The Morning After: Heavy Drinking, Cognitive Function, and the Economic Impact of Alcohol Use

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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 a hangover, but heavy drinking causes more burdensome symptoms. These range from headache and dehydration to nausea, fatigue, and what people might call brain-fog.

But aren’t these aftereffects more of a minor inconvenience than anything else?

Recently researchers at the University of Bath in the U.K. asked the same question. To find an evidence-based answer, they decided to engineer 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 had 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. Researchers measured performance of participants in both 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 clearly tied to productivity. The data indicate that hangover symptoms, widely accepted as a typical outcome of moderate alcohol use, do indeed have a significant impact on productivity.

Loss of productivity is cause for concern when it comes to the workplace, and the effects are widespread. The Centers for Disease Control (CDC) estimate the cost of excessive alcohol use is increasing. Their data shows it costs a staggering $249 billion – that’s nearly a quarter trillion dollars – in the year 2010. That cost estimate came from a study on binge drinking, but since moderate drinking can cause hangovers, too, the University of Bath study presents an added cause for concern. It’s estimated that, in the US, drinking costs state and local economies around $3.5 billion per year. 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, such as lowered quality of life, impact on relationships, and pain and suffering.

What Can We Do?

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 of which are mutually exclusive. Alcohol is cheap and readily available. Therefore, one approach might be to make it more expensive or more difficult to obtain. To do this, we can tax and regulate alcohol sales more strictly. For example, local authorities can limit the number of retail stores could by location. Some experts suggest holding retailers liable for damage done by intoxicated customers. Finally, others propose states should control alcohol sales, rather than by private retailers. States like New Hampshire limit the sale of liquor to special Liquor and Wine Outlets. Across the country, we tax and regulate imports – but we can raise taxes and increase restrictions as a deterrent to excess.

Policymakers and members of the business community debate the cost or likely effectiveness of additional restrictions on alcohol sales. It’s clear, though, that implementing new rules would likely have an impact on the costs of excessive drinking. Investing in widespread education about the broad economic impact of excessive alcohol use is also a viable idea. Complementary to this approach, there’s increasing momentum behind the idea of changing cultural norms around drinking. Most people want to avoid hangovers, and there are some sobriety or dry curious movements – see our article on Dry January – that simply encourage people to embrace the health and emotional benefits of reducing alcohol consumption.

Education and Awareness

As excessive drinking became more common during the COVID-19 pandemic, the negative effects of alcohol consumption – and even the effects that most people would rather avoid, such as disturbed sleep, hangovers, illness and impaired executive functioning – have become less stigmatized. But cultural attitudes do change over time. Since the costs – both personal and economic – have become more widely studied and known, our overall attitude toward the negative effects of alcohol may also change. Stigma can present an obstacle for people seeking treatment. However, moving toward a model of stigma-free harm reduction – combined with increased education and awareness – may begin to move the needle on these heavy costs.

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