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Substance Abuse and Addiction Health Center

Hangovers More of a Headache Than You Think

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But more common than potential medical problems is the muddleheaded feeling the day after. Robert Cloninger, MD, a well-known researcher in alcohol studies, defines a hangover quite simply as "feeling bad after drinking." But it does go beyond just that, Cloninger tells WebMD.

"You don't think as well; you're achy; you're slower; you're really not functioning a 100%," he says. Cloninger is a professor of psychiatry, genetics, and psychology at Washington University in St. Louis, Mo.

Wiese writes about the common symptoms of hangovers, predominantly a headache, then a poor sense of overall well-being, diarrhea, loss of appetite, shakiness, fatigue, and nausea. The alcohol causes the bad feelings because it leaves a person dehydrated and malnourished. One debatable theory, Wiese writes, is that a hangover is the first stage of alcohol withdrawal.

Wiese affirms Cloninger's definition, saying multiple studies show decreased reaction times, less ability to concentrate, lower managerial skills, and increased risk for injury, even after some of the more obvious hangover symptoms are gone and alcohol can no longer be detected in the blood.

Wiese describes one study looking at airline pilots, where pilots drank enough one night to meet the criteria for having a hangover the next day. The pilots followed an eight-hour "bottle to throttle" standard before entering a flight simulator. Wiese says even though half of the pilots didn't feel like they had a hangover, their thought, or cognitive, functions were clearly reduced.

"The point being is that many people see being hungover as having a headache or just not feeling great, but don't recognize that their cognitive function is actually impaired," says Wiese, "and that may have implications for whether people decide to work with heavy machinery, decide to drive, or operate aircraft, for example. People should be aware that their cognitive function may not be optimal, even though they may not be feeling the most severe symptoms."

Wiese says 75% of all drinkers will have a hangover in a year, and 15% will have a hangover at least monthly, which has a large economic impact. "You're talking about a big part of the American workforce, and if each of those [people] misses work one or two times a year, and then if you toss on the decreased productivity from the cognitive decline ... it starts to become a fairly large opportunity cost, a large loss in productivity," Wiese says.

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