The annual outbreak of veisalgia on New Year’s Day

Descriptions of the effects of alcohol in medical literature are many and varied

hroughout 2019 I had been deferential to my low tolerance for alcohol. So, what led me to deem it polite to accept our neighbours’ New Year party invitation, but impolite to stop them filling and re-filling my glass with liqueur the colour of potassium permanganate and the kick of a horse? Sloshing drinks into someone’s glass unasked displays a vulgar extravagance, but I was weak in not yielding to the temptation of denying myself a boozy indulgence.

This means that for the first time in many years, I’ve contracted veisalgia − from the Norwegian kveis, or “uneasiness following debauchery”, and the Greek algia, for “pain” − better known as a hangover. The King James Bible is a great work of man, replete with hints and tips aimed at promoting civilised behaviour. But if only I’d read the minatory advice of Isaiah (Ch 5, verse 11), who knows about the perils of an all-day bender: “Woe unto them that rise up early in the morning, that they may follow strong drink.” Woe indeed, is my mute endorsement through the mists of a queasy languor.

Of course, the entire responsibility for my delicate state is split evenly between our neighbours – to whom resigned compliance was the only appropriate response in the face of their reckless generosity with the booze – and acetaldehyde, ox-felling concentrations of which are exacerbating my deranged physiology.

According to hangover experts Bang et al, writing in Parkinsonism and Related Disorders (2016, 22: e146‒e148), the enzyme aldehyde dehydrogenase (ALDH) acts on acetaldehyde to help maintain normal mitochondrial function and protect against neurotoxicity, implying that ALDH-boosting measures may mitigate hangover effects by reducing the availability of acetaldehyde. Bang et al tested the efficacy of a commercial anti-hangover product (KISLip, Pico Entech, South Korea) by determining whether it enhanced ALDH activity … in rats. Surprisingly, the rats weren’t loaded into a taxi and driven to a popular rodent nite-spot to be plied with festive booze. Rather, they were induced to a state of alcoholic stupor under laboratory conditions, the better to allow the researchers to conclude: “Oral intake of anti-hangover substance has significantly enhanced enzyme activities of alcohol metabolism in [a] rat model, particularly ALDH activity …”

While a drowsy Keatsian numbness pains my sense, should I risk further straining this morning’s brittle family tensions by asking a loved one to nip down to the Spar for a case of rodent compatible KISLip? No. In which case I seek some consolation by comparing my drinks intake with that of the alcoholic author of Under the Volcano (1947) Malcolm Lowry (1909‒1957). In his Malcolm Lowry: A biography (1973: p412), Douglas Day notes that in a letter to Clarisse Francillon, dated 16 February 1949, Lowry discloses: “For the last year I had averaged at least 2.5 to 3 litres of red wine a day … in Paris this had increased to about two litres of rum per day.”

With my consumption of red wine averaging, at most, three litres of red wine a year, I find my self-righteousness punctured by the realisation that I’m nonetheless included in a category that forms a significant part of the alcohol epidemiological landscape. Writing in BMC Medicine (2015, 13: 113), Bellis et al consider “Holidays, celebrations, and commiserations: Measuring drinking during feasting and fasting to improve national and individual estimates of alcohol consumption.” They note that the “prevailing culture of heavy drinking on festivals, holidays, and other special occasions, now combined with alcohol promotion that exploits such associations, means special occasion drinking is a critical component of alcohol epidemiology.”

However, more sobering than any amount of KISLip is Bellis et al’s observation that alcohol is related to over 200 different health conditions and I guess that one rarely mentioned health condition is alcohol’s ability – I can miserably confirm – to separate one’s sense of responsibility from the fun to be had by imbibing this liquid mood elevator. One outcome – with luck, I suppose – is guilt, such as that which I’m feeling at the thought of a day that I’ve largely wasted. Was it worth it to provoke a panoramic view of my neighbour’s full horseshoe of capped teeth when he laughed at my Chic Murray joke – “I went into the study, where the curtains were drawn; but everything else was real” – and was he laughing with me … or at me? And for all the twinkle-eyed tolerance that many extend to Malcolm Lowry’s prodigious alcohol intake, his biographer Douglas Day (p151) redresses the balance with Louis MacNeice’s sharp observation that Lowry was “only an unkempt waster”.

I won’t bore you with New Year resolutions, although you might guess what one of them is. Meanwhile, the coarsening and corrosive aspects of excess alcohol consumption cannot be overplayed and it’s perhaps timely that readers will have an opportunity to attend the Global Alcohol Policy Conference, “Alcohol, Equity and Global Health: The benefit of alcohol control for sustainable development for all”, which will be held from Monday 9 March 2020 to Wednesday 11 March 2020 in Dublin
www.gapc2020.org.

Best wishes for 2020.