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“Never again!!!”

Most of us have made that promise to ourselves, at least once, the morning after the night before. And too many of us will have failed to keep it, repeating the mistake only too soon.

In The Horrible Hangover, Drs Rutherford and Fry investigate a subject which will be close to many of our hearts... and heads! Here are your hangover questions answered…

1. How quickly does alcohol affect us?

Before we understand the morning after, we need to take a look at what happens the night before.

The only sure fire way to guarantee that you don鈥檛 get a hangover is to drink in moderation

Sally Adams

“When you drink, it can take between 10 and 90 minutes for the effects to be felt, but actually alcohol exerts its effects very quickly in your blood stream,” explains Sally Adams from the University of Bath. “It crosses the blood brain barrier and pretty much interacts with every neurotransmitter in your brain.”

So we may not feel tipsy immediately, but alcohol’s impact is rapid.

2. Why does it make us do silly things?

Neurotransmitters are molecules that pass signals inside our brains and, as we’ve learned, alcohol knocks out a lot of these messages. “This is why we see such strange effects,” says Adams, “from not being able to speak to not being able to walk properly.”

Alcohol very quickly affects the neurotransmitters that control our rational thought processes and inhibitions, so quite early on we see there are changes in things such as decision making and impulsivity – “Almost after the first drink.”

3. How does our body get rid of the alcohol?

“When you take alcohol into your body it’s something that needs to be removed,” says Andrea Sella from University College London. This is the job of an enzyme that we all have in our liver, called alcohol dehydrogenase, which removes essentially two units of hydrogen from the alcohol and transforms it into a molecule called acetaldehyde. “Acetaldehyde is actually quite poisonous so it’s then very rapidly converted onwards.”

But the issue here, says Sella, is that when you drink, you tend to take in a lot more alcohol than your liver is actually able to cope with. So the alcohol can’t be processed quickly enough and the acetaldehyde builds up. “If this happens,” she says, “you will feel extremely ill indeed.”

4. Why do some people feel hangovers worse than others?

It all depends on the rate at which we can perform the process described above.

“For any individual,” says Andrea Sella, “the speed at which alcohol will be processed is determined by how much alcohol dehydrogenase you’ve got in your system” – this is genetically determined. There are some genes which change how efficient this enzyme is at clearing acetaldehyde from your liver.

Has research taught us anything else? Yes, there have been a few studies into why some individuals’ hangovers are more manageable, and the conclusion they reached was pretty straightforward: these people just don’t drink as much!

5. What are the recognised symptoms for a hangover and what causes them?

Journalist and author Adam Rogers sets out the symptoms that most of us associate with a hangover: sensitivity to light and sound, a feeling of fatigue, potentially nausea, potentially a headache, digestive issues and a general feeling of malaise.

“Why people have all those symptoms is not totally clear,” says Rogers, but “the best going theory right now is that it’s an inflammatory response.” If you test people’s blood or saliva you will find elevated levels of what are called cytokines – molecules that the body releases when we are sick, as part of a normal immune response. It’s certainly the case that a bad hangover can often feel like the ’flu.

6. Why do we get the dreaded headache?

“It’s quite likely that the hangover headache is caused by dehydration,” says Sally Adams, “but also electrolyte imbalance. It’s likely that you’ll lose a lot of water due to going to the toilet frequently but also sweating. These all contribute to the likelihood that you might experience a headache and dehydration.”

7. Why do we also feel down in the dumps?

It’s not just the physical symptoms that make us feel lousy the morning after the night before. “Unfortunately, there’s been very little research that has looked at the effects of hangover on mood,” says Adams says, but those that have, have shown that hangover leads to poorer mood and also increased anxiety. In fact, she adds, one current PhD student is investigating “hangxiety” – a handy new moniker for the effects of alcohol hangover on anxiety.

8. Do different drinks produce different hangovers?

Studies have compared the hangover effects of a clear liquor-like vodka to a brown liquor like bourbon. Vodka is just ethanol and water, but bourbon has a bunch of other things in it too: it has grain that isn’t as distilled as often as with vodka and it goes through an aging process that pulls chemicals from the wooden barrels.

“In one study,” explains Adam Rogers, “people did report that their hangovers that came from bourbon were worse than the hangovers that came from vodka. But no one knows why that would be.”

Notably too, when scientists gave the bourbon drinkers cognitive tasks to undertake, they performed just as well (or as badly) as those who drank vodka. So, although the question of whether different kinds of booze give you a different kind of hangover is a fascinating one, says Rogers, “the answer is, it probably doesn’t matter.”

9. Are there any hangover cures that actually work?

There’s a real lack of data but Sally Adams says it could be good news for the fan of the fry-up: there’s a little bit of research that suggests that one of the best things for a hangover could be bacon and eggs because they both contain amino acids that could contribute to us feeling better. But she admits that this is definitely speculative. “I’m sorry to say that at the moment, the evidence does seem to suggest the only sure fire way to guarantee that you don’t get a hangover is to drink in moderation.”

10. Why don’t we know more about the science of hangovers?

Whereas there have been tens of thousands of studies on alcohol carried out over decades, there have only been a few dozen done on hangovers. Why is that? The answer is pretty simple: “Trying to recruit for studies where you give people alcohol is much easier than when you have to recruit people to come up to the experimental labs when they’re hungover,” explains Adams.

There’s another issue too. There have been studies that have induced a hangover in people in order to observe them the next day: “But the problem is that the alcohol we can give ethically in the lab doesn’t match with what people would administer themselves on a night out, so it wouldn’t be a really good real life model of normal drinking.”