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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.
But there’s a lot of purporting and not a lot of proof. Most have not been backed up well by science in terms of usefulness for hangover treatment, and often their effects don’t seem like they’d match up with what scientists know about the biology of the hangover.
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.”
OTTAWA – The federal Liberals are creating a new agency to beef up Canada’s ability to handle rapidly spreading infectious diseases and protect from future pandemics.
Industry Minister François-Philippe Champagne said the agency is meant to preserve the “top-gun team” of public servants that helped steer Canadians through COVID-19.
Health Emergency Readiness Canada is being tasked with boosting Canada’s life-sciences sector and ensuring Canadians get faster access to vaccines, medical therapies and diagnostics by accelerating the transition from research to commercialization.
“The danger would have been (that) if we don’t have a permanent agency sitting somewhere, that collective knowledge that we have accumulated during COVID would even be dispersed eventually, perhaps even lost within the civil service,” Champagne told reporters on Tuesday.
“We’re pulling them together in a team so that when people are talking about health, emergency readiness, they know where to knock.”
The new agency will be based in the Industry Department but include staff from the Public Health Agency of Canada and Health Canada. Champagne said it requires no new legislation and is based on spending Parliament already approved through this year’s budget.
“We want to keep a very close nexus with industry,” Champagne said.
The agency will co-ordinate efforts between Canadian industry and academic researchers as well as with international partners.
This follows a similar move by the European Union to create an agency in 2021 that not only tries to prepare the continent for pandemics, but seeks to learn from mistakes during the COVID-19 pandemic.
Canada was not adequately prepared for the COVID-19 pandemic with an outdated and understocked emergency stockpile, and a virtually non-existent vaccine production industry.
Last year, the British Medical Journal called out Canada’s “major pandemic failures” such as jurisdictional wrangling and a high death rate in long-term care homes.
Yet the Trudeau government has resisted calls from medical experts and the NDP to follow countries like the U.K. in having an inquiry into how governments handled the COVID-19 pandemic and how they could better manage a future pandemic.
When asked about an inquiry, Champagne said the announcement is focused on having the right materials and researchers on hand when needed.
“We all hope that there be no other pandemic. But the responsible thing to do is to make sure that you have the team stand by and ready,” he said.
Champagne told a biotechnology industry gathering on Friday that officials found Canada was not ready in co-ordinating “health emergency readiness” when peers started looking into preparing for future events.
“We realized that things were scattered,” he said.
He said Canada faced the danger of being the only G7 country “without a dedicated team” for pandemic preparedness.
Once fully operational, the agency will have an “industrial game plan” to move quickly on research and industrial mobilization if another health emergency like a pandemic is declared.
Champagne said the pandemic and investments in personalized medicine have made the public enthusiastic about the biotechnology sector.
“If there is one industry that I think Canadians have fallen in love again with, it’s certainly that industry,” he said.
This report by The Canadian Press was first published Sept. 24, 2024.
EDMONTON – An Alberta doctors‘ group says even though a new pay deal with the province is ready to be implemented, the government isn’t putting its money where its mouth is.
Dr. Shelley Duggan, the Alberta Medical Association’s new president, says doctors are worried the province’s health-care system is on the verge of collapse, and the pay deal is still waiting on approval from the province’s Treasury Board.
Former association president Dr. Paul Parks says Premier Danielle Smith promised the deal by September and the delay is hurting the struggling health-care system.
Parks says the government’s work to break up the provincial health authority is sparking chaos and that creating multiple administrative layers could stifle co-ordination.
Health Minister Adriana LaGrange recently said the government is committed to getting a fair and sustainable compensation model for primary care physicians.
Late last year, Smith announced $200 million in federal funding over two years to help physicians keep their practices open, with the province rolling out another $57 million in February.
This report by The Canadian Press was first published Sept. 23, 2024.
HALIFAX – A Nova Scotia woman has applied for a medically assisted death, saying after years of battling to receive out-of-country surgery for an illness that causes “indescribable” pain, she struggles to maintain the will to live.
Jennifer Brady completed her MAID application in June. She has lymphedema in her legs, a condition in which tissues swell from the accumulation of fluids normally drained through the body’s lymphatic system.
In an interview Thursday, the 46-year-old mother of two said she has intense daily pain, skin infections that resemble a sunburn intensified “1,000 times,” and blood infections that exhaust her to the point “you feel like you’re dying.”
However, Brady said that after she received treatment in Japan in 2022 — at her own expense — her swelling decreased, particularly in her right leg, and some symptoms were relieved. She said she believes that if she can receive the funds to pay for more surgery, her condition can improve — as will her desire to remain alive.
The possibility that her health can improve is what led to her MAID request being denied.
In a letter sent to Health Minister Michelle Thompson on July 7, Dr. Gord Gubitz, the clinical lead of Nova Scotia’s MAID program, said his team is rejecting Brady’s application because her condition is not considered “irremediable.”
“It seems reasonable to me that if an assessment (and surgery, if clinically indicated) … could help to reduce Brady’s suffering and obviate the need to consider MAID, this option should be explored. Your office can make this happen,” Gubitz wrote to Thompson.
After telling her story to CBC this week, Brady said she has received online support from people offering encouragement and financial help. However, she said she still needs the health minister to authorize funding for treatment she cannot get in the province.
On Wednesday, Thompson told reporters, “I will not make a commitment to do that,” and then added, “If that individual will work with the department and reach out, perhaps there is another path forward.” The minister refused detailed comment, citing an ongoing court case and privacy law.
In Brady’s case before the Nova Scotia Supreme Court launched over two years ago, she took issue with the province’s decision to deny her funding for out-of-country care, arguing it was unreasonable and unfair.
In legal briefs, government lawyers argued Brady failed to receive a referral for the treatment. The lawyers said she was on a wait-list to see a Nova Scotia plastic surgeon and became “frustrated.”
Brady’s January 2024 affidavit responding to the lawyers said that given her physical deterioration, the plastic surgeon’s years-long waiting time and his lack of expertise in her illness, “the department created standards that were functionally impossible to meet.”
On Thursday, Brady said she found the minister’s latest comments frustrating and “somewhat disingenuous,” adding that they left her wondering whether Thompson had personally reviewed her case.
She said that even if she wins in court and is awarded about $60,000 in costs related to her 2022 treatment in Japan, the years of legal battles, the continuing pain and her deteriorating mental health have led to her decision that MAID is the best option. “It was after a winter where I could barely get out of bed and when I did, I just didn’t want to be here.”
Brady spends at least five hours daily in a full body massage machine that helps move fluid in her legs to reduce swelling. “I mean, what’s the point honestly? I’m in that machine and the machine itself is so uncomfortable.”
Applying for MAID “definitely isn’t a strategic move,” she said. “That’s not my plan A. I want to live. I want to be here for my kids. I love my job.”
“I want the option (of MAID) to be there. But if I were given the treatment today (for lymphedema) I would definitely take it,” she said.
Brady, a dietitian and professor at Acadia University’s faculty of nutrition, said she is also suffering from depression, a condition for which she’s been unable to take medicines as they tend to increase the swelling in her legs.
Her lymphedema developed after a hysterectomy to treat her cervical cancer in 2019. She said she was informed in 2021 that local surgical options weren’t available to her, which led her to Dr. Joshua Vortenbosch, an expert in lymphedema at McGill University. However, she was denied funding for the surgery in Montreal. The rejection led her to do research, and to her 2022 trip for surgery in Japan.
In Japan, she received lymphovenous anastomosis, a procedure in which a surgeon connects lymph vessels in the limbs to nearby veins to bypass damaged areas and restore the flow of lymph fluids.
This report by The Canadian Press was first published Sept. 20, 2024.
