James G. Wigmore, Forensic Toxicologist, Speaker, Author

“Woe unto them that rise up early in the morning, that they may follow strong drink” (Isaiah 5:11)

The alcohol hangover has been known since Biblical times. The correct scientific term for hangover is “veisalgia”, which comes from the Norwegian “kveis” which translates into “uneasiness following debauchery” and the Greek “algia” which means “pain”.

An excellent review of the scientific papers published on hangover is:

Weise, J.G., Shlipak, M.G., and Browner, W.S., “The Alcohol Hangover”, Annals of Internal Medicine, 132: 897-902, 2000 (WOA608U1)

In this review, a literature search was conducted on MEDLINE (1965 to 1999) and found more than 4,700 articles have studied the effects of alcohol intoxication, but only 108 have studied hangover.  I also have section on hangover in my book, which includes ten additional studies (6.08).

Hangover Symptoms

Hangover symptoms typically occur approximately 8 to 10 hours after drinking ceases.  The common symptoms of hangover are listed in the following Table.

The highest prevalence of hangovers is, not unsurprisingly, in college students.  Twenty-five percent of them reported having a hangover in the previous week and 29% reported not attending classes due to a hangover.  More the 75% of all drinkers have experienced a hangover at least once after consuming alcohol.  Interestingly, hangover also appears to be more common in light to moderate drinkers than in heavy drinkers.

The severity of hangover appears to also be increased by:

  • Lack of food consumption while drinking

  • Decreased amount of sleep while partying

  • Increased physical activity while intoxicated

  • Dehydration

  • Poor physical health

  • Consumption of alcoholic beverages which contain a high concentration of congeners (e.g. Brandy vs Vodka)

Other Adverse Effects of Hangovers

Although hangovers might seem to be trivial and merely uncomfortable, it can have substantial economic consequences.  It is estimated that the decrease in productivity and absenteeism due to hangovers costs approximately $1.4 billion a year in Canada (which one could extrapolate to a cost of $14 billion in the US).  In Finland with a population of approximately 5 million people, it is estimated that more than 1 million workdays are lost each year due to hangovers.

Hangovers can also cause an increase risk of injury and impairment of driving and piloting abilities as well as a decrease in managerial effectiveness.  If you do overindulge during the festive holiday season and miss work due to a hangover, it might be better to say to your boss than you suffered from the medical condition of “veisaglia” rather than you had a hangover!

In my next blog I will discuss the probable major cause of hangover and a sure-fire way of avoiding a hangover.


Another study relevant for the festival season is one by Walker et al 2013, (WOA106U1) titled “Half Full or Empty: Cues That Lead Wine Drinkers to Unintentionally Overpour” Epub ahead of print on 2013 Sep 12, by the Substance use and Misuse Journal.

In this study, 46 female and 27 male wine drinkers (mean age 29 years) were required to pour as much wine as they normally would for one serving under 7 different conditions.  The average volume of wine poured using a standard wine glass (10 fl oz) was 3.85 fl oz.  The amount of wine poured increased from 9-12% when the wine was poured into a wider glass, if the wine was white rather than red (the lower contrast makes it more difficult to judge the volume) and when the wine glass was held in the hand rather than on the table.  Thus, simple steps such as using narrower wine glasses and putting the wine glass on the table while pouring, may assist in reducing the volume of wine overpoured and then consumed.

Also be aware that the alcohol concentration of wine is not uniform and can vary from approximately 10% to 15% v/v alcohol – an increase in the alcohol concentration of nearly 50%!  One should always look at the alcohol content on the wine label on the bottle and adjust accordingly.