The Morning After: Heavy Drinking and Cognitive Function

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Hangovers feel awful, but are they really such a big deal?

Most people who consume alcohol have occasionally suffered undesirable effects the morning after. Even moderate drinking can cause some hangover effect, but heavy drinking causes more burdensome symptoms. These range from headache and dehydration to nausea, fatigue, and “brain-fog.”

But aren’t these aftereffects just a minor nuisance?

Recently researchers at the University of Bath asked the same question. They engineered a study to measure the aftereffects of heavy drinking on cognitive functioning. Not only that, they hoped to quantify the costs of hangovers on the wider economy.

Measurable Decline in Executive Functioning

The scientists published their findings in the Journal of Clinical Medicine. Their subjects were thirty-five individuals between the ages of 18 and 30, all non-smokers, all of whom reported experiencing a hangover at least once in the previous month. The participants were asked to complete a series of tasks that involved core executive functioning. That is, the brain functions that we use when planning, setting goals, and making decisions. The participants’ performance was studied both in hungover and non-hungover states.

Perhaps unsurprisingly, the study found measurable impairments when participants were in a hungover state. The effects were wide-reaching and affected a number of everyday workplace tasks and functions. Decision making, switching attention from one task to another, goal setting and planning, maintaining focus, and updating information held in short-term memory were all negatively impacted. The participants made more errors, and completed the tasks more slowly and with less success, while in a hungover state.

Economic Impact of Alcohol Use

This relatively small study has broader implications, since executive functioning is obviously tied to productivity. Hangover symptoms, which are widely considered a normal part of moderate alcohol use, actually have a significant impact on productivity.

Loss of productivity is cause for concern when it comes to the workplace, and the effects are widespread. Indeed, the CDC recently estimated that the cost of excessive alcohol use was on the rise, hitting a staggering $249 billion – that’s nearly a quarter trillion dollars — in 2010. That cost estimate came from a study on binge drinking. With hangovers sometimes resulting from even drinking that could be considered moderate, the University of Bath study presents an added cause for concern. It’s estimated that, in the US, drinking costs state economies a median of $3.5 billion. That number comes from health care costs, law enforcement, and legal expense, and motor vehicle crashes as well as lost workplace productivity. And there are other costs which are more difficult to quantify. These include lowered quality of life, impact on relationships, and pain and suffering.

What Can Be Done?

Excessive alcohol use is a drain on the economy – to the tune of billions of dollars — and hangovers negatively impact both quality of life and workplace productivity.

How can we address this problem?

The answer is a matter of ongoing debate. To mitigate the economic costs, the CDC, as well as other organizations, propose a number of possible solutions. None are mutually exclusive. Alcohol is cheap and readily available, so some recommend make it more expensive or more difficult to obtain. We can also regulate the sale of alcohol more strictly. For example, the number of retail stores could be limited by number or by location. Some suggest holding retailers liable for damage done by intoxicated customers. Finally, some propose states should control alcohol sales, rather than private retailers (Imports are already taxed and regulated, but these restrictions could be tightened).

These ideas can be debated as to their cost or likely effectiveness, but implementing some would likely have an impact on the costs of excessive drinking. Another solution might be to invest in more widespread education about the broad economic impact of excessive alcohol use. Complementary to this approach, there is increasing momentum behind the idea of changing cultural norms around drinking. Most people do want to avoid hangovers, and there are some sobriety or “dry curious” movements that simply encourage people to embrace the health and emotional benefits of choosing to live a hangover-free life.

Stigma and Drinking, Stigma and Treatment

As excessive drinking becomes less taboo, its ill effects – and even the effects that most people would rather avoid, such as disturbed sleep, hangovers, illness, and impaired executive functioning – become less stigmatized. But cultural attitudes do change over time, and as the costs – both personal and economic — become studied and known, so might society’s attitude toward alcohol’s ill effects. However, stigma around seeking treatment still presents an obstacle for people who want to quit drinking. Moving toward a model of stigma-free harm reduction, combined with better educational and more widespread information, may begin to move the needle on these heavy costs.