Q and A, with Dr. Jason Campagna, Soma Get Fit Medical Director

Q and A,

By Jason Campagna, M.D., P.h.D.

Medical Director Soma Get Fit

Q:  “I’d like to speak with a health expert (e.g. a doctor, registered dietitian or similar source) who can answer the following: If someone is heading to a social occasion where they expect to have several alcoholic drinks, is there anything they should do — or avoid doing — beforehand to minimize the chances of becoming drunk? What steps will help reduce the post-party after-effects (e.g. a hangover or general feeling of exhaustion)? This is for a health piece in a Canadian consumer women’s magazine.”

A:  In general, there is nothing that anyone can do prior to consuming alcohol which can reliably prevent or diminish the chances of becoming ‘drunk’. The basic mechanics of alcohol consumption and the bodies response to it are fairly straight forward. All alcoholic beverages have some amount of actual alcohol in them (the proof designation). This is the dose of the alcohol. Once consumed, that dose of alcohol is broken down by pathways which are to some degree effected by how much one normally drinks. A heavy drinker can break down more alcohol per hour than a light drinker. So, in short, if someone is normally a light drinker but engages in heavy drinking, they are setting themselves up to be quite drunk in short order. The pathways that break the alcohol down in the body do this breaking down in a specific way: they ‘consume’ some constant amount of the dose each hour. Lets say you drink 100 units of alcohol in a single glass of wine. Lets also say that your body can consume about 200 units of alcohol per hour. As long as you do not exceed 200 units of alcohol per hour, you will not become drunk. Heavy drinkers can break down more units per hour, which explains why they can drink more. If a glass of wine has 100 units, but a shot of vodka has 180, then in an hour we are talking 2 glasses of wine or one shot of vodka before problems begin. This much is pretty simple and true for everyone. The major factor for any one person is how much of the dose of alcohol in a drink actually makes it into your bloodstream. Sticking with the 100 units per glass of wine for the moment. It turns out that if you have not eaten a meal in some number of hours, almost all of that dose gets taken right into the blood. So, drink 100 units, get 100 units in your blood. But, food in the stomach stops much of that absorption so that perhaps you only get 40 or 50 units into the bloodstream. In short, if you eat and drink you get less dose into the blood and can drink more.

The problems come in three ways. One was mentioned above. Someone is normally a light drinker but drinks heavily that night. Second, someone eats dinner and drinks wine but feels no effect from the wine, so keeps drinking at that pace after the meal. That person will go from absorbing 40 units of 100 (40%) to something approaching 90 units or so (90%) pretty quickly. If that person does not “slow down”, lots of alcohol hits the bloodstream and even though you may have felt okay over dinner, that changes pretty fast. The last issue comes from the dehydrating effects of alcohol. Drinking makes you urinate. This is called the diuretic effect of alcohol. The dehydration that comes from drinking can really cause someone to get drunk much faster (100 units in your blood seems like much more to the body when you lose lots of volume by urinating all night long). So, drinking even at a pace that seems okay for you, can be too much after a few hours.

The hangover part is well understood, but a real nightmare to make better! For every hangover recipe or formula we know of, there are hundreds that people of tried over the years and have faded away. The breakdown product of the alcohol in your blood is actually a toxin. This toxin also gets broken down by the body. But, at a much, much slower rate that the alcohol. The hangover effects of the alcohol are due to this toxin in the blood. In fact, the alcohol abuse drugs we prescribe to people actually just inhibit the pathways that break down that toxin so that after a few sips of alcohol, the effects of the toxin are immediate. People just feel hungover immediately! So, less drink equals better morning. Keeping hydrated is the most important thing other than limiting intake that anyone can do. Drink lots of water as you drink alcohol and drink water before going to bed. Dehydration makes the toxins effects much, much worse. So, in short, there are no good prevention steps but slowing down drinking as the night wears on and staying hydrated are absolutely required to even have a fighting chance of feeling well the next day!

This entry was written by scrawford, posted on October 21, 2009 at 12:20 pm, filed under Fitness, Food, Nutrition and tagged alcohol, health, jason campagna, SOMA GET FIT. Leave a comment or view the discussion at the permalink.