you’re at Captain Easy’s doing Guana Grabbers, and it’s sunset. You hurry up to Blue Water and have a drink or two, and you wind up having appetizers for dinner. And somehow, you ultimately wind up in your bed; the last thing you hear is “I was drinking doubles, causin’ lots of trouble…”
Now it’s the next day, and you are aware that something is dreadfully awry. Your tongue is stuck to the roof of your mouth, your head is pounding, you have the jitters, your balance is off as you walk to the bathroom, and you’re conflicted about whether to sit on the throne or hurl into it. And, it’s the last day of your vacation, and the weather is the best it’s been all week.
Before we get into emergency hangover management, lets consider how we could have avoided the situation. First, NEVER try to maintain hydration on a hot day with beer or other alcoholic beverages. The diuretic effect almost always wins, and you wind up with a net fluid loss, even if you’ve consumed an entire case of beer. Always carry some fresh water or an electrolyte drink such as Gatorade, and make the effort to drink it. Some folks will drink a beer, then an equivalent amount of water. When you’re drinking, make sure you eat. Yes, it “spoils the buzz,” but you’ll feel better in the long run. Pace yourself, try to limit yourself to a max of one beer or drink per hour. If you’re doing mixed drinks, use less alcohol and more mixer, and use a non-insulated cup with lots of ice. Stop drinking an hour or two before you go to bed, and try to get in at a reasonable hour. And resist the urge to do Cuervo shots; NO GOOD CAN COME FROM THIS BEHAVIOR, PERIOD!
But, let’s assume you’ve really tied one on. What can be done? The good news is, all hangovers eventually go away. It’s the duration of the “eventually” that causes problems. If you’re young and/or stupid, you can try the “hair of the dog” strategy, and just start drinking again. Some people survive this, some go into the DTs, you just never know. My experience is that you trade a brief period of partial relief for a longer, nastier hangover.
The first thing to do is start hydrating. Drink whatever you can get down, good old water works very well; I’d stay away from carbonated drinks. Drink as much as you can; don’t get irritated if you start peeing a lot, that means the treatment is starting to work. The next thing to do is eat. I like a big greasy cheeseburger, but suit your own needs. If your stomach is feeling rocky, try a little toast, something light. Eat a little, wait a few moments, try again. If you can get down a substantial meal, you’ll feel better. If you are vomiting and you can’t quit, you may need some help. You can try whatever the drug store has, Emetrol, etc. You have to keep it down for it to work, which is tough when you’re vomiting a lot. Phenergan or Tigan rectal suppositories are effective, but you need a doctor’s prescription. And, yes, I have occasionally phoned in the Rx for a beleaguered friend.
I like Extra Strength Excedrin for a hangover headache. Each tab or cap has 250 mg aspirin, 250 mg acetaminophen (Tylenol), and 65 mg caffeine. Eat something first, then take three of them (NOT if you have an ulcer or you’re having intractable vomiting). Stay away from narcotics such as Vicodan or Percacet unless the headache is making you suicidal; the associated nausea can make things worse.
Xanax is very effective for the jitters, although it will make you sleepy; some folks just like to sleep through a hangover. I suggest a 0.5 mg tab; you can take another in 20 minutes or so if you still feel terrible (don’t try to drive). I’ve seen people walking up and down the docks trying to bum a couple of Xanax; we always carry a few for emergencies.
If you follow this regimen and you are relatively healthy, you should get enough relief in 3-6 hours to salvage at least some of your day. Keep eating and drinking water, don’t push your luck with heat or physical activity, and when you’re starting to feel better, don’t succumb to the urge to start partying again.
I am aware that younger folks bounce back quicker, and that there is substantial variation among individuals. Use my suggestions as guidelines. And remember, you’re far better off if you can avoid a hangover in the first place.