Proceedings of the 14th Alcohol Hangover Research Group Meeting in Glasgow, UK ^†

Abstract

This proceedings summarize the presentations of the 14th Alcohol Hangover Research Group (AHRG) meeting, 11–13 April 2024 in Glasgow, UK. At this annual meeting, researchers and industry representatives discussed the current state of knowledge on the causes, consequences, and treatment of alcohol hangovers, networked, and established collaborations to conduct joint future research projects. At the 14th AHRG meeting, factors impacting the presence and severity of hangovers were discussed, such as having underlying diseases, daily diet, baseline mood and personality, new information on the pathology of the alcohol hangover, a mobile phone app to monitor alcohol consumption and hangovers, and various novel treatments.

1. Introduction

The 14th Alcohol Hangover Research Group (AHRG) meeting was held in Glasgow, UK, 11–13 April 2024, and was organized by Joris Verster (Utrecht University, The Netherlands) and Gillian Bruce (University of the West of Scotland, UK).

Joris Verster (Utrecht University, The Netherlands) opened the meeting and summarized the main activities and accomplishments of the past 14 years of the AHRG. Significant achievements of the AHRG include publishing consensus papers on best practices in hangover research [1,2], and the development of a definition for the hangover [3]. The alcohol hangover refers to the combination of negative mental and physical symptoms which can be experienced after a single episode of alcohol consumption, starting when blood alcohol concentration (BAC) approaches zero [3]. This definition has recently been adopted by the World Health Organization [4], and the alcohol hangover has been included as a separate child entity in the 11th International Classification of Diseases (ICD-11) [4]. These proceedings summarize the presentations held at the 14th AHRG meeting.

2. Personality, Mood, and Health Correlates

Sam Royle (University of Salford, UK) presented a preliminary analysis of a survey assessing the possible relationship between psychological distress and coping with hangover severity. Past research has indicated potential relationships between pain catastrophizing and both the severity of clusters of hangover symptoms [5] and overall hangover severity [6]. Observed relationships between pain catastrophizing and hangover severity may indicate broader roles of coping and psychological distress (stress, depression, anxiety, and loneliness) in relation to hangover experience. In a follow-on study, a survey was conducted with three aims: (1) to confirm the symptom clusters identified by Royle et al. [5]; (2) to explore the relationship between psychological distress and hangover symptom severity; and (3) to explore the potential mediating role of coping in hangover symptom severity. Respondents completed measures of depression, anxiety, stress, loneliness, and coping, alongside questions related to their experience of the 2019 coronavirus disease (COVID-19) pandemic, and their drinking and hangover experience in the past week.

Preliminary confirmatory factor analyses indicated that stress, depression, anxiety, and loneliness loaded onto a latent factor representing psychological distress. Split-sample exploratory/confirmatory factor analysis was used to establish an appropriate factor structure for the coping measure, with ‘maladaptive coping’ identified as a latent variable and included in further structural models. Confirmatory factor analysis was also carried out on hangover symptom ratings, and again confirmed the symptom clusters identified and previously reported by Royle et al. [5].

Structural model-based analyses were performed on data from 136 respondents who had experienced alcohol hangover in the past week. COVID-19-associated income loss, psychological distress, maladaptive coping, and hangover severity outcomes were analyzed. Neither psychological distress nor maladaptive coping were associated with the severity of hangover symptom clusters; however, both psychological distress and maladaptive coping were associated with single-item overall hangover severity, with maladaptive coping partially mediating the relationship between psychological distress and single-item hangover severity. Discrepancies between different measures of hangover severity may be due to the single-item hangover severity measure capturing a broader conceptualization of the hangover experience than selective symptom scales [7].

Agnese Merlo (Utrecht University, The Netherlands) discussed the impact of the COVID-19 pandemic on alcohol consumption and hangovers among university students in Türkiye. Previous studies highlighted the negative impact of COVID-19 lockdowns on student wellbeing and revealed that overall, there was a reduction in alcohol consumption during lockdown periods [8,9]. However, there were significant individual differences, showing both decreases (around 25% of participants) and increases in alcohol consumption (about 25% of participants). This study aimed to replicate these findings in a Turkish university student population (n = 302, aged 18–30) using a retrospective online survey [10]. Five time periods were assessed: (1) before the COVID-19 pandemic (1 January 2020–10 March 2020), the first no-lockdown period (11 March 2020–28 April 2021), (3) the lockdown period (29 April 2021–17 May 2021), (4) the second no-lockdown period (18 May 2021–31 December 2021), and (5) the third no-lockdown period (1 January 2022–December 2022). In contrast to other countries, Türkiye had only one relatively short lockdown period. The analyses revealed that alcohol consumption patterns also shifted significantly: weekly consumption, drinking days, and hangover frequency all decreased during the lockdown period, accompanied by an increase in the percentage of non-drinkers and participants reporting no hangovers. However, no changes were observed in average hangover severity.

Lydia Devenney (The Open University, UK) examined whether baseline mood and personality could predict alcohol consumption and hangover severity. To this extent, an online survey was conducted among adults in the UK and Ireland. Preliminary data from n = 643 participants was presented. A partial correlation analysis, controlling for estimated BAC, revealed no significant associations between mood and personality variables and measures of alcohol consumption or hangover severity. Further, hierarchical regression analysis indicated that baseline mood and personality were no significant predictors of either alcohol consumption or hangover severity. The analysis revealed that the number of alcoholic drinks consumed accounted for only 11% of the variance in hangover severity. Instead, subjective intoxication was the strongest predictor of hangover severity, explaining 64% of the variance. The findings support previous research showing that baseline mood and personality have no relevant impact on hangover severity [11].

Evi van Oostrom (Utrecht University, The Netherlands) discussed the impact of attaining a healthy daily diet on experiencing alcohol hangovers. Previous research has shown a direct positive relationship between attaining a healthy diet and immune fitness [12], i.e., the body’s capacity to respond to health challenges (such as infections) by activating an appropriate immune response, which is essential to maintain health and prevent and resolve disease [13]. Other studies revealed that hangover-resistant drinkers have a better overall immune fitness compared to hangover-sensitive drinkers [14], and that the magnitude of the inflammatory response to alcohol [15] and immune fitness reported on days with a hangover [16] is associated with next-day hangover severity. It was therefore hypothesized that attaining a healthy diet may reduce the chances of developing (severe) hangovers. However, up to now only a few scientific studies have been conducted to support this hypothesis. A recent study among Turkish students [10] revealed significant but modest negative correlations between attaining a healthy diet and hangover frequency. A poorer diet, assessed with the single-item Healthy Diet Scale [12], was associated with experiencing more hangovers. Another study in 13 hangover-sensitive drinkers using 24 h dietary recall records revealed that higher levels of dietary nicotinic acid and zinc were associated with experiencing less severe alcohol hangovers [17]. Examples of foods rich in nicotinic acid are those containing high levels of niacin or tryptophan such as meat, fish and poultry, avocado, peanuts, whole grains, and mushrooms. Nicotinic acid is the dietary source of NAD⁺ and NADP⁺, which are both critical in alcohol metabolism [18]. When greater amounts of nicotinic acid are available, alcohol may be metabolized faster, which can result in experiencing less severe hangovers. Examples of foods rich in zinc are meat, shellfish, and legumes such as lentils and beans. Zinc (Zn²⁺) is essential in the conversion of ethanol into acetaldehyde [19]. Thus, greater amounts of zinc may help the faster breakdown of acetaldehyde. Although promising, studies with larger sample sizes are needed to confirm these findings and further evaluate the relationships between daily diet, immune fitness, and alcohol hangover. In addition to nutrients in the regular daily diet, the extent to which the additional supplementation of nutrients on drinking occasions prevents or reduces hangovers should be evaluated. This research will contribute to the development of effective hangover treatments.

Stephanie Oskam (Utrecht University, The Netherlands) discussed the impact of having underlying diseases on alcohol consumption and experiencing hangovers. Six out of ten Americans have a chronic disease such as diabetes, asthma, or cardiovascular disease [20]. Most chronic diseases have an underlying immune-related pathology [21]. Patients with one or more underlying diseases often reported reduced immune fitness compared to healthy adults [22], along with chronic systemic inflammation [21]. Alcohol consumption can worsen these conditions [23]. In addition, alcohol can interact with the medicinal treatments of these patients, causing more severe side effects (e.g., sedation) or making the treatment less effective [24]. Therefore, it can be hypothesized that individuals with underlying diseases are more susceptible to developing hangovers after alcohol consumption, and that these hangovers may be more severe. Consequently, it is expected that individuals with underlying diseases will moderate their alcohol consumption. To further explore this, data from a survey of n = 1865 young adults (18–30 years old) with and without impaired wound healing (i.e., slow healing wounds and/or wound infection) was compared [25]. Alcohol consumption and drinking motives were assessed. The sample comprised n = 372 individuals with self-reported impaired wound healing. Surprisingly, compared to the preceding month’s alcohol consumption of the healthy control group, the self-reported impaired wound healing group reported being intoxicated significantly more often, and consuming a significantly greater amount of alcohol during the preceding month’s heaviest drinking occasion. Compared to the healthy control group, the self-reported impaired wound healing group scored significantly higher on the motive ‘drinking to cope’. The latter suggests that individuals with underlying diseases may use alcohol as a strategy to cope with the consequences of having underlying diseases. The population in most Western countries is aging [26], leading to an increase in the number of individuals with underlying diseases [20]. Given that alcohol hangovers are experienced across the lifespan [27], it is crucial to further investigate the relationship with having underlying diseases and their treatments. This largely unexplored area of research deserves significant attention in future hangover studies.

3. Assessment

Gabriel Sperrer (University of Vienna, Austria) discussed the development of an innovative phone app, designed to help alcohol consumers to monitor and reduce their alcohol consumption. The presentation emphasized the prevalence and risks of excessive alcohol consumption among young adults, noting that alcohol is a leading cause of death for men under 40, contributing to three million deaths globally each year [28]. Via the app, it is aimed to create awareness of these facts and encourage responsible drinking by offering features to track drinking habits, prevent hangovers, and understand personal consumption trends. In the app, in real-time on a night out, users can record their drinks and receive reminders to drink water. Considering an estimated BAC, and recordings of subjective intoxication, the app predicts possible next-day hangover severity. This data helps the app provide personalized warnings to avoid overconsumption. The app’s scientific foundation is robust, utilizing pharmacokinetic modeling based on the ADME framework and a three-compartment model to estimate blood alcohol concentration (BAC) accurately [29]. The app is currently under development and is being tested to optimize its reliability and validity to forecast hangover severity, thereby helping alcohol consumers to make informed drinking decisions.

4. Pathology

Analia Karadayian (University of Buenos Aires, Argentina) discussed the role of acetaldehyde and the possible protective action of n-acetyl cysteine (NAC). Aside from the liver, the brain is one of the tissues most adversely affected by the after-effects of ethanol. Many of the motor impairments and unpleasant symptoms experienced during a hangover are primarily due to alterations in neural pathways. These effects on the central nervous system arise from the disruption of macromolecules caused by an increase in the generation of oxidative species, leading to processes such as lipid peroxidation, protein carbonylation, and DNA damage [30]. Animal models have demonstrated that hangovers can have long-lasting effects on motor and affective behavior, persisting for at least 14–20 h [31,32]. Over the last two decades, the impact of alcohol hangover on the brain has been increasingly studied, with a particular focus on bioenergetic and oxidative stress. The after-effects of acute ethanol exposure are linked to an imbalance between the production of free radicals and antioxidants. This imbalance is accompanied by reductions in oxygen consumption, the inhibition of enzymatic activity in the respiratory chain complex, and declines in mitochondrial membrane potential, particularly observed in the mouse brain cortex and cerebellum [33]. Recent data indicate that most biochemical alterations due to hangover occur specifically in the mitochondria present at brain cortex synapses. Specifically, synaptic mitochondria exhibit exacerbated levels of reactive oxygen species, lipid damage, decreased enzymatic and non-enzymatic antioxidants, and mitochondrial dysfunction [34]. Indeed, acute ethanol exposure leads to mitochondrial dysfunction, characterized by the release of cytochrome c into the cytosol. This release activates caspase-9, initiating the intrinsic apoptotic pathway. Moreover, increased levels of pro-apoptotic proteins such as Bax and decreased levels of anti-apoptotic proteins such as Bcl-2 were observed at hangover onset. All together, these were in line with the activation cascades down to caspase-3 which is a key executioner of apoptosis [35]. The apoptosis induced by ethanol contributes to neurocognitive deficits during alcohol hangover, as previously documented. It is expected that the loss of neurons and the disruption of neural networks in the brain cortex are linked to impaired motor and cognitive functions.

A central theme is how ethanol metabolism and its byproducts, especially acetaldehyde, contribute to the adverse effects of hangover. Ethanol is metabolized primarily in the liver through a two-step process involving key enzymes. The first step is the conversion of ethanol to acetaldehyde by the enzyme alcohol dehydrogenase (ADH). Acetaldehyde, a highly reactive and toxic compound, is then further metabolized to acetate by the enzyme aldehyde dehydrogenase (ALDH). Acetate is eventually converted to carbon dioxide and water, which can be easily eliminated from the body. Acetaldehyde is thought to play a crucial role in the development of hangover symptoms. Due to its high reactivity, acetaldehyde can form adducts with proteins and DNA, leading to cellular damage. It also induces oxidative stress by generating reactive oxygen species (ROS) and disrupting the antioxidant defense system. This oxidative stress can damage cellular components, including lipids, proteins, and nucleic acids.

An intriguing aspect of studying acetaldehyde’s role in alcohol hangovers is the potential therapeutic application of n-acetyl cysteine (NAC). NAC is known to boost levels of glutathione, a critical antioxidant, and may help mitigate oxidative stress. Additionally, NAC can react with acetaldehyde to form less harmful adducts, potentially reducing acetaldehyde-induced toxicity [36]. This raises the question of whether NAC supplementation could effectively lower acetaldehyde levels and ameliorate hangover symptoms by forming innocuous adducts, thereby protecting the brain from oxidative damage and apoptosis. Preliminary results have shown that NAC can prevent mitochondrial dysfunction in the brain cortex at the onset of an alcohol hangover. This was evidenced by a significant restoration of oxygen consumption, mitochondrial transmembrane potential, ATP production, and the enzymatic activity of the mitochondrial respiratory complex. This novel evidence provides a comprehensive understanding of the molecular mechanisms underlying alcohol hangovers, highlighting acetaldehyde as a potential target for future therapeutics aimed at preventing or mitigating hangover effects. While these results in animal studies are promising, a recent clinical trial in humans found that NAC was not effective in preventing or reducing hangover severity [37]. More studies in humans are needed to further evaluate the possible efficacy of NAC in the treatment of the alcohol hangover.

Ann-Kathrin Stock (TU Dresden, Germany) presented data on the effects of alcohol hangover (in an experimental setting) and alcohol withdrawal (inpatient treatment setting) on white matter integrity (assessed via serum neurofilament levels) and cognitive control (assessed via the CANTAB^® test battery). The a priori hypothesis was that both acute tolerance and tolerance due to prolonged alcohol abuse should lead to increased glutamatergic excitotoxicity and the associated cognitive deficits (albeit on a much larger scale in the case of alcohol abuse, than in the case of hangovers). The results of the presented study revealed that there was a significant increase in serum markers of white matter damage during the 21-day withdrawal period of alcohol use disorder patients, which was associated with slower motor responses and lower risk-taking/delay aversion in gambling. Yet, no such effects were observed in healthy young men undergoing an experimentally induced alcohol hangover. It was concluded that the functionally relevant increase in white matter damage despite gold-standard inpatient treatment for alcohol withdrawal necessitates further investigation and the better management of withdrawal-related excitotoxicity.

5. Treatment

Emina Išerić (Utrecht University, The Netherlands) presented a literature overview of animal studies that evaluated the efficacy of potential hangover treatments. A literature search conducted on PubMed identified 29 relevant studies. The majority of the studies were conducted in the Republic of Korea, followed by China. The animals tested were mice and rats, and most experimental studies compared a treatment group with a placebo group. The primary measures of most studies were biomarkers of alcohol metabolism or biomarkers of immune functioning. In addition, some studies included tests to reflect aspects of hangover behavior, such as locomotive tests, righting reflex tests, social interaction tests, and the elevated plus-maze test. Treatments under evaluation comprised ‘natural’ ingredients (e.g., dihydromyricetin (DHM), ginseng, or Korean pear), probiotics (e.g., Lactococcus lactis), and various compounds that aim to accelerate ethanol metabolism (e.g., glutathione-enriched yeast). The studies proposed several mechanisms of action to explain why the products were thought to be effective against hangovers. Most notably, studies showed that the products accelerated the breakdown of ethanol and acetaldehyde, increased levels of alcohol dehydrogenase (ADH, accelerates the breakdown of ethanol), increased levels of aldehyde dehydrogenase (ALDH, accelerates the breakdown of acetaldehyde), or increased the levels of ethanol-metabolizing enzymes such as cytochrome P450 2E1 (CYP2E1). Thus, the products may accelerate alcohol metabolism, and thereby reduce oxidative stress, and reduce the inflammatory response associated with alcohol consumption. The extent to which these effects on biomarkers and the behavioral tests to evaluate ‘hangover behavior’ used in animal models can be translated to alcohol hangovers experienced by humans was discussed. It was concluded that, although the results of animal studies with several compounds are promising, the efficacy of these products should be evaluated via double-blind, placebo-controlled clinical trials in humans.

Maureen Zijlstra (Utrecht University, The Netherlands) evaluated the UK and Australian hangover product market [38]. A search on the online platform Amazon shows that there are many products marketed that claim to prevent or reduce alcohol hangovers. For the evaluation of the UK and Australian hangover product market, searches were conducted for ‘hangover treatment’. After removing duplicates and irrelevant products, the searches revealed n = 19 hangover products for the UK and n = 19 hangover products for Australia. Considerable differences were noted between the countries. First, only two hangover products were available in both countries. Second, vitamins (e.g., vitamin C, vitamin B6, and vitamin B12) and minerals (e.g., potassium and sodium) were popular ingredients in both countries. However, in contrast to the UK, in Australia ‘natural’ ingredients such as DHM, ginger extract, and milk thistle extract were also popular ingredients of hangover products. Third, the most common dosage forms differed between the UK (powders and tablets) and Australia (capsules and drinks). Finally, a literature search revealed no scientific support from double-blind, placebo-controlled clinical trials in humans that any of the marketed hangover products in UK or Australia is effective in preventing or reducing alcohol hangovers. Taken together, this research revealed that hangover product markets differ from country to country. Cultural differences, differences in attitudes towards alcohol consumption and hangovers, and differences in what should constitute a hangover treatment product could explain differences between countries and cultures. More research is needed to evaluate these factors and to explore and compare hangover product markets in different parts of the world.

Sean O’Neill (Toast! Supplements, USA) discussed how Toast! designed the Before You Drink Gummy’s formulation on the hypothesis that hangovers are caused by alcohol’s inflammatory effects, with alcohol metabolism playing a critical role. The Before You Drink Gummy includes substantial amounts of zinc and niacin to provide the body with the key nutrients used in metabolizing alcohol, and to counter inflammation. The product includes a blend of anti-inflammatory and anti-oxidative ingredients including matcha green tea, milk thistle, and L-cysteine. These ingredients were selected based on clinical research on their benefits for the liver or in terms of reducing the general damage caused by alcohol. Over the years, the ingredients and dosages of Before You Drink Gummy have been refined, based on ongoing scientific knowledge, consumer demands, and decisions based on the gummy format. For example, artificial sweeteners and high fructose corn syrup were eliminated from the product’s formula. Although there is individual variation, most consumers report a substantial reduction in hangover severity when taking Before You Drink Gummy, as compared to their experience without them. As a next step in the development of Before You Drink Gummy, a double-blind, placebo-controlled clinical trial is in preparation to demonstrate its efficacy and safety.

Panagiotis Nikolaou (Greece) discussed the impact of the exposure of alcoholic beverages to electromagnetic waves on alcohol hangover severity and alcohol toxicity. Electrodynamic treatment comprised a technology applying a specifically configured external electrodynamic field, generated by electronic devices, and applied to bulk quantities of alcoholic beverages post-production. The method mitigates the adverse effects of toxic substances by inducing subtle changes to their physical and chemical properties while preserving the beverage’s integrity and stability. Thus, the treatment does not change the smell and taste of the alcoholic beverage, nor its alcohol content. The method could be easily integrated with existing production processes. Informal tests in over 50 individuals revealed that participants reported fewer and milder hangover symptoms after consuming electrodynamically treated beverages. The improvements were greater if the beverages were treated for longer exposure periods. Potentially, the electrodynamic treatment method could become a groundbreaking solution for producing safer alcoholic beverages. However, much more research from double-blind, placebo-controlled studies in humans is needed to further evaluate to what extent applying the electrodynamic treatment method to alcoholic beverages is able to reduce alcohol toxicity and mitigate hangover symptoms.

Jacqueline Iversen (Sen-Jam Pharmaceutical, Huntington, NY, USA) discussed the development of SJP-001. SJP-001 is a new hangover treatment that is currently in development. The aim is to obtain FDA approval for marketing SJP-001 as an OTC drug. SJP-001 is a combination of a non-steroid anti-inflammatory drug (naproxen) and an antihistamine drug (fexofenadine). SJP-001 aims to prevent or reduce the inflammatory response to alcohol consumption and thereby prevent or reduce the next-day alcohol hangover. A pilot study examining SJP-001 (220 mg naproxen and 60 mg fexofenadine) showed a significant reduction in overall hangover severity compared to a placebo [39]. However, as the sample size of this pilot study was small, a larger double-blind, placebo-controlled clinical trial is now scheduled. The design of this clinical trial was discussed. The trial will include n = 48 participants. They will be tested on four different occasions, receiving either fexofenadine, naproxen, SJP-001, or a placebo. The treatments are to be administered before the start of alcohol consumption. Half of the subjects will receive a low dose of naproxen and fexofenadine (220 mg and 60 mg, respectively), and the other n = 24 participants will receive a high dose of naproxen and fexofenadine (440 mg and 120 mg, respectively). After a night of supervised sleep, the participants will report their next-day overall hangover severity, assessed with a single-item scale ranging from 0 (absent) to 10 (severe) [7]. As secondary outcome measures, the severity of individual hangover symptoms will be assessed. Blood samples will be taken at different timepoints during the test days to collect pharmacokinetic data on naproxen, fexofenadine, and SJP-001. In addition, saliva samples will be collected to assess biomarkers of immune functioning. The study aims to confirm the efficacy of SJP-001, provide more insight into its mechanism of action, and to help determine the appropriate dose of SJP-001 for further Phase 3 studies.

6. Discussion

During this 14th Alcohol Hangover Research group meeting, multiple aspects of the alcohol hangover were discussed. Further evidence was provided on the correlations between a person’s personality and mood with alcohol hangover symptoms, focusing on psychological distress, quality of life, and drinking behavior during lockdowns. Most research on hangovers is conducted on student populations. However, these are not representative of the general population. Given this, the importance of research on individuals with underlying diseases and the elderly was highlighted. Alcohol consumption and hangovers negatively affect health, and may compromise treatment, treatment compliance, and recovery. However, research on the impact of having hangovers in patient populations is lacking. Various lifestyle factors can improve or aggravate health. As such, it can be questioned to what extent these factors have an impact on the presence and severity of alcohol hangovers. For example, dietary nutrient intake was discussed, as a healthy diet may increase immune fitness, thereby supporting a quicker recovery from hangovers, or reducing their severity. Knowledge on the impact of specific nutrients on hangover severity may also guide the development of effective hangover treatments. New research into the pathophysiology of the alcohol hangover was discussed, including alcohol withdrawal-related excitotoxicity. Differences in alcohol metabolism, oxidative stress, and the inflammatory response to alcohol consumption interplay in the pathogenesis of the alcohol hangover. More research is needed to fully understand the pathology.

An overview of the current published animal studies on alcohol hangovers was presented that comprised studies that looked at these mechanisms and tested the effects of potential hangover treatments. Several of these proved to be promising, but their efficacy needs to be confirmed in double-blind, placebo-controlled studies in humans. Another presentation discussed a recent rat study examining the possible protective action of n-acetyl cysteine (NAC) in greater detail. The study revealed that NAC restored mitochondrial dysfunction. While being promising, clinical trials in humans have revealed that NAC is not effective in reducing hangover severity.

Hangover treatments remain popular, and a search on the Internet reveals that a variety of these products are supplements that are sold over the counter. A comparison between UK and Australian hangover products was presented, showing that vitamins and minerals are the most popular ingredients of these products. In addition, natural ingredients (e.g., herbs and plant extracts) are also popular. However, differences between the countries are evident regarding the popularity of natural ingredients, as well as the dosage forms (e.g., pills and capsules versus transdermal patches and drinks). Although marketed, no scientific evidence from double-blind, placebo-controlled studies in humans has been published demonstrating the efficacy and safety of these hangover products. At the 14th AHRG meeting, two companies presented their hangover products. Both products are currently in development and clinical trials are planned to evaluate their efficacy. The Before You Drink Gummy (Toast Supplements) is a hangover treatment that comprises a blend of anti-inflammatory and anti-oxidative ingredients including matcha green tea, milk thistle, and L-cysteine, aiming to enter the supplement market. SJP-001 (Sen-Jam Pharmaceutical) consists of a combination of the over-the-counter drugs naproxen and fexofenadine and aims to obtain FDA approval for the prevention of alcohol hangovers. Promising results from a pilot study with SJP-001 were presented, as well as the design of a newly planned clinical trial. In addition to these new treatments, alternative ways to manage and monitor alcohol consumption and prevent hangovers were presented. For example, the development of a mobile phone application to monitor alcohol consumption in real time was presented. In addition to alcohol consumption (quantity and frequency), the app also collects data on next-day hangovers and sleep, with the aim of developing an individually tailored built-in warning system which can predict (and warn the drinker in real time) about the risk of experiencing a next-day hangover and its corresponding severity. The warning system could help individuals to moderate their drinking behavior and prevent or reduce hangovers. Another interesting approach to preventing hangovers is based on changing the beverage, rather than changing a person’s drinking behavior. A technique was presented that aims to reduce alcohol toxicity, including alcohol hangovers, by treating alcoholic beverages with electromagnetic radiation. Preliminary data from rat studies are promising, and a clinical trial in humans is planned for the near future. If proven effective, this technique could potentially have a huge impact on the alcohol industry and the production of alcoholic beverages. Taken together, in various ways researchers and companies are collaborating to develop strategies and products to prevent or reduce alcohol hangovers. These combined efforts are essential as consumers wish to have a pleasant night out, including the consumption of alcohol, but also wish to wake up refreshed the next day without experiencing a hangover.