Alcohol is potentially one of the world's oldest drugs and, for thousands of years, has had a range of applications. Alcohol holds a special place in the Australian culture so much so that many countries think of the Aussie stereotype as a person with a drink or ‘stubby’ always in one hand -- s sometimes both.
But what happens when you participate in one of Australia's favourite pastimes? Let’s have a look at some of the main aspects of alcohol and address some questions.
This is supported by the National Health Survey 2014-15 that showed that 80.6 per cent of Australians aged 18 and over had consumed alcohol in the past year; this is higher than the 70.1 per cent in the US and global average of 65 per cent. The statistics become concerning when they identified that 17.4 per cent of adults over 18 had consumed more that 2 standard drinks per day on average. This is a number that exceeds the guidelines put in place by the 2009 National Health and Medical Research Council (NHMRC).
Alcohol is produced by the fermentation of grains, fruits, vegetables and honey; which is the process by which bacteria, yeasts or microorganism breakdown down sugars into ethanol and carbon dioxide in anaerobic conditions (without oxygen). Alcohol fits into the depressant category of drugs whereas substances like ecstasy fall into stimulants and LSD fits into hallucinogens. The way in which alcohol can affect a person depends on a number of variables which include age, gender, physical condition (size), if other drugs have been consumed as well as if food has been eaten.
Once consumed, alcohol is absorbed mainly by the small intestine but some of it is also absorbed through the lining of your stomach. It enters the bloodstream, circulates the body and has some interesting effects. Over time, the liver metabolises the alcohol from the bloodstream turning it into water, carbon dioxide and energy. But what about all of the fun stuff it get’s up to in between?
It can take up to an hour for alcohol to start having an effect on the body, and this time changes depending on the previously mentioned variables. Alcohol interferes with neural pathways within the brain, altering the speed at which different regions communicate. This is all because alcohol is a depressant; it slows down brain and central nervous system activity. Low blood alcohol content (BAC) of around 0.04 to 0.099 per cent can result in a relaxing feeling, lowered inhibitions, impaired concentration and reduced coordination -- but you knew all of this already.
As BAC starts to increase (0.1 to 0.199 per cent), effects can include slurred speech and altered emotional state, and high BAC (0.2 per cent to above 0.40 per cent) can lead to vomiting, breathing difficulties, confusion and even coma with a BAC of 0.5 per cent plus being a potential of death due to respiratory failure.
These are the basics when it comes to alcohol and its consumption, but what about the specifics? I asked people to send their questions in regarding alcohol, and I’m going to address them all now!
Why do I feel bad the day after drinking?
As someone who hasn’t experienced a hangover before (scientifically referred to as veisalgia), I can only imagine the level of pain that the rest of the human populace must go through when consuming too much of the hard stuff. There are many aspects associated with a hangover and the symptoms can vary depending on the person. Regardless, alcohol is metabolised into acetaldehyde thanks to alcohol dehydrogenase; an enzyme in the liver.
The acetaldehyde is then further metabolised into a non toxic acetate -- think vinegar -- thanks to acetaldehyde dehydrogenase and glutathione. Unfortunately, excessive consumption of alcohol depletes glutathione stores resulting in the decreased metabolism of acetaldehyde, leaving it in your system for longer and is identified as one of the main culprits of hangovers; causing severe headaches and vomiting. That’s not all though.
* Alcohol is a diuretic which increases the amount of water and salt that leaves the body -- and too much drinking, coupled with not drinking water during, results in dehydration which can result in light-headedness. For every alcoholic drink that you consume, your body can excrete 4 times as much liquid.
* Alcohol decreases the pH of the environment in the stomach, making it more acidic (low ph = acidic, high pH = basic or alkaline). This decreases the rate at which the stomach is emptied and can lead to nausea and vomiting during or after a big night on the town.
* It causes your blood vessel to dilate (vasodilation) due to the metabolism of alcohol into acetaldehyde which increases blood flow around the body. While drinking, this is what causes you to feel warm as blood flow to the surface of your skin increases, this excites the thermoreceptors (temperature receptors) in your skin. The day after however, can result in headaches.
* A drop in blood glucose levels while drinking can result in an array of symptoms including moodiness, shaking, weakness and tiredness.
* Congeners are associated with hangovers -- these are byproducts of the fermentation of alcohol that differ depending on the type of alcohol that you’re drinking.
* Alcohol triggers an immunological response causing inflammation. This is because the body reacts to some of the products in the alcohol or from products produced during metabolism. It is this that can result in symptoms like not being able to concentrate, decreased appetite and memory problems.
Why do I go red in the face when drinking?
People who go noticeable red in the face might need to check in with their doctor. A study done in 2013 found that people who go red in the face can’t tolerate alcohol as well as others due to their inability to break down acetaldehyde (a toxic product of alcohol metabolism). This results in an increase in blood pressure and this sign may serve as a marker of hypertension risk associated with drinking.
Hypertension is elevated blood pressure of 140 over 90 mm of mercury (mmHg), which is a standardised measurement relative to the current atmosphere. Some ethnicities, like people of Asian heritage, are more intolerant of alcohol than others. It’s your body reacting to the presence alcohol and its byproducts; almost like an mild allergic reaction.
What are the health effects of drinking?
There is a vast assortment of research out there in regards to the consumption of alcohol and associated health benefits and risks of drinking particular amounts. I’m going to try my hardest to put all of these into context but a lot of research only shows benefits for middle aged to older people with low levels of consumption. Drinking alcohol in moderation can provide benefits to the body in regards to minimizing multiple cardiovascular disease risk factors as well as decreased risk of diabetes mellitus and pancreatitis.
Excessive consumption of alcohol leads to lots of harmful conditions such as alcoholic hepatitis (inflammatory condition of the liver), hepatocarcinoma (liver cancer also called hepatocellular carcinoma or malignant hepatoma) and cirrhosis (build up of scar tissue on the liver). Moderation is key so find your Goldilocks zone; not too much, not too little.
When consumed in safe doses, alcohol can reduce blood pressure but it can have the opposite effect when it is consumed excessively. Not only that but it decreases the blood's ability to clot (hence the warning of being intoxicated when getting a tattoo) and can help to clear fat deposits from arteries; decreasing chances of heart disease. This in turn also decreases your chances of a particular type of stroke. Ischemic stroke is when a blockage prevents oxygen from getting to particular areas of the brain.
The thinning effect of alcohol allows for blood to follow easily and has the chances of removing particular blockages from the pipes. Red wine is also beneficial for the lowering of cholesterol levels but this is an exclusive beverage benefit; so you can have glass now.
Some people use alcohol as part of their nightly routine for when they go to bed. Alcohol does assist in going to sleep if consumed moderately before bed with low doses having little effect on sleep. Though you go to sleep quicker, the quality of sleep with be poor with alcohol consumption leading to people waking up during the night if too much is consumed. It prevents you from entering deeper stages of sleep (rapid eye movement or REM sleep), so you’re not well rest when you wake. So if trying to sleep, have some decaffeinated “sleepy time” tea before bed instead.
Liquid courage also makes it easier for particular people to socialize due to it enhancing your cognition if consumed lightly which has a positive effect on a person's mental wellbeing. The opposite of this is also true with some arguing that alcohol negatively affects a person's mood making them more of a pain in the butt. This also depends on the individual and consumption so monitor your intake and get a close friend to tell you when you need to pull your head out of your ass.
Another issue associated with alcohol is the consumption of medication. The liver is an incredibly hard worker and, with help from the kidneys, is responsible for the detoxification of the body (so don’t buy into that detox stuff). The liver can metabolize approximately 30ml of alcohol per hour or 1 standard drink. An important note, though: one standard drink and one drink are two completely different things so please be aware of your intake.
When alcohol is consumed along with any medication, alcohol is priority number one resulting in medications having stronger, longer lasting effects because they’re not broken down as quickly. This also goes for illicit substances that one might consume when partying. So drink water with your meds instead!
Why do I feel the effects of alcohol more as I age?
There are a number of variables that combine that results in older people being affected by alcohol more than their younger counterparts. One of the main reasons why is because your body cannot metabolise alcohol as effectively as when you were younger -- this is because of the general effects of aging. There is also the idea that, because older people contain less water, alcohol is less diluted when you age.
This results in you feeling more intoxicated quicker and also why you feel worse afterwards more as you get older. After drinking the same amount of alcohol, older people have a higher BAC. So remember this oldies, you can’t drink like you use to on a physiological level because science says so!
Will mixing different drinks together affect you?
There are many little sayings used to warn people of this phenomena, and how mixing different drinks together is going to result in a really bad time. Surprisingly, there is very little research into how the consumption of different drinks affects the severity of your hangover; which is really disappointing. Though a link hasn’t been tested and therefore established, that doesn’t mean that there are some theories associated with the sayings.
There are some ideas to suggest that depending on which substance you start with effects the hangover that you end with. Beer is significantly weaker than wine in the sense of a ‘normal serving’, and spirits even more so. So starting on wine rather than beer might result in individuals being more inclined to move on to the harder stuff and drinking more of it because of their impaired judgement.
It is this judgement that makes you think that 14 beers is too much but 4 beers, 3 glasses of wine, 2 tequila shots, 2 Red Bull and a Cosmo are fine. Overall, this might lead to more alcohol being consumed in general, resulting in an increased probability of feeling the maths the next day.
There is also the idea that ties in with the first idea that is associated with congeners, one of the prime suspects of a hangover that was previously mentioned. These are substances like acetone, acetaldehyde, tannins and fusel oil that all naturally occur in different beverages due to fermentation. Dark liquors like whiskey have up to 37 times the number of congeners in them in comparison to light liquors like vodka, which is generally considered to have almost none.
Though outdated, a study performed 2009 got people drunk on bourbon or vodka to a BAC of 0.11 per cent and found that, though their cognition wasn’t affected -- the original premise for the study -- it found that people who had consumed the bourbon describe their hangovers as significantly worse than people who only consumed vodka. Maybe when becoming more and more intoxicated, people might be keen to consume more dark liquors, increasing the chances of a really shit hangover. Who would’ve thought it!
How do I avoid or treat hangovers?
This is definitely one of the most sort out aspects of drinking that I was questioned on and one that is filled with mystery, and suspense, and a whole lot of nonsense.
The only best way to avoid a hangover is by not drinking in the first place, but that’s boring -- so let's not look into that too much. A study published in 2016 looked at natural products for the prevention and treatment of hangovers and this is what they found. One warning, a lot of the tests done in these experiments used small sample sizes and might not accurately represent the positive effects of these natural remedies.
* Kudzu, either the root or flower, is a traditional Chinese medicine that has been used for a long time. Studies in both mice and humans found that it enhanced the removal of acetaldehyde from the body, potentially decreasing symptoms of hangovers including headaches, flushes and palpitations.
* Fructus evodiae is another traditional Chinese medicine with properties that might aid in the removal of a killer hangover. Fructus evodiae in mice models showed to increase the expression of alcohol metabolising and antioxidant enzymes leading to lowered plasma alcohol concentrations than in other tests groups.
* Korean pear contains a prophylactic agent to rid a person of a hangover. A study conducted using the juice found that it decrease the severity of a hangover as well as aided in remembering what happened during the night and made outside, aka light, hurt less. This was accomplished by increased activities of both ADH and ALDH.
* Mango has also been shown to increase the activity of both ADH and ALDH resulting in a decrease in plasma alcohol concentrations through the promotion of acetaldehyde metabolism.
* Ginger is essentially a superpower herb with it being used for almost everything and anything. Studies found that the controlled consumption of a formula consisting of ginger, pith of tangerine and brown sugar has been used traditionally in China to alleviate diarrhea, nausea and vomiting. Maybe just have some ginger tea on a cold day and ginger ale on a hot one.
* Asparagus leaf and root extracts have been shown to increase the activity of ADH and ALDH to aid in the metabolism of alcohol.
* Prickly pear juice has been shown to target the symptoms of hangovers that are associated with inflammation which include dry mouth and nausea.
* Finally we have Asian ginseng, which has shown to have positive effects on hangover symptoms through the stimulation of a handful of enzymes which aid in the metabolism of alcohol as well as have an antioxidant effect.
So this is a list of all of the natural remedies which aid in the prevention and treatment of hangovers but what about all of the immediate options that we have available to us. A lot of the time, it simply comes to taking precautions when drinking excessively.
* Avoid dark liquors when possible because of the high concentration of congeners. Vodka almost contains no congeners, so it might be a good idea to make it your new drink of choice. Mix it with a sports drink to ensure the replacement of electrolytes that is lost originally because of the diuretic properties of alcohol. I used to occasionally drink concerning amounts of lychee vodka and grape Gatorade, and swear that it works -- with no empirical evidence to support such a claim.
* This continues on to the general rule of thumb and that is to ensure that you drink plenty of water to stay hydrated. I have heard theories of three alcoholic beverages to one of water, with others saying a 1:1 ratio works best. It doesn’t rid you of a hangover but can decrease the severity by dampening some symptoms associated like thirst, fatigue, headache and dry mouth. Regardless if you’re prone to severe hangovers or not, more water is better.
* Ensuring that you have plenty of time to sleep after a big night also ensures that you won’t have to suffer as much. Getting to sleep while more than slightly inebriated is super easy; we’ve all had those evenings when we wake either completely or partially dressed due to us giving up during the process of undressing. Though it is easy, alcohol negatively affects the quality of sleep by limiting the duration that you experience rapid eye movement (REM) sleep. After a big one, try to sleep in.
* Have yourself a solid midnight snack or ensure that you have a decent feed organised for the next morning. A lot of people don’t eat much during a night out and this can cause hypoglycemia (low blood sugar). Though it isn’t going to prevent a hangover, it will decrease the chance and severity of weakness and headaches.
* Some studies have shown that the consumption of B vitamin supplements before hitting the town can aid in decreasing the wickedness of your hangover so maybe a Berocca before bevs might be an idea to try and see if it works for you.
* Finally, the drugs and the best one that you can take for a hangover is an anti inflammatory (aspirin or ibuprofen). Some of the symptoms associated with a hangover is due to slight inflammation that occurs due to the damage your body sustains from the toxic effects of alcohol as well as its metabolic byproducts. Having an ibuprofen will ensure that you don’t feel these effects as viciously.
This is a list of some of the steps that one can take to prevent and or treat particular elements when it comes to drinking and hangovers. There is no ultimate cure and some people will react differently to different methods. Some people might have their own techniques that they swear by and that’s awesome but it might not work for everyone.
Though outdated, a study conducted in 2005 said that there is “No compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover. The most effective way to avoid the symptoms of alcohol induced hangover is to practise abstinence or moderation.” Take all findings with a pinch of salt and do what works for you.
Why do I not remember everything when drinking?
Some people can retain their memories when drinking but there have also been moments in which people can not remember a thing and have to rely on the pieces provided to them by their “friends” who were a long for the ride. Consuming alcohol has been shown to have negative effects on the consolidation of memories which a process in which short-term memories become long-term ones as they sleep. It has also shown to have an effect on a brain chemical called glutamate which is an important neurotransmitter that not only is important for the creation and management of memories but it is also essential for other human thought processes and body movement. All of these normal body functions are inhibited to a degree when consuming alcohol because it suppresses the release and cause people to “blackout”. The more you drink, the more likely you are to not remember what happen and this changes between people because people can have varying base levels of the chemical in their body.
Why do people feel the effects of alcohol differently e.g. not get hangovers?
We’re different in our own, special way and it is these particular factors which affect how intoxicated you get, how quickly and if you feel like absolute shit the next day. One of the well researched factors is women vs men; women can’t handle it as well. Factors affecting this include that women on average have more fat and less water than men decreasing the dilution of alcohol. Women also have less alcohol dehydrogenase which the enzyme for breaking down alcohol. Contraceptives have also been shown to potentially increase the susceptibility for getting tipsy.
Another factor that affects how drunk or quickly a person becomes intoxicated has to do with size; because it matters, it always matters. A larger individual has essentially more fluid than a smaller person so the alcohol is less diluted in a small person if both individuals were consuming the same amounts of alcohol. It is this idea that is also associated with the effectiveness of alcohol changing as you get older.
Another one is that some people are just physiologically better to handle alcohol than others which can result in them being able to tolerate more or avoid hangovers the next day. Alcohol processing goes through two steps and that is the conversion of alcohol to acetaldehyde (super toxic to the body) and then to acetate and water which is practically the same as diluted vinegar. The first conversion is you getting drunk and the duration that acetaldehyde is in your system affects how bad you’re going to feel later.
You liver does a lot of work but that’s not the only worker that is on the floor; your gut biome is there also and this can vary greatly between people. The bacteria within your gut also produce enzymes that aid in the metabolism of alcohol as well as affect the rate of which acetaldehyde is removed. Your biome is affected by genetics and lifestyle factors like exercise, sleep patterns and diet. This combined with general health and liver functionality results in the production of more and/or better quality enzymes allowing for some people to just handle their drinks better.
What is the best food to have before or when drinking?
Research has shown that eating a meal (around 550 calories) an hour before wine o’clock results in the body being able to eliminate alcohol and bad byproducts of your night 45% faster than if you were not to eat anything at all; regardless of it being a high protein, fat or carbohydrate based meal.
A lot of people would probably tell you that this is because the food absorbs some of the alcohol preventing it from entering your body; this is wrong. The main reason to why this works is because it increases blood flow to the liver boosting functionality for approximately 200 minutes after consumption. It is believe that this boost allows for the increased breakdown and elimination of alcohol from the body. Eating during or before bed is also going to ensure that you blood sugar does drop to dangerous levels which is associated with some of the yuckiness one feels the following day.
There you have it. This is the complete run down of alcohol involving steps before drinking, during and the awesome experience that I assume most of you go through afterwards. Heed my warning readers; though there is some evidence to support particular claims when it comes to the consumption of alcohol and hangover remedies, this doesn’t necessarily means that it is going to work for every individual. When drinking, drink sensibly. Using alcohol as an essential to have a good time is not a necessity and is an outdated and dangerous norm. Know your body, it’s been a part of you for awhile so you know how to communicate with it better than anyone else. Find what works for you and have fun.
Man, I need a drink now.
Nathan is the Sydney-based high school science and math teacher behind Inform, a website dedicated to communicating the nuances and facets behind science.