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Debaucherous evening last night? You’re probably dealing with veisalgia right now.
More commonly known as a hangover, this unpleasant phenomenon has been dogging humanity since our ancestors first happened upon fermentation.
Those nasty vertigo-inducing, cold sweat-promoting and vomit-producing sensations after a raucous night out are all part of your body’s attempt to protect itself from injury after you overindulge in alcoholic beverages.
Your liver is working to break down the alcohol you consumed so your kidneys can clear it out ASAP. But in the process, your body’s inflammatory and metabolic reactions are going to lay you low with a hangover.
As long as people have suffered from hangovers, they’ve searched in vain for a cure. Revelers have access to a variety of compounds, products and devices that purport to ease the pain.
Hangovers are virtually guaranteed when you drink too much. That amount varies from person to person based on genetic factors as well as whether there are other compounds that formed along with ethanol in the fermentation process.
Over the course of a night of heavy drinking, your blood alcohol level continues to rise. Your body labors to break down the alcohol – consumed as ethanol in beer, wine or spirits – forming damaging oxygen free radicals and acetaldehyde, itself a harmful compound.
The longer ethanol and acetaldehyde stick around, the more damage they can do to your cellular membranes, proteins and DNA, so your body’s enzymes work quickly to metabolize acetaldehyde to a less toxic compound, acetate.
Over time, your ethanol levels drop through this natural metabolic process. Depending on how much you consumed, you’re likely to experience a hangover as the level of ethanol in your blood slowly returns to zero. Your body is withdrawing from high levels of circulating alcohol, while at the same time trying to protect itself from the effects of alcohol.
Scientists have limited knowledge of the leading causes of the hangover. But they do know that the body’s responses include changes in hormone levels to reduce dehydration and cellular stress.
Alcohol consumption also affects a variety of neurotransmitter systems in the brain, including glutamate, dopamine and serotonin.
Inflammation increases in the body’s tissues, and the healthy gut bacteria in your digestive system take a hit too, promoting leaky gut.
Altogether, the combination of all these reactions and protective mechanisms activated by your system gives rise to the experience of a hangover, which can last up to 48 hours.
Your misery likely has company
Drinking and socializing are cultural acts, and most hangovers do not happen in isolation. Human beings are social creatures, and there’s a high likelihood that at least one other individual feels the same as you the morning after the night before.
Each society has different rules regarding alcohol use, which can affect how people view alcohol consumption within those cultures.
Drinking is often valued for its relaxing effect and for promoting sociability. So it’s common to see alcohol provided at celebratory events, social gatherings and holiday parties.
In the United States, drinking alcohol is largely embraced by mainstream culture, which may even promote behaviors involving excessive drinking. It should be no surprise that overindulgence goes hand in hand with these celebratory social events – and leads to hangover regrets a few hours later.
Your body’s reactions to high alcohol intake and the sobering-up period can influence mood, too. The combination of fatigue that you experience from sleep deprivation and hormonal stress reactions, in turn, affect your neurobiological responses and behavior. As your body is attempting to repair itself, you’re more likely to be easily irritated, exhausted and want nothing more than to be left alone.
Of course, your work productivity takes a dramatic hit the day after an evening of heavy drinking.
When all is said and done, you’re the cause of your own hangover pain, and you’re the one who must pay for all the fun of the night before. But in short order, you’ll forget how excruciating your last hangover was. And you may very soon talk yourself into doing the things you swore you’d never do again.
Speeding up recovery
While pharmacologists like us understand a bit about how hangovers work, we still lack a true remedy.
Countless articles describe a variety of foods, caffeine, ion replenishment, energy drinks, herbal supplements including thyme and ginger, vitamins and the “hair of the dog” as ways to prevent and treat hangovers.
But the evidence isn’t really there that any of these work effectively. They’re just not scientifically validated or well reproduced.
For example, Kudzu root (Pueraria lobata), a popular choice for hangover remedies, has primarily been investigated for its effects in reducing alcohol-mediated stress and hangover.
But at the same time, Kudzu root appears to inhibit the enzymes that break down acetaldehyde – not good news since you want to clear that acetaldehyde from your system quickly.
To fill this knowledge gap, our lab is working with colleagues to see if we can find scientific evidence for or against potential hangover remedies. We’ve focused on the benefits of dihydromyricetin, a Chinese herbal medicine that is currently available and formulated as a dietary supplement for hangover reduction or prevention.
Dihydromyricetin appears to work its magic by enhancing alcohol metabolism and reducing its toxic byproduct, acetaldehyde. From our findings in mice models, we are collecting data that support the usefulness of dihydromyricetin in increasing the expression and activity of enzymes responsible for ethanol and acetaldehyde metabolism in the liver, where ethanol is primarily broken down.
These findings explain one of the several ways dihydromyricetin protects the body against alcohol stress and hangover symptoms.
We are also studying how this enhancement of alcohol metabolism results in changes in alcohol drinking behaviors. Previously, dihydromyricetin was found to counteract the relaxation affect of drinking alcohol by interfering with particular neuroreceptors in the brain; rodents didn’t become as intoxicated and consequently reduced their ethanol intake.
Through this combination of mechanisms, we hope to illustrate how DHM might reduce the downsides of excessive drinking beyond the temporary hangover, and potentially reduce drinking behavior and damage associated with heavy alcohol consumption.
Of course, limiting alcohol intake and substituting water for many of those drinks during an evening out is probably the best method to avoid a painful hangover.
However, for those times when one alcoholic beverage leads to more than a few more, be sure to stay hydrated and catch up on rest.
Your best bet for a smoother recovery is probably some combination of nonsteroidal anti-inflammatory drug like ibuprofen, Netflix, and a little downtime.
Background on authors:
Dr. Daryl L. Davies is the Associate Dean for Undergraduate Education and a professor in the Titus Family Department of Clinical Pharmacy at the University of Southern California’s School of Pharmacy. He also leads a leads a research team seeking to develop novel therapeutics for the treatment of neurodegenerative diseases and alcoholism and is considered a pioneer by his peers in the field of purinergic receptors and their role in CNS regulation of alcohol-induced changes in alcohol intake and signaling.
Dr. Terry David Church, is an assistant professor in the Department of Regulatory and Quality Sciences, and lecturer for the undergraduate program at the University of Southern California’s School of Pharmacy.
Joshua Silva is a PhD student at the University of Southern California’s School of Pharmacy. His doctoral project is titled “Dihydromyricetin (DHM) Increases Alcohol Metabolism and Reduces Alcohol-Induced Liver Injury.”
Advocates call for COVID-19 vaccination plan for migrant and undocumented workers – Airdrie Today
TORONTO — Migrant and undocumented workers must have access to the COVID-19 vaccine as part of Canada’s immunization effort, advocates said Wednesday, calling on all levels of government to ensure the workers are guaranteed the shots.
The Migrant Rights Network, along with doctors and labour groups, voiced concerns that thousands of migrant and undocumented workers may not get the vaccine because of their immigration status.
“Concrete action is urgently necessary to ensure life-saving public health measures are accessible to all migrant and undocumented people,” said Syed Hussan, spokesman for the group.
An estimated 1.6 million people in Canada don’t have permanent resident status and many work in essential jobs in health care, construction and agriculture, the group said.
While governments have said the vaccine rollout will be universal, the advocates made specific recommendations to ensure the workers receive the shot.
Granting workers permanent resident status would address the problem, but in the absence of that the group recommended vaccines be provided to the workers free of charge and without a health card required to obtain them.
Advocates also said the shot shouldn’t be mandatory and health-care providers must train people providing the doses to ensure migrant or undocumented workers aren’t turned away.
Dr. Danyaal Raza, chairman of Canadian Doctors for Medicare, said many undocumented workers are afraid to get the shot because they worry about having to provide identification.
“Many uninsured people with precarious status worry about being reported to the Canadian Border Services Agency to face detention or deportation,” he said.
“Some, as a result, may avoid receiving the vaccine altogether. We need to be able to assure those affected that their privacy will be respected.”
Pauline Worsfold, a registered nurse with the Canadian Federation of Nurses and chair of the Canadian Health Coalition, said migrant workers cannot be included as an “afterthought” in the country’s vaccine rollout.
If Canada’s goal is to eliminate COVID-19, as many people as possible must be vaccinated, she said.
“They must have access to universal health care immediately, regardless of their immigration status, and it should be private and confidential so that we can eliminate the COVID virus and the variants that are now spreading like wildfire,” she said.
A spokeswoman for the Public Health Agency of Canada said COVID-19 vaccines across the country are being administered for free.
“While they’re available to priority populations first, they’ll be available to everyone in Canada who is recommended to get the vaccine by federal, provincial and territorial public health authorities,” Anna Maddison said in a statement.
“This applies to everyone in Canada, including those who aren’t citizens.”
Maddison said that each province is in charge of its own plan to administer the vaccine.
In Ontario – where thousands of migrant workers arrive to work on farms every spring – a spokesman for the Ministry of Health said the government’s goal is to provide a shot to everyone who is eligible and wants a vaccine.
“When temporary workers get vaccinated depends on where they fall in the priority framework,” David Jenson said in a statement.
“You do not need an (health) card to receive the vaccine. If you do not have an (health) card, you may bring another form of a government issued-photo ID.”
This report by The Canadian Press was first published Feb. 24, 2021.
Shawn Jeffords, The Canadian Press
B.C.'s COVID-19 death count stays low, as vaccination roll-out stays slow – Powell River Peak
Health officials identified two people who died from COVID-19-related causes overnight, after one such death was recorded the day before. While that raises the province’s death toll from the virus to 1,338, the three deaths in two days is the lowest two-day total since November 5 and 6, when there were two COVID-19-related deaths identified.
This good news is partly because 98% of seniors in care homes have been vaccinated, provincial health officer Bonnie Henry told media yesterday. She called the success of the vaccine in older people “miraculous.”
Nonetheless, B.C.’s roll-out of vaccines continues to be slow, with only 6,521 doses being administered in the past 24 hours. There were 2,809 additional people who got a vaccine dose in the past 24 hours, and 3,712 doses went to people as a second dose.
In total, 230,875 doses have been given to 168267 people, with 62,608 people getting second doses. Starting in March, if around four million eligible British Columbians remain unvaccinated, the province would have to vaccinate about 19,000 people per day in order for all of them to be vaccinated by the end of September.
“Just as our health-care system has risen to the challenge of protecting and caring for people who have become ill with this virus, so too are countless others working hard to get people immunized as quickly and safely as possible,” Henry and Health Minister Adrian Dix said in a joint statement.
“Vaccinating our entire population is a monumental task that must account for the diversity of our geography and our population. We must consider how to safely deliver vaccine to rural and remote communities, how to connect with seniors and elders everywhere, and how to ensure the process to get immunized is as simple as possible. We are pushing hard right now, and we must continue to balance speed with the need for careful thought and planning.”
There were 456 newly identified infections in the past day, down by 103 from yesterday. A total of 78,278 people in B.C. have contracted the virus since officials detected the first case on January 28, 2020.
The vast majority of the 4,668 people actively battling infections have been told to self-isolate, although 237 are in hospital, with 64 of those inflicted seriously enough to be in intensive care units.
More than 92.2% of those infected in B.C., or 72,219 individuals, are considered to have recovered because they have tested negative for the virus twice. Another 7,924 people are being closely watched by health officials for symptoms because they have had known exposure to at least one identified case.
Here is the breakdown of where the 456 new cases are located:
• 108 in Vancouver Coastal Health (23.6%);
• 259 in Fraser Health (56.7%);
• 35 in Island Health (7.6%);
• 30 in Interior Health (6.5%);
• 20 in Northern Health (4.4%); and
• four people who regularly reside outside Canada.
There were no new healthcare facility outbreaks in the past day, according to Henry.
The outbreak at the seniors’ home Creekside Landing in Vernon has been declared over, Henry and Dix said.
The number of outbreaks at seniors’ homes has dwindled significantly since January, when there were more than 50 outbreaks for much of the month.
There are now only 11 outbreaks at those homes, with none of those being in the Vancouver Coastal Health region.
The five active outbreaks at seniors’ living facilities in Fraser Health are:
• CareLife Fleetwood in Surrey;
• Fleetwood Villa in Surrey;
• George Derby Centre in Burnaby;
• Royal City Manor in New Westminster; and
• Shaughnessy Care Centre in Port Coquitlam.
Two outbreaks at seniors’ homes in Nanaimo – Eden Gardens and Wexford Creek – are the only ones in the Island Health region.
The outbreak at the Acropolis Manor in Prince Rupert is the only active outbreak in Northern Health.
The three active outbreaks at seniors’ living facilities in Interior Health are at:
• Brocklehurst Gemstone Care Centre in Kamloops;
• Noric House in Vernon; and
• The Florentine in Merritt.
The list of B.C. hospitals with active COVID-19 outbreaks includes:
• Burnaby General Hospital in Burnaby;
• Dawson Creek and District Hospital in Dawson Creek;
• Kelowna General Hospital in Kelowna;
• Mission Memorial Hospital in MIssion;
• St. Paul’s Hospital in Vancouver; and
• Vancouver General Hospital.
So you got your COVID-19 shot. Does that mean life goes back to normal? – CBC.ca
After Toronto family physician Dr. Tali Bogler received her final dose of a COVID-19 vaccine in January, she felt a newfound sense of relief — but also knew her daily life wasn’t going to suddenly change.
On an afternoon in late February, while still dressed in her bright blue hospital scrubs after a shift, she was cuddling one of her twin daughters while catching up with her parents on a video chat.
It’s the same kind of virtual family time Bogler has experienced throughout the pandemic. Being vaccinated doesn’t mean she’ll start seeing them in person without precautions any time soon, she said, since her parents won’t get their shots for months.
“It’s really hard,” she said, though acknowledging there’s also a sense of excitement for what’s to come. “This period of time, from now until September, I guess, when everyone else is vaccinated, is a transition period.”
More and more Canadians will be grappling with that sense of limbo in the weeks and months ahead after getting vaccinated and protected against COVID-19 while millions of others are still waiting for their turn.
“What does that normalcy look like?” asked Dr. Donald Vinh, an infectious disease specialist and medical microbiologist at the McGill University Health Centre.
“That’s a question that we are collectively struggling with.”
Experts who spoke with CBC News stressed that people still need to err on the side of caution and keep their guard up awhile longer, whether vaccinated or not, to protect those around them.
But after a year of lockdowns and restrictions, there’s also bound to be plenty of friends and families hoping to spend time together once more Canadians start getting their shots — a reality that requires taking stock of everyone’s comfort level when it comes to risk.
“I do think we’re entering into a phase where people are more and more tired of having to deal with public health restrictions, and so we’re probably more likely to encounter that,” said infectious disease specialist Dr. Susy Hota, an associate professor at the University of Toronto.
“I think the important message to give people is that in the short term, nothing changes. So they have to live their lives the same way as they were before they were vaccinated, because it will take some time to get enough people vaccinated.”
Risk ‘quite low’ among vaccinated people
Of course, as time passes, more vaccinated people will know more vaccinated people, be it friends, family members or co-workers.
So, at what point can those groups of COVID-protected people start spending time together without the usual pandemic safety concerns?
“If your parents are older, and they’ve gotten vaccinated — and you’re vaccinated — the risk is quite low, especially if you are continuing publicly to maintain all the other public health measures,” Hota said.
But those situations won’t be common for a while, forcing friends and families to navigate a stark, two-tier world of protection levels.
That means even while vaccinations scale up, public health measures such as mask-wearing and distancing from others are expected to stay in place.
“We often talk about herd immunity,” said Dr. Vinita Dubey, Toronto’s associate medical officer of health. “And that’s often what we really need to have before we can be confident that having so many people vaccinated is acting like that wall to keep COVID from coming back into our community.”
While the vaccines in use so far are proving highly effective at stopping serious illness and death, they aren’t 100 per cent protective and don’t offer instant immunity. Researchers also still aren’t sure how much they might curb transmission of the virus.
“If it interrupts infection, then it’s kind of stopping that chain of transmission from happening, just by virtue of having fewer people who are going to get infected,” Hota said. “But there may still be some asymptomatic infections and some ability to shed virus.”
In Israel, where mass vaccinations are already taking place, the country’s largest health-care system has so far reported a 94 per cent drop in symptomatic COVID-19 infections — and early study findings suggest at least one vaccine may curb transmission, too.
Those results bode well, but it’s still going to take time to confirm them more broadly, Vinh said.
In the meantime, plenty of people waiting to get vaccinated will remain highly vulnerable to the impacts of a COVID-19 infection, be it lingering, long-lasting symptoms or a gruelling recovery following an ICU stay.
“People who have had cancer, people who had transplants, people who have genetic conditions,” he said.
Find ways to lower risk
At first blush, it’s probably not the news most people want to hear. Finally, at long last, vaccine shipments are ramping up and more residents will be rolling up their sleeves in the months ahead, yet nothing changes?
Hota said while it might feel that way at first, there’s likely going to be a slow and steady reduction in restrictions as vaccination campaigns roll out from high-risk age groups to younger populations.
“If you rush it,” she said, “you can jeopardize the whole approach.”
Dr. Dominik Mertz, an infectious disease specialist and associate professor at McMaster University in Hamilton, said it will become even more crucial in the months ahead to assess your comfort level around risk, and the comfort level of those with whom you’re considering spending time.
“Policy decisions aside, it’ll be a discussion,” he said.
“Some families may decide, OK, my grandparents or parents are vaccinated — they’re high risk, but highly protected — and we as a family decide it’s OK meeting in their house.”
But you can also make those efforts to start seeing each other without fully scrapping precautions, he said. Instead of meeting indoors post-vaccination, you could spend time outside where the transmission risk is lower.
“Maybe don’t take the full risk,” Mertz said. “Find something in between, where your personal needs are met but you don’t take the highest possible risk.”
And, he said, it’s important to pay attention to what’s happening in your broader community, not just your own social circle.
High levels of community transmission would mean the chance of people you know being infected goes up as well. It’s a trend public health officials are watching closely given the cases of highly contagious variants already circulating, which could lead to another surge in cases.
WATCH | Pfizer-BioNTech vaccine may curb transmission, early research suggests:
‘Normalcy is on the horizon’
With so much to consider, Canadians could face some frustration and ethical dilemmas over the next year.
Toronto resident Mary Ellen Abrams, who is currently living in a retirement community in Palm Springs, Calif., said she was surprised to get access to a local vaccination program during her stay in the U.S. — but then found herself stumped on what to do next.
“We’re all kind of saying, by mid-March, two weeks after the second dose, we should all be able to hang around each other, to go for dinner together,” said the 65-year-old. “They’ve opened up indoor dining here in California and we thought, ‘Gosh, can we do that?'”
She also wondered whether it would be safe to see her grandchildren in Toronto after she gets back and completes the mandatory hotel quarantine, since she hasn’t spent time with them in-person since last March, beyond saying hello on a front porch or during drive-by greetings.
But finding answers to her questions hasn’t been easy, Abrams said, with little information available on any government websites about what you can or can’t do in your daily life post-vaccination.
“Everyone will want to be vaccinated if they know they can get their life back to somewhat normal,” she said.
Vinh said that scenario requires a little more patience to avoid giving the virus more chances to spread during what has the potential to mark a turning point in the pandemic.
“We don’t want to say, ‘Well, we have a vaccine coming and they say it is almost 100 per cent effective, and once I get my first shot I can go out and do my thing, my regular thing,'” he said. “Not yet, not yet.”
The payoff of getting your shot, for now, remains the personal protection it provides, not a sudden end to the pandemic for everyone in your life — even though that’s the ultimate hope for mass vaccination efforts.
Bogler, the Toronto physician and mother to twins, can certainly relate to that feeling.
Memories of her COVID-19 exposures at work are still fresh, including a stretch where she had to isolate from her daughters and partner for two weeks last year. But those close calls likely won’t be the norm for her anymore, taking a weight off her shoulders even as she continues masking, distancing, and staying apart from her parents awhile longer.
“Normalcy is on the horizon,” she said.
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