Sensitivity to experiencing alcohol hangovers: reconsideration of the 0.11% blood alcohol concentration (BAC) threshold for having a hangover

Joris C. Verster , L. Darren Kruisselbrink, Karin A. Slot, Aikaterini Anogeianaki, Sally Adams, Chris Alford, Lizanne Arnoldy, Elisabeth Ayre, Stephanie Balikji, Sarah Benson, Gillian Bruce, Lydia E. Devenney, Michael R. Frone, Craig Gunn, Thomas Heffernan, Kai O. Hensel, Anna Hogewoning, Sean J. Johnson, Albertine E. van Lawick van Pabst, Aurora J.A.E. van de LooMarlou Mackus, Agnese Merlo, Rene J.L. Murphy, Lauren Owen, Emily O.C. Palmer, Charmaine J.I. van Rossum, Andrew Scholey, Chantal Terpstra, Vatsalya Vatsalya, Sterre A. Vermeulen, Michelle van Wijk, Ann-Kathrin Stock

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Abstract

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.
Original languageEnglish
Article number179
Number of pages7
JournalJournal of Clinical Medicine
Volume9
Issue number1
DOIs
Publication statusPublished - 9 Jan 2020

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Alcohols
Drinking
Research
Students
Alcoholic Intoxication
Blood Alcohol Content
Alcohol Drinking
Toxicology
Consensus
Ethanol

Keywords

  • Alcohol
  • Hangover
  • Sensitivity
  • Subjective intoxication
  • Blood alcohol concentration

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Verster , Joris C. ; Kruisselbrink, L. Darren ; Slot, Karin A. ; Anogeianaki, Aikaterini ; Adams, Sally ; Alford, Chris ; Arnoldy, Lizanne ; Ayre, Elisabeth ; Balikji, Stephanie ; Benson, Sarah ; Bruce, Gillian ; Devenney, Lydia E. ; Frone, Michael R. ; Gunn, Craig ; Heffernan, Thomas ; Hensel, Kai O. ; Hogewoning, Anna ; Johnson, Sean J. ; van Lawick van Pabst, Albertine E. ; van de Loo, Aurora J.A.E. ; Mackus, Marlou ; Merlo, Agnese ; Murphy, Rene J.L. ; Owen, Lauren ; Palmer, Emily O.C. ; van Rossum, Charmaine J.I. ; Scholey, Andrew ; Terpstra, Chantal ; Vatsalya, Vatsalya ; Vermeulen, Sterre A. ; van Wijk, Michelle ; Stock, Ann-Kathrin. / Sensitivity to experiencing alcohol hangovers : reconsideration of the 0.11% blood alcohol concentration (BAC) threshold for having a hangover. In: Journal of Clinical Medicine. 2020 ; Vol. 9, No. 1.
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abstract = "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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Verster , JC, Kruisselbrink, LD, Slot, KA, Anogeianaki, A, Adams, S, Alford, C, Arnoldy, L, Ayre, E, Balikji, S, Benson, S, Bruce, G, Devenney, LE, Frone, MR, Gunn, C, Heffernan, T, Hensel, KO, Hogewoning, A, Johnson, SJ, van Lawick van Pabst, AE, van de Loo, AJAE, Mackus, M, Merlo, A, Murphy, RJL, Owen, L, Palmer, EOC, van Rossum, CJI, Scholey, A, Terpstra, C, Vatsalya, V, Vermeulen, SA, van Wijk, M & Stock, A-K 2020, 'Sensitivity to experiencing alcohol hangovers: reconsideration of the 0.11% blood alcohol concentration (BAC) threshold for having a hangover', Journal of Clinical Medicine, vol. 9, no. 1, 179. https://doi.org/10.3390/jcm9010179

Sensitivity to experiencing alcohol hangovers : reconsideration of the 0.11% blood alcohol concentration (BAC) threshold for having a hangover. / Verster , Joris C.; Kruisselbrink, L. Darren; Slot, Karin A.; Anogeianaki, Aikaterini; Adams, Sally; Alford, Chris; Arnoldy, Lizanne; Ayre, Elisabeth; Balikji, Stephanie; Benson, Sarah; Bruce, Gillian; Devenney, Lydia E.; Frone, Michael R.; Gunn, Craig; Heffernan, Thomas ; Hensel, Kai O.; Hogewoning, Anna; Johnson, Sean J.; van Lawick van Pabst, Albertine E.; van de Loo, Aurora J.A.E.; Mackus, Marlou; Merlo, Agnese; Murphy, Rene J.L.; Owen, Lauren; Palmer, Emily O.C.; van Rossum, Charmaine J.I.; Scholey, Andrew; Terpstra, Chantal; Vatsalya, Vatsalya; Vermeulen, Sterre A.; van Wijk, Michelle; Stock, Ann-Kathrin.

In: Journal of Clinical Medicine, Vol. 9, No. 1, 179, 09.01.2020.

Research output: Contribution to journalArticle

TY - JOUR

T1 - Sensitivity to experiencing alcohol hangovers

T2 - reconsideration of the 0.11% blood alcohol concentration (BAC) threshold for having a hangover

AU - Verster , Joris C.

AU - Kruisselbrink, L. Darren

AU - Slot, Karin A.

AU - Anogeianaki, Aikaterini

AU - Adams, Sally

AU - Alford, Chris

AU - Arnoldy, Lizanne

AU - Ayre, Elisabeth

AU - Balikji, Stephanie

AU - Benson, Sarah

AU - Bruce, Gillian

AU - Devenney, Lydia E.

AU - Frone, Michael R.

AU - Gunn, Craig

AU - Heffernan, Thomas

AU - Hensel, Kai O.

AU - Hogewoning, Anna

AU - Johnson, Sean J.

AU - van Lawick van Pabst, Albertine E.

AU - van de Loo, Aurora J.A.E.

AU - Mackus, Marlou

AU - Merlo, Agnese

AU - Murphy, Rene J.L.

AU - Owen, Lauren

AU - Palmer, Emily O.C.

AU - van Rossum, Charmaine J.I.

AU - Scholey, Andrew

AU - Terpstra, Chantal

AU - Vatsalya, Vatsalya

AU - Vermeulen, Sterre A.

AU - van Wijk, Michelle

AU - Stock, Ann-Kathrin

PY - 2020/1/9

Y1 - 2020/1/9

N2 - 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.

AB - 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.

KW - Alcohol

KW - Hangover

KW - Sensitivity

KW - Subjective intoxication

KW - Blood alcohol concentration

U2 - 10.3390/jcm9010179

DO - 10.3390/jcm9010179

M3 - Article

VL - 9

JO - Journal of Clinical Medicine

JF - Journal of Clinical Medicine

SN - 2077-0383

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