Exacerbation of Hangover Symptomology Significantly Corresponds with Heavy and Chronic Alcohol Drinking: A Pilot Study

Alcohol hangover is a combination of mental, sympathetic, and physical symptoms experienced the day after a single period of heavy drinking, starting when blood alcohol concentration approaches zero. How individual measures/domains of hangover symptomology might differ with moderate to heavy alcohol consumption and how these symptoms correlate with the drinking markers is unclear. We investigated the amount/patterns of drinking and hangover symptomology by the categories of alcohol drinking. We studied males and females in three groups: 12 heavy drinkers (HD; >15 drinks/week, 34–63 years old (y.o.)); 17 moderate drinkers (MD; 5–14 drinks/week, 21–30 y.o.); and 12 healthy controls (social/light drinkers, SD; <5 drinks/week, 25–54 y.o.). Demographics, drinking measures (Timeline followback past 90 days (TLFB90), Alcohol Use Disorders Identification Test (AUDIT)), and alcohol hangover scale (AHS) were analyzed. Average drinks/day was 5.1-times greater in HD compared to MD. Average AHS score showed moderate incapacity, and individual measures and domains of the AHS were significantly elevated in HD compared to MD. Symptoms of three domains of the AHS (mental, gastrointestinal, and sympathetic) showed domain-specific significant increase in HD. A domain-specific relation was present between AUDIT and specific measures of AHS scores in HD, specifically with the dependence symptoms. Exacerbation in hangover symptomology could be a marker of more severe alcohol use disorder.

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Updating the Definition of the Alcohol Hangover

Journal of Clinical Medicine ◽

10.3390/jcm9030823 ◽

2020 ◽

Vol 9 (3) ◽

pp. 823 ◽

Cited By ~ 15

Author(s):

Joris C. Verster ◽

Andrew Scholey ◽

Aurora J.A.E. van de Loo ◽

Sarah Benson ◽

Ann-Kathrin Stock

Keyword(s):

Blood Alcohol Concentration ◽

Heavy Drinking ◽

Physical Symptoms ◽

Time Of Day ◽

Alcohol Concentration ◽

Blood Alcohol ◽

Single Episode ◽

New Findings ◽

Alcohol Hangover ◽

Definition Of

In 2016, the Alcohol Hangover Research Group defined the alcohol hangover as “the combination of mental and physical symptoms experienced the day after a single episode of heavy drinking, starting when blood alcohol concentration (BAC) approaches zero”. In the light of new findings and evidence, we carefully reviewed the different components of that definition. Several studies demonstrated that alcohol hangovers are not limited to heavy drinking occasions. Instead, data from both student and non-student samples revealed that at a group level, alcohol hangover may occur at much lower BAC levels than previously thought. Regression analysis further revealed that for individual drinkers, the occurrence of hangovers is more likely when subjects consume more alcohol than they usually do. However, hangovers may also occur at a drinker’s usual BAC, and in some cases even at lower BAC (e.g. in case of illness). We also carefully reviewed and modified other parts of the definition. Finally, hangovers are not necessarily limited to the ‘next day’. They can start at any time of day or night, whenever BAC approaches zero after a single dinking occasion. This may also be on the same day as the drinking occasion (e.g. when drinking in, or until the morning and subsequently having a hangover in the afternoon or evening). To better reflect the new insights and sharpen the description of the concept, we hereby propose to update the definition of the alcohol hangover as follows: “The alcohol hangover refers to the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero”, and recommend to use this new definition in future hangover research.

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Perceived Immune Fitness, Individual Strength and Hangover Severity

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph17114039 ◽

2020 ◽

Vol 17 (11) ◽

pp. 4039

Author(s):

Aurora J. A. E. van de Loo ◽

Nikki Kerssemakers ◽

Andrew Scholey ◽

Johan Garssen ◽

Aletta D. Kraneveld ◽

...

Keyword(s):

Immune Status ◽

Important Determinant ◽

Blood Alcohol Concentration ◽

Heavy Drinking ◽

Alcohol Concentration ◽

Convenience Sample ◽

Single Item ◽

Checklist Individual Strength ◽

Alcohol Hangover ◽

Drinking Occasion

Various factors may contribute to alcohol hangover severity. The purpose of the current investigation was to evaluate the possible impact of alcohol consumption patterns, perceived immune status, and baseline fatigue on hangover severity. A survey was completed by a convenience sample of N = 199 Dutch students who reported on their latest past month’s heavy drinking occasion, including subjective intoxication (perceived drunkenness) and next-day hangover severity, which were rated on single-item scales ranging from 0 (absent) to 10 (extreme). In addition, perceived (momentary) immune fitness was assessed, and the Checklist Individual Strength (CIS) was completed to assess baseline fatigue. The analysis revealed that instead of the amount of alcohol consumed or estimated blood alcohol concentration, it appeared that subjective intoxication (i.e., level of drunkenness) was the most important determinant of alcohol hangover severity. Especially in men, albeit modest, it was perceived that immune fitness also significantly contributed to the level of hangover severity experienced.

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The Alcohol Hangover Research Group: Ten Years of Progress in Research on the Causes, Consequences, and Treatment of the Alcohol Hangover

Journal of Clinical Medicine ◽

10.3390/jcm9113670 ◽

2020 ◽

Vol 9 (11) ◽

pp. 3670

Author(s):

Joris C. Verster ◽

Lizanne Arnoldy ◽

Sarah Benson ◽

Andrew Scholey ◽

Ann-Kathrin Stock

Keyword(s):

Alcohol Consumption ◽

Research Group ◽

Blood Alcohol Concentration ◽

Physical Symptoms ◽

Alcohol Concentration ◽

Blood Alcohol ◽

Single Episode ◽

10Th Anniversary ◽

Recent Advances ◽

Alcohol Hangover

The alcohol hangover is defined as the combination of negative mental and physical symptoms, which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero. Here, we present the book “The alcohol hangover: causes, consequences, and treatment”, written to celebrate the 10th anniversary of the Alcohol Hangover Research Group (AHRG), summarizing recent advances in the field of alcohol hangover research.

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3376 Super Bingers: Traits and Patterns Associated with High-Intensity Drinking

Journal of Clinical and Translational Science ◽

10.1017/cts.2019.354 ◽

2019 ◽

Vol 3 (s1) ◽

pp. 154-155

Author(s):

James Keoni Morris ◽

Julia E. Swan ◽

Josh L. Gowin ◽

Melanie L. Schwandt ◽

Nancy Diazgranados ◽

...

Keyword(s):

Alcohol Use ◽

Binge Drinking ◽

High Intensity ◽

Heavy Drinking ◽

Drinking Patterns ◽

Timeline Followback ◽

Level 3 ◽

Males And Females ◽

Level 1 ◽

Level 2

OBJECTIVES/SPECIFIC AIMS: This study attempts to evaluate the drinking patterns and traits of individuals who partake in high intensity drinking, defined as binge drinking at 2 or more times the minimum binge count (4 drinks for females, 5 drinks for males). METHODS/STUDY POPULATION: We analyzed data from non-treatment seeking volunteers enrolled in NIAAA screening protocols. The sample included 706 males and 474 females ranging in age from 18 to 91. Subjects were assigned to one of four groups (Non-Binge, Level 1, Level 2, Level 3) based on the highest binge session reported in their Timeline Followback questionnaire. The criteria for each group were different for males and females based on the current NIAAA definitions of binge drinking. The cutoffs for females were 0-3 drinks for Non-Binge, 4-7 drinks for Level 1, 8-11 drinks for Level 2, and 12+ drinks for Level 3. The male drink cutoffs were 0-4, 5-9, 10-14, and 15+ respectively. We looked at various drinking measures (Timeline Followback, Self-Reported Effects of Alcohol (SRE), Alcohol Use Disorders Identification Test (AUDIT)) and trait measures (UPPS-P Impulsivity Scale, Barratt’s Impulsiveness Scale, Buss Perry Aggression Questionnaire) to identify mean differences between groups. RESULTS/ANTICIPATED RESULTS: There were significant differences in drinking patterns between the groups for both males and females. Number of drinking days, average drinks per drinking day, and number of heavy drinking days all increased as binge level increased. There were also significant differences between groups in males for trait measures. Level 2 and Level 3 bingers scored significantly higher on impulsivity and aggression than the Level 1 and Non-Binge groups. Ongoing analyses are examining differences among binge groups on other measures including SRE and AUDIT. Future analyses will explore potential mechanisms underlying the relationships between trait measures and binge drinking using structural equation modeling. DISCUSSION/SIGNIFICANCE OF IMPACT: This study found significant differences between high-intensity drinkers, or “super bingers”, and lighter binge and non-binge drinkers. Super bingers showed an overall heavier drinking pattern across measures. The elevated aggression, impulsivity, and overall heavy drinking patterns of super bingers suggest a behavioral profile that makes this group in particular at higher risk for developing alcohol use disorder and related problems. These traits and behaviors may also help identify targets for treatment interventions for alcohol use disorder.

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Sensitivity to Experiencing Alcohol Hangovers: Reconsideration of the 0.11% Blood Alcohol Concentration (BAC) Threshold for Having a Hangover

Journal of Clinical Medicine ◽

10.3390/jcm9010179 ◽

2020 ◽

Vol 9 (1) ◽

pp. 179 ◽

Cited By ~ 12

Author(s):

Joris C. Verster ◽

L. Darren Kruisselbrink ◽

Karin A. Slot ◽

Aikaterini Anogeianaki ◽

Sally Adams ◽

...

Keyword(s):

Alcohol Intake ◽

Blood Alcohol Concentration ◽

Threshold Value ◽

Alcohol Concentration ◽

Absolute Amount ◽

Blood Alcohol ◽

Higher Alcohol ◽

Lower Alcohol ◽

Alcohol Hangover ◽

Drinking Occasion

The 2010 Alcohol Hangover Research Group consensus paper defined a cutoff blood alcohol concentration (BAC) of 0.11% as a toxicological threshold indicating that sufficient alcohol had been consumed to develop a hangover. The cutoff was based on previous research and applied mostly in studies comprising student samples. Previously, we showed that sensitivity to hangovers depends on (estimated) BAC during acute intoxication, with a greater percentage of drinkers reporting hangovers at higher BAC levels. However, a substantial number of participants also reported hangovers at comparatively lower BAC levels. This calls the suitability of the 0.11% threshold into question. Recent research has shown that subjective intoxication, i.e., the level of severity of reported drunkenness, and not BAC, is the most important determinant of hangover severity. Non-student samples often have a much lower alcohol intake compared to student samples, and overall BACs often remain below 0.11%. Despite these lower BACs, many non-student participants report having a hangover, especially when their subjective intoxication levels are high. This may be the case when alcohol consumption on the drinking occasion that results in a hangover significantly exceeds their “normal” drinking level, irrespective of whether they meet the 0.11% threshold in any of these conditions. Whereas consumers may have relative tolerance to the adverse effects at their “regular” drinking level, considerably higher alcohol intake—irrespective of the absolute amount—may consequentially result in a next-day hangover. Taken together, these findings suggest that the 0.11% threshold value as a criterion for having a hangover should be abandoned.

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Sex Differences in the Presence and Severity of Alcohol Hangover Symptoms

Journal of Clinical Medicine ◽

10.3390/jcm8060867 ◽

2019 ◽

Vol 8 (6) ◽

pp. 867 ◽

Cited By ~ 12

Author(s):

van Lawick van Pabst ◽

Devenney ◽

Verster

Keyword(s):

Sex Differences ◽

Alcohol Intoxication ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Blood Alcohol ◽

Small Magnitude ◽

Severity Scores ◽

Alcohol Hangover ◽

Peak Blood ◽

Drinking Occasion

Studies have demonstrated significant sex differences in alcohol intoxication effects. In contrast, the majority of studies on the alcohol hangover phase did not investigate sex differences. Therefore, the current study examined possible sex differences in the presence and severity of alcohol hangover symptoms. Data from n = 2446 Dutch students (male = 50.7%, female = 49.3%) were analyzed. They reported the presence and severity of 22 hangover symptoms experienced after their past month heaviest drinking occasion. Subjects were categorized according to their estimated peak blood alcohol concentration (eBAC) and presence and severity of the hangover symptoms were compared between men and women. In the lowest eBAC group (0% ≤ eBAC < 0.08%), no significant sex differences were found. In the subsequent eBAC group (0.08% ≤ eBAC < 0.11%), severity of nausea was significantly higher in women than in men. In the third eBAC group (0.11% ≤ eBAC < 0.2%), women reported higher severity scores on nausea, tiredness, weakness, and dizziness than men. Men reported the presence of confusion significantly more often than women, and women reported the presence of shivering significantly more often than men. In the fourth eBAC group (0.2% ≤ eBAC < 0.3%), women reported higher severity scores on nausea and tiredness than men. In the highest eBAC group (0.3% ≤ eBAC < 0.4%), no significant sex differences were found. In conclusion, across the eBAC groups, severity scores of nausea and tiredness were higher in women than in men. However, albeit statistically significant, the observed sex differences in presence and severity of hangover symptoms were of small magnitude, and therefore, have little clinical relevance.

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2263

Journal of Clinical and Translational Science ◽

10.1017/cts.2017.123 ◽

2017 ◽

Vol 1 (S1) ◽

pp. 33-33

Author(s):

Corbin Daniel Ester ◽

Bethany Stangl ◽

Aruna Gogineni ◽

Lauren Blau ◽

Vatsalya Vatsalya ◽

...

Keyword(s):

Sex Differences ◽

Family History ◽

Alcohol Use ◽

Heavy Drinking ◽

Alcohol Expectancies ◽

Subjective Response ◽

Drinking Patterns ◽

Risky Drinking ◽

Alcohol Sensitivity ◽

Alcohol Hangover

OBJECTIVES/SPECIFIC AIMS: The current study examined hangover following IV alcohol self-administration (IV-ASA) using the Computer-Assisted Infusion System. The goal of the study was to identify predictors of hangover, including drinking history, alcohol sensitivity, family history, expectancies, and sex differences in nondependent drinkers. METHODS/STUDY POPULATION: The study sample included 89 healthy, nondependent drinkers aged 21–45 years. After a screening to exclude any medical illness or psychiatric disorders, participants completed an IV-ASA session. Each session consisted of a 25-minute priming phase, during which participants were prompted to press a button to receive individually standardized alcohol infusions, followed by a 2-hour “open bar” phase, during which they were instructed to recreate a typical drinking experience. Results from the IV-ASA included peak and average BrAC. Drinking patterns were assessed using the Alcohol Use Disorders Identification Test, which provided 3 subscales: consumption (AUDIT-C), dependence (AUDIT-D), and harmful drinking (AUDIT-H). Subjective response to alcohol was measured using the Drug Effects Questionnaire (DEQ). The Alcohol Hangover Scale (AHS) was used to assess hangover for the period between participants’ departure from the study unit and 10 am the next morning. The Alcohol Effects Questionnaire (AEFQ) is a measure which includes 40 true/false statements about how alcohol typically makes respondents feel, and was used to measure alcohol expectancies. RESULTS/ANTICIPATED RESULTS: Results showed that 78% of participants endorsed having at least 1 hangover symptom following IV-ASA. The most commonly reported items were tired, thirsty, headache, and hangover. There was no association between hangover scores and the AUDIT-C or IV-ASA. Because alcohol consumption was not related to hangover symptoms, risky drinking behavior was examined. Results indicated that participants endorsing 4 or more items on the AUDIT-D plus AUDIT-H subscales showed significantly higher average hangover scores. Linear regression analyses indicated that alcohol hangover scores were associated with DEQ items feel, high, and intoxicated. Ongoing analyses are examining additional predictors of hangover including family history, alcohol expectancies, sex differences, and other alcohol sensitivity measures. DISCUSSION/SIGNIFICANCE OF IMPACT: The results indicated that risky drinking patterns and alcohol response measures were positively associated with hangover symptoms in non-dependent drinks, while no correlation between consumption and hangover symptoms were found. Since previous research has shown than greater subjective response is associated with heavy drinking and predictive of alcohol use disorder, it is possible that hangover symptoms is a marker of this relationship. Since the role of hangover in the transition from heavy drinking to disorder still remains unclear, it will be important to characterize this relationship between alcohol sensitivity and hangover as a function of drinking patterns. This understanding may help to prevent this transition from at-risk drinking to alcohol dependent drinking.

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Homeless people under the influence of alcohol admitted to hospital emergency departments in Poland

Nordic Studies on Alcohol and Drugs ◽

10.1177/1455072520908387 ◽

2020 ◽

Vol 37 (2) ◽

pp. 190-200

Author(s):

Anna Burak ◽

Katarzyna Cierzniakowska ◽

Aleksandra Popow

Keyword(s):

Alcohol Use ◽

Emergency Departments ◽

Average Length ◽

Blood Alcohol Concentration ◽

Homeless People ◽

Medical Personnel ◽

Alcohol Concentration ◽

Blood Alcohol ◽

Hospital Emergency ◽

Hospital Emergency Departments

Aim: To assess the incidence of diagnoses related to alcohol use in the population of homeless people admitted to hospital emergency departments (EDs). Material and method: Data were analysed from three hospitals concerning stays of homeless people in three EDs in Bydgoszcz, Poland, in 2013–2015; 3133 stays were identified. The data were compiled using Microsoft Excel and Statistica 10 statistical software. Results: At the time of admission to EDs, 31% of homeless people were considered to be under the influence of alcohol. Diagnoses related to alcohol use accounted for 25% of all diagnoses. The average blood alcohol concentration in the patients was 2.97 per mille. The average blood alcohol concentration in the group of men was significantly higher than that in the group of women ( p = 0.015). The average length of stay in the ED of patients under the influence of alcohol was significantly longer ( p < 0.0001) than among sober patients. Conclusions: Homeless people under the influence of alcohol account for a third of the population of homeless patients admitted to hospital emergency departments, while alcohol-related ICD-10 diagnoses account for a fourth of all diagnoses in these patients. Homeless patients under the influence of alcohol stay longer in hospital emergency departments than do sober homeless people, which may translate into more frequent acts of aggression towards medical personnel. In Poland there are no systemic ED-level solutions as regards dealing with homeless patients for whom alcohol dependence is in many cases a reality.

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Preliminary Effectiveness of Remotely Monitored Blood Alcohol Concentration Device as Treatment Modality (Preprint)

10.2196/preprints.30186 ◽

2021 ◽

Author(s):

Frank D. Buono ◽

Colette M. Greed ◽

Martin Boldin ◽

Allison Aviles ◽

Natalie Wheeler

Keyword(s):

Alcohol Use ◽

Alcohol Use Disorder ◽

Blood Alcohol Concentration ◽

Alcohol Concentration ◽

Treatment Motivation ◽

Blood Alcohol ◽

Limited Effectiveness ◽

Long Term Treatment ◽

The Impact

UNSTRUCTURED Alcohol use disorder is a chronic disorder with a high likelihood of relapse. Consistent monitoring of blood alcohol concentration through breathalyzers is critical to identifying relapse or misuse. Smartphone applications as a replacement of, or in conjunction with breathalyzers, have shown limited effectiveness. Therefore, the purpose of this research protocol manuscript is to evaluate the usage and acceptability of a wireless blood alcohol concentration device in collaboration with a long-term treatment facility to assess increased sobriety for patients with alcohol use disorder. The randomized clinical trial will be across two arms, access to the wireless breathalyzer versus no access to the breathalyzer, while both groups have access to treatment. Evaluation will last three months with a six week-follow up, during which each participant will be interviewed at admission, 1 month in, 2 months in, 3 months in and follow-up. Outcomes will focus on the acceptability of the wireless breathalyzer within the alcohol use disorder population and the impact of quality-of-life measures and clinical features on treatment motivation. In addition, we intend to identify the participants’ experiences in relationship to their treatment satisfaction and perceived support.

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Smartphone Apps Targeting Hazardous Drinking Patterns among University Students Show Differential Subgroup Effects over 20 Weeks: Results from a Randomized, Controlled Trial

Journal of Clinical Medicine ◽

10.3390/jcm8111807 ◽

2019 ◽

Vol 8 (11) ◽

pp. 1807 ◽

Cited By ~ 2

Author(s):

Anne H. Berman ◽

Claes Andersson ◽

Mikael Gajecki ◽

Ingvar Rosendahl ◽

Kristina Sinadinovic ◽

...

Keyword(s):

University Students ◽

Controlled Trial ◽

Blood Alcohol Concentration ◽

Heavy Drinking ◽

Alcohol Concentration ◽

Drinking Patterns ◽

Smartphone Apps ◽

Excessive Drinking ◽

Positive Effects

Overconsumption of alcohol, from hazardous to excessive, heavy, and harmful levels, is common among university students. Consenting Swedish students were assigned to one of two smartphone apps offering feedback on estimated blood alcohol concentration (eBAC; Promillekoll/PartyPlanner) or assessment only (n = 2166; 1:1:1 ratio). App participants with excessive drinking according to public health criteria (>9/>14 drinks/week for women/men, respectively) at a 7 week follow-up were additionally assigned to the skills-based TeleCoach app or waitlist (n = 186; 1:1 ratio). All participants were followed at 14 and 20 weeks. At 7 weeks, Promillekoll users showed higher risk of excessive drinking (odds ratio (OR) = 1.83; p ≤ 0.01; n = 1558). Students in eBAC app groups with only hazardous use showed fewer binge drinking occasions at 14 weeks and lower eBAC levels up to 20 weeks compared to controls (n = 1157). Also, more highly motivated participants at baseline in both eBAC app groups drank less compared to controls at 7 and 20 weeks. Hidden Markov model analysis revealed a frequent-heavy drinking group (n = 146; 4.6 days/week, SD = 1.4), where those with access to TeleCoach had fewer drinking days compared to assessment-only controls (p < 0.001). eBAC apps showed positive effects up to 20 weeks, particularly for motivated students, and a skills-based app can reduce consumption for those with frequent-heavy drinking patterns.

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