/ 21 December 2008

Hangover? Take two eels and call me in the morning

The French call it la gueule de bois, or wooden mouth. For Germans, it’s Kater, or a tomcat. Japanese know it as futsukayoi, or “two-days drunk.”

But whatever the language and wherever it takes place, a hangover is the same: headache, nausea, shaking, blurred vision, biliousness, dry mouth … the list of evils is long.

Just as lengthy is the roster of remedies for alcohol abuse that have been touted over the centuries.

In Roman times, Pliny the Elder swore by raw owls’ eggs.

In Elizabethan England, a pair of eels suffocated in wine was touted as the trick. Green frogs were an acceptable substitute for those who were out of eels.

In the 19th century, hungover chimney sweeps would sip warm milk with a teaspoon of soot added.

Look around today, and the internet has unleashed an explosion in proposed hangover fixes, from fried food and the hair of the dog to expensive formulae derived from plant extracts.

For those who wake up with a throbbing head and a mouth like a parrot’s cage, the choice seems like a life-saver — as long as they overlook the fact the “cures” are underpinned more by hope than the approval of science.

“From aspirin and bananas to Vegemite and water, internet searches present seemingly endless options for preventing or treating alcohol hangovers,” say US paediatricians Rachel Vreeman and Aaron Carroll.

“No scientific evidence, however, supports any cure or effective prevention,” they write in the latest issue of the British Medical Journal (BMJ).

In a 2005 study, doctors in Britain and The Netherlands reviewed the only trials of hangover cures that had been conducted to objective criteria.

The eight remedies tested were three drugs and four dietary supplements, as well as the fruit sugar fructose. The drugs comprised tolfenamic acid, a painkiller; a beta-blocking drug called propranolol; and tropisetron, used for nausea and vertigo.

The dietary supplements were derived from dried yeast; from a flower called borage (Borago officinalis); the globe artichoke (Cynara scolymus); and prickly pear (Opuntia ficus-indica).

Volunteers were chosen randomly and were divided into two groups, with one group taking the supposed remedy and the other taking a placebo.

The borage, the yeast and the tolfenamic acid did ease some symptoms in a number of volunteers, and a previous study found the prickly pear also made a difference. Apart from that, “no compelling evidence” could be found to describe any of these products as effective in treating or preventing a hangover.

In plain language, say experts, to avoid a hangover, do not drink or drink only in moderation and have water too, to avoid dehydration, as well as some food.

Whoever finds a cure for hangovers is clearly on the fast track to millions.

In 2004, alcohol-related absenteeism from work, due in part to hangovers, cost Britain up to £1,8-billion, according to an estimate by 10 Downing Street. But this figure does not include indirect costs such as the impact of worker performance from hangovers.

But can a cure ever be found? And — here’s an intriguing question — should we even look for one?

Edzard Ernst, a professor of complementary medicine at the Peninsula Medical School at Britain’s University of Exeter, who took part in the 2005 study, says a hangover is a simple word for a complex thing.

It comprises symptoms affecting different parts of the body, varies according to the individual and the circumstances in which the drinking occurred (for instance, a hangover headache could be exacerbated after a night in a smoky, noisy nightclub).

All this means there are many different pathological pathways — metabolic, hormonal and so on — in which genetic variations will also play a role.

Put these factors together, and it is most unlikely that a single, one-off cure is available, suggests Ernst.

“A hangover is your body telling you a message: ‘Don’t abuse me’,” said.

“If we had a foolproof cure for hangovers, we would drink more. Those of us who like their tipple, me included, would probably hesitate a bit less over the last glass.” — AFP