WI tend to think of a hangover as the price of inebriation: a little bit of wellbeing borrowed from the future for the sake of a good time, at a cost to be confirmed in the morning. Studies show that commonly touted remedies – ginseng, Korean pear juice, prickly pear, clove extract – don’t do anything, which feels like justice.
But what if a hangover cure really existed? What if you could drink too much and avoid the consequences? How would that affect your evening plans?
Myrkl – a probiotic remedy developed by the Swedish company De Faire Medical – is said to be the first hangover pill that works. Articles reporting its launch have referred to it as a “hangover prevention pill” and a “scientifically backed hangover cure”.
The company’s advertising material is a bit more cautious. It refers to Myrkl (pronounced “miracle”, not “Merkel”) as a “pre‑drinking” pill. In a press release, the CEO says its purpose is to help “regular moderate drinkers to wake up feeling their best the next day”.
The pill contains a proprietary supplement intended to metabolize alcohol into carbon dioxide and water in the intestinal tract and thus reduce the amount of alcohol absorbed by the bloodstream and prevent organ damage. The company claims the pill breaks down “up to 70% of alcohol consumed within 60 minutes”. A double-blind study with 24 participants, funded by De Faire, concluded that using the pills for a week did indeed result in “a substantially lower uptake of alcohol into the blood”.
The publicity spurred by the company’s claims meant that Myrkl, which costs £30 for 30 pills, sold out before its UK launch this week. But I managed to get myself a packet and, armed with a load of booze, put the pill to the test.
The recommended dosage of Myrkl is two capsules, taken between one and 12 hours before the consumption of alcohol. Each capsule is full of powdery beige stuff – rice bran laced with a probiotic culture and vitamin B12. I take my first dose about two hours before going out.
It’s hard to gauge exactly how much alcohol one consumes at a dinner party. I tend to measure my intake by how fun I’ve been. On this occasion, I worry that I’ve shown too much restraint for the purposes of the experiment, so I drink another large glass of wine as soon as I get in. I apologize if you heard me playing the piano at 11.30pm. I can’t really play the piano.
I wake the next day in a dreadful state: my head hurts, my throat is sore and I feel as if I have barely slept. I’m so surprised by this that for a few hours I’m convinced I have Covid. How many Covid tests have been squandered in the past two years in the same spirit of denial?
By the afternoon, I feel OK, but on the strength of these initial findings I’m forced to consider the possibility that I’m immune to Myrkl.
It’s easy to define drunkenness – it’s just a measure of the alcohol in your blood – but very difficult to define a hangover. Morning-after symptoms vary widely in their nature and intensity, depending on circumstances, genetics and other factors known and unknown.
“There have been hundreds of thousands of studies done on alcohol, intoxication and consumption, but hangover research is still in its infancy,” says Dr Sally Adams, an associate professor of psychology at the University of Birmingham. “We don’t really know all of the mechanisms that contribute to hangover.”
Adams, who includes the alcohol hangover in her areas of specialist interest, is at least able to offer a definition: “A range of psychological and physical symptoms that are experienced the day after an episode of drinking … It used to be that it was ‘ heavy drinking’, but even a small amount of alcohol can give some people the symptoms.”
While it may be difficult to pinpoint when exactly a hangover ends, it begins, officially, when your blood alcohol level reaches zero. “Anything before that is still intoxication, technically,” says Adams.
Because it’s so hard to define, a hangover is also hard to measure. “Research hasn’t been really able to establish any sort of a biomarker of hangover,” says Adams (who doesn’t use a preceding article). “So, largely what’s been relied on is self-report measures: tell me on a scale of one to 10 how hungover you feel, or to what extent you have the symptoms – everything from anxiety to vomiting. That’s kind of the best we’ve got.” One commonly used questionnaire asks subjects to rate 19 symptoms, including thirst, tiredness, irritability, depression, sweating and sleep disturbance.
Adams has read the study on which Myrkl bases his claims. She found it deficient in one important respect: the word “hangover” does not appear once. “It’s a randomised, double-blind, placebo-controlled study, which are all the right things that we would want to be happening in this kind of trial,” she says. “But I don’t know how they can claim that hangover is affected by the pill when it’s not measured.”
The answer is: they don’t, quite. What the study found was that subjects who had taken the capsules for seven days prior to drinking any alcohol had “a substantial reduction of alcohol absorption into the blood” compared with those given a placebo. The idea is that you get less hungover, because ultimately you get less drunk.
I take two more capsules at about four in the afternoon. I’m staying in, so it’s possible to measure my evening intake with precision: a single bottle of beer, followed by a single bottle of wine. I know from long experience that under normal conditions this is more than sufficient to produce a hangover (and that I will have to rewatch that night’s episode of the TV series I’m halfway through).
I wake up feeling strangely fine – no headache, no sore throat, stomach more or less settled. I am plagued by a vague sense of foreboding, as if a debt I have neglected to pay is out there somewhere increasing interest. But I don’t know whether this is a symptom of a hangover or a symptom of not having one. And I don’t know if the pill is the reason I feel this way.
If the pill does turn out to be a hangover cure, it will be a first. “There’s been no convincing evidence, no compelling evidence, that anything works that you can take before you drink or after you drink,” says Adams. “I’d like to see more data, but I’m skeptical.”
Adams raises a further limitation of the Myrkl-funded study: 10 of the 24 participants were excluded from the results because the amount of alcohol ingested for the trial “did not lead to measurable relevant alcohol concentrations in the blood”. Subjects were given 0.3g of alcohol for every kilogram of their body weight. For a person who weighs 60kg (9st 6lb), that is 2.25 units. “Most UK beers are much stronger than two units a pint, so that’s not even a pint,” says Adams. In other words, this is intoxication at a level not normally associated with hangovers.
For the purposes of rigour, I’m keeping the dosage the same – one beer, one bottle of wine – although I drink them hours apart and take the pills in between. I don’t really want the last glass, but it’s science.
Once again, I feel oddly fine when I wake up the next morning – no headache, no stomach issues – although I can’t help noticing it’s 5.26am. Over the course of the day, I experience several symptoms from the hangover checklist – loss of concentration, tiredness, irritability, restlessness – but these are things I also associate with an unscheduled early start.
Myrkl’s publicity takes pains to link its product to responsible social drinking, insisting the pill is “in no way designed as an excuse to drink beyond NHS guidelines”. Dr Dawn Harper, from the TV show Embarrassing Bodies, is quoted in the company’s press release. “If you want to go out and get drunk, Myrkl would simply mean that it would take you a lot longer and cost you a lot more,” she says. “Where I see Myrkl could be relevant is for the huge number of moderate drinkers in the UK.”
But if a pill could eliminate hangovers, wouldn’t it do away with the main deterrent against the overconsumption of alcohol – the consequences? Isn’t the hangover the bedrock on which moderate social drinking is based? “The research seems to suggest that that’s not the case,” says Adams. “People go on, they drink, they have terrible hangovers – and they keep repeating this behavior. It’s not a good dig.”
Nevertheless, it’s easy to see the danger in a pill that claims to keep you from getting as drunk as you might normally. “The other thing I worry about is that people might use it to try to drive after drinking,” says Adams. None of the subjects in the study, not even in the placebo group, reached a blood alcohol level anywhere near the legal driving limit.
I drink the bottle of wine, but not the beer, because I’m out of beer. This is still a lot for a Sunday night; I’m looking forward to a few days off. I don’t know if I’ve missed out on two hangovers because of Myrkl, but I have a feeling that even if the pills are doing me no harm, they are doing me no favors, either.
Even the worst of the common hangover symptoms – dehydration, bad sleep, stomach upset – don’t fully illustrate the havoc that is taking place within you. “Some drugs have certain receptors that they bind to in the brain, but alcohol literally will interact with every neurotransmitter in your brain,” says Adams. “When you’re in a state of hangover, your brain is desperately trying to get back to some sort of equilibrium. The next day, all your neurotransmitters are trying to get back to normal. And that’s really effortful on your brain. That’s why people experience terrible anxiety, what’s been coined ‘hangxiety’.”
On the final morning, to my surprise, I feel pretty good: eager, light of mood and filled with an utterly alien sense of possessing the upper hand. This may be illusory, but it feels like a miracle, especially because I forgot to take the pills the day before. I’m afraid I can describe the results of my experiment only as hopelessly inconclusive.
I may not have a hangover, but I do have worries about drinking at levels that might require a regular remedy for the effects. Even the Myrkl-funded study begins with a few paragraphs about the dangers of alcohol. “While social drinking is commonly accepted, alcohol abuse is a serious medical and social problem,” its authors write. “Almost 3.3 million people die from alcohol abuse each year worldwide, accounting for almost 5% of all deaths.” The more you think about it, the harder it is to believe the UK has a vast population of moderate drinkers – all adhering to the NHS guideline of 14 units a week – who have only the most responsible uses in mind for a £1 hangover pill .
On the final morning, despite feeling pretty chipper, I confess to Adams that I have a certain unease about experimenting with a hangover cure. I wonder if it might be alcohol-induced anxiety. “That’s the worst thing for me,” she says. “That’s actually what stopped me drinking: I felt too anxious the next day. This research drove me to not drink any more.”