‘Beer is the reason I get up every afternoon.’
In certain cultures, an evening of heavy drinking is a regular social activity and the ill-effects suffered the following morning are accepted as an inevitable part of life. The economic cost of alcohol-related absence is frequently caused by workers experiencing symptoms of ‘hangover’. This is the term used to describe the collection of symptoms that occur in drinkers on the day following a heavy drinking session, once the ethanol has been cleared from the blood (Figure 2). Even when a hangover is not severe enough to cause absence, it may severely impair the ability of a person to function effectively in the workplace. The economic impact of alcohol-related illness is dominated by these short-term productivity deficits, with chronic alcohol-related diseases only accounting for a small proportion of this cost.
The list below shows the most reported symptoms of hangover, with the commonest first:
poor sense of well-being
anorexia (lack of appetite)
tremor (trembling hands) fatigue
Symptoms vary enormously between people and episodes, making research into this condition difficult, even without considering the ethical issues of deliberately making people ill. A variety of physiological mechanisms have been proposed that could reasonably explain the occurrence of hangovers, but without much evidence to back them up. We will consider each of the possibilities briefly.