“I feel bad for people who don’t drink. When they wake up in the morning, that’s as good as they’re going to feel all day.” — Frank Sinatra
“I’m not saying everyone should drink, it just worked for me” – Jackie Gleason
“Alcohol doesn’t solve any problems, neither does milk”. unknown origin, but it had its own Facbook page! (1)
I’ve wanted to write about this topic for a while. As we’re facing the apex of the season’s drinking cycle, I thought it might be timely.
I write this while sipping a nice double Manhattan, straight up, of course. My hors d’ouvres included some N-acetyl cysteine (NAC) as 4X600 mg capsules. Why am I doing this? I’m seeking to reduce the amount of acetaldehyde produced as my body breaks down the alcohol I ingest. NAC reduces acetaldehyde, a toxic byproduct of alcohol metabolism, by either directly binding to it or boosting the body’s natural antioxidant, glutathione, which detoxifies it, potentially reducing hangover severity and alcohol-induced damage by lowering acetaldehyde levels and oxidative stress.
You’d think that organized medicine would pay more attention to this widespread side effect of a common recreational activity. They do have a name for that morning after symptom complex veisalgia, derived from the Norwegian word “kveis” (uneasiness after debauchery) and the Greek word “algia” (pain). Try using that term next time you have to call in.
The chemistry of the process has been pretty well studied.
Whether this stuff really works has been a matter for debate. Placebo controlled trials have shown little protection against hangover symptoms by NAC compared with placebo, although women tended to have less nausea and weakness (2). A more recent study showed similar clinical results, and measured some serum markers (sodium and 8-hydroxy-deoxyguanosine (8-OHdG), the latter a marker for oxidative stress), finding no differences between the groups (3). But those are only indirect markers of whatever effect NAC might have. It has been shown to reduce acetaldehyde following drinking (4). Acetaldehyde not only contributes to hangover systems, it is directly toxic to the liver, accounting for much of alcohol induced liver damage.
So, if we listen to “the science”, what do we hear? Simple observation is discounted in highbrow circles these days. But here on Harbal, both of us can vouch that we feel better day after drinking if we’d taken NAC. We both have Norwegian blood and certainly don’t want our debauchery followed by uneasiness. Despite the weight we give to the results of controlled clinical trials, they still don’t account for a number of variables, like drinking history, underlying conditions, body size, age, etc. So, if taking a few NAC capsules prior to a slight binge, knowing the effects might be iffy but that production of a liver toxin would be reduced, what’s to lose? You can get the stuff on Amazon for cheap (5).
If there a downside? I’ve talked to people who worry that NAC would do for us boozers what Narcan has done for heroin addicts, where an antidote to the intoxicant promotes injection of even higher doses, knowing that rescue can be had easily (6). But NAC isn’t an antidote. At best, it may tempt some to down a few extra figuring that tomorrow’s misery will be mitigated. That’s a dose-response study I haven’t seen yet.
So, how about hauling a few capsules to tonight’s party? If you have a full bottle you can share. As we Norwegians like to say:
Sköl!
And Happy New Year!!
Let Frank sing it to you https://www.youtube.com/watch?v=m121tmJzcAc
References
1. Alcohol doesn’t solve any problems, neither does milk. Facebook https://www.facebook.com/profile.php?id=100070371907952
2. Coppersmith V, Hudgins S, Stoltzfus J, Stankewicz H. The use of N-acetylcysteine in the prevention of hangover: a randomized trial. Sci Rep. 2021 Jun 28;11(1):13397. doi: 10.1038/s41598-021-92676-0. Erratum in: Sci Rep. 2021 Jul 21;11(1):15262. doi: 10.1038/s41598-021-94669-5.
3. Podobnik B, Demšar L, Šarc L, Jerin A, Osredkar J, Trontelj J, Roškar R, Brvar M. N-Acetylcysteine Ineffective in Alleviating Hangover from Binge Drinking: A Clinical Study. Toxics. 2024; 12(8):585. https://doi.org/10.3390/toxics12080585
4. Brvar M. N-acetylcysteine Reduces Acetaldehyde Levels in Binge Alcohol Drinking 6/22/23. https://clinicaltrials.gov/study/NCT05911282
5. Horbäach NAC Supplement N-Acetyl Cysteine 1200mg | 250 Powder Capsules | for Women and Men | with Natural Peppermint | Non-GMO, Gluten Free.https://www.amazon.com/Horbaach-Cysteine-Capsules-Non-GMO-Supplement/dp/B07N7R4TFB/ref=sr_1_6_pp?crid=6N7L4DGXWLKM&dib=eyJ2IjoiMSJ9.wVf8Z_CE0A775-AzB7X_r0SzvXQ57f6xcLUuxGGp1zmQLlrIk7Mpta25w60hbWcy6XO6JrBIa1aREL3kYWmaJnUJFaboG5qu0KvOhNV4B5uyieaP7HDn4sbX_du0ZbVucB_VyohSbHaSXie0Xb2qny_ZvAzrnfacHzXkvGhHRXVdJxqFK6WmIS6cxWJ2pwZTZBx3KUT_VC2hoa5JxGaeOhUs4DMFF_QyLJGdH7f_yguKJkG_oUSaQqY2hDYDlHcNEQTBX-VahaKkdKqWKli1MxE9KxiBfnfSzdQC55gcsho.SN0skEvQPatzw8eP4bjI2NwjKeJ4gL2sMzWTiioCQ00&dib_tag=se&keywords=n+acetyl+cysteine&qid=1767145088&sprefix=n+acetyl%2Caps%2C208&sr=8-6
.6. Hood J. Narcan Parties are No Longer a Dangerous Urban Myth. Healing Properties 1/25/22. https://healingproperties.org/narcan-parties-dangerous-urban-myth/
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