Is the hangover a disease?
The hangover is the unpleasant consequence of excessive alcohol consumption and impairs not only your physical but also your mental performance. The resulting malaise can last up to three days. So it’s no wonder that an alcohol hangover is an illness under certain circumstances. In this article we will show you when this is the case. Because whether a hangover is really an illness is not so easy to answer.
Where does the word hangover come from?
Before we approach the question of whether a hangover is a disease, let’s first look at the origin of the word “hangover”. This can be traced back to the term “catarrh”. This was introduced and spread jokingly by students in the 19th century. Behind it is an inflammation of the mucous membrane in the respiratory organs. This disease is accompanied by watery and mucous secretions. Of course, this has little to do with excessive alcohol consumption and its symptoms. However, the term has remained. The hangover is sometimes also referred to as a cat’s whine. This term comes from the time of Goethe and was derived from the word “Kotzen-Jammer”.
A difference to alcohol intoxication?
A hangover is often equated with alcohol intoxication (alcohol poisoning). This is currently the case, for example, on the German Wikipedia page. In other Wikipedia languages, however, it is often not. The equation is therefore controversial. One difference to alcohol intoxication is that typical hangover symptoms primarily occur when the body no longer contains any alcohol. That is, when the ethanol (alcohol) has already been completely metabolised. The typical alcohol hangover mainly manifests itself when you are already “sober” again. Acute alcohol poisoning, on the other hand, manifests itself in a strong and rapid reaction of the body in the form of vomiting. In extreme cases, this also requires medical attention. Such acute alcohol intoxication usually occurs before the actual and typically meant hangover symptoms appear.
The symptoms of alcohol hangover
An alcohol hangover can lead to headaches, difficulty concentrating, nausea, vomiting, fatigue, increased sweating, tiredness, muscle and stomach pain, depressive moods and general malaise several hours after the first consumption. It limits the body’s ability to perform and can therefore lead to absenteeism from work. If the mucous membrane of the stomach is severely irritated, it can lead to loss of appetite and, in extreme cases, vomiting. Motor and mental abilities also suffer from the consequences of alcohol consumption. Slight trembling, difficulty concentrating, dizziness and restlessness are common symptoms. If large amounts of alcohol are consumed, a temporary loss of memory, also known as “film break”, can be the result. The part of the brain responsible for the transfer from short-term memory to “long-term memory” is simply deactivated.
Causes of the hangover
The causes of hangovers are varied and complex. Science is not yet in agreement in many areas. Current assumptions are the following: Alcohol consumption causes dehydration of the body and a rapid withdrawal of various substances from the blood, which is called dysaquilibrium. This causes the typical headaches. When ethanol is broken down in the body, the intermediate product acetaldehyde is formed, which causes stimulation and denaturation of the body’s own proteins. If nicotine is also consumed during alcohol consumption, this can aggravate the headache. Finally, during the breakdown of alcohol, free radicals are formed, i.e. oxidative stress, which also manifests itself in the form of headaches and general malaise.
The definition of the disease
A disease exists if the normal physical or mental functions are disturbed and this disturbance is so significant that the well-being and performance are negatively affected. A subjective perception of impairment is sufficient for this. This definition makes it difficult to distinguish between a disease and a disorder of well-being.
However, the term disease is used colloquially in many situations in which there is actually no disease. It usually refers to a feeling of discomfort, which is also described with the expressions “feeling ill” or “becoming ill”.
The medical view
Medicine largely uses the above definition. According to this view, there is not only “sick” and “healthy”. No, but also various intermediate stages. In addition, from a medical point of view, a disease is only given if there is a pathological finding.
The legal view
Disease is defined differently in legal terms. According to this view, a “disease is any disturbance of the normal constitution or the normal activity of the body which can be cured, i.e. eliminated or alleviated”.
This was defined by the German Federal Supreme Court (BGH) in 1958. The problem is that this view does not cover incurable diseases, as these cannot be cured. However, this definition is not to be found in the law.
The WHO’s view
The World Health Organisation (WHO) uses a negative formulation. In their view, a disease exists when a person is not healthy. Health is a state of complete well-being, namely of a physical, mental and social nature. The mere absence of infirmities and diseases cannot be sufficient for this.
Is a hangover a disease?
Due to the different definitions, it cannot be determined uniformly whether and when alcohol intoxication is a disease. For example, the hangover is not defined as a disease by the World Health Organisation (WHO) or health insurance companies. Instead, so-called disease catalogues are used in which diseases are categorised and numbered. An example of this is the international “ICD-10” (International Statistical Classification of Diseases and Related Health Problems) used by the health insurance companies, or the newer DSM-5 of the WHO.
According to general medical observation, there must be a negative influence on performance and well-being. If you drank alcohol the day before, this does not necessarily mean that you are not feeling well. Whether your well-being is impaired is a subjective question that only you can answer. A reduction in performance usually goes hand in hand with an extensive consumption of alcohol – however, this cannot be generalised and varies from person to person. The medical view does not make the classification of a hangover as a disease dependent on a certain amount of alcohol, but on how you and others perceive your condition and your performance.
Alcohol intoxication is more quickly classified as a disease according to the definition of the Federal Supreme Court: Here, any disturbance of the normal activity and the normal condition of the body is already sufficient. The dehydration alone that accompanies the breakdown of alcohol is already a deviation from the normal physical condition and must therefore be designated as a disease in the legal sense. This was also the decision of the Frankfurt judges in 2019, because in the so-called hangover ruling of the Higher Regional Court of Frankfurt, advertising for food supplements against alcohol hangovers was prohibited. The hangover has the character of a disease and food supplements are generally not allowed to make any health-related healing promises; accordingly, advertising for them was banned.
Can I take sick leave with a hangover?
When it comes to the question of whether a hangover is an illness, for many the real crucial question behind it is whether you can take sick leave. After a long weekend, it can happen that you don’t feel fit for work on Monday morning. However, in order to stay away from work and sober up at home, you need a sick note. A doctor prescribes it for you and uses the generally applicable definition of illness as a guideline. However, he or she must also classify the illness in the “illness catalogue” for the health insurance companies, if only to be able to bill for the treatment. In Germany, this is according to the ICD-10. Since a hangover, as mentioned above, has no disease categorisation in the ICD, a doctor cannot let you take a sick leave because of a hangover.
Own assessment, important
However, it is up to his assessment how much and for how long he considers your physical capacity to be so limited that he certifies your inability to work. He can simply classify your condition in other ICD categories and “write you off sick” on the basis of symptoms such as headaches or severe malaise. However, this would not be done explicitly on the basis of a clinical picture called hangover and is detached from the case law of the Federal Supreme Court or the hangover ruling from Frankfurt. This difference is important to understand. The fact that hangover is defined as a disease in the legal sense has nothing to do with the classification of diseases by doctors and health insurers in this case. This also dispels the rumour that you can now take sick leave because of a hangover. This is a story that can easily be retold. On closer examination, however, there is no truth to this myth.
Conclusion1: Is the hangover a disease?
The question whether the hangover is a disease can be answered with “yes” and “no”. Yes, the hangover is a disease in the legal sense, due to the sometimes severe symptoms. This also means that no advertising may be made that promises to “cure” the hangover. At the same time, however, the answer is no, hangovers are not a disease. The WHO and the health insurance companies do not classify hangovers as a disease in their catalogues.
Conclusion2: Can you go on sick leave because of a hangover?
This question can also be answered with “yes” and “no”. “No”, you cannot take sick leave explicitly because of a hangover, because the disease classification described above is missing in the corresponding catalogues. Such a disease categorisation of hangover would be needed by a doctor to be able to put you on sick leave because of a hangover. At the same time, the answer is “yes”, a medical doctor can still indirectly and at his own discretion write you off sick, just because of symptoms such as headache or severe malaise.
But that means: not officially because of a “hangover”. And that means: compared to the past, nothing has changed at all due to case law (see, for example, the hangover ruling above). So going to the doctor because of a hangover remains just as unattractive as it always was. This is because the ailments caused by a hangover usually dissipate within a few hours. Accordingly, the chances are not good that a doctor will write you off sick for a day or more. At least not if you openly communicate what the probable causes of the acute malaise are. And then the question is, do you really want to spend the hours of great suffering dragging yourself to the doctor?
Disclaimer: this post appears on the one:47 After Party Drink blog. One:47 is not an anti-hangover drink and does not promise to cure a hangover. One:47’s blog covers all sorts of topics related to partying, including alcohol and drinks. One:47 itself supports normal liver function (through choline), contributes to electrolyte balance (through magnesium), helps protect cells from oxidative stress (through vitamins B2, C and zinc) and increases overall well-being the next day.