Drugs and Alcohol, the Real Orientation

by Steven J. Owens (unless otherwise attributed)

Let's start with a disclaimer, so some idiot doesn't read this and then do something stupid and tell his or her parents to sue me:

I am neither a lawyer, a doctor, a parental figure, or in any way, shape or form qualified to instruct young'un's about life and moral character. If you're looking here for moral guidance, you've come to the wrong place. The following is meant for competent adults to read to amuse themselves and fill an empty quarter-hour. Anybody taking medical advice from me should start by taking my advice to go have their head examined.

If you're under age, you shouldn't drink -- in fact you just turn right around and head back to disney.com, mister! (You shouldn't smoke, either - did you know that something like 95% of "new" smokers each generation start smoking as kids? In other words, once you grow up a little, you realize what a stupid hobby it is, so you don't start. Also, guess what - smoking before you're fully grown makes you shorter, dumbass!)

Now seriously, while I think underage drinking laws in my country are a little bit uptight and counter-productive (Europe has both a tradition of letting people drink at younger ages than the US, and a lower incident of underage alcohol abuse; coincidence?), as a good citizen I'm going to save my acts of civil disobedience for things that really matter, like wars and suspension of habeas corpus and illegal, warrantless wiretaps conducted on a vast scale by the NSA at the explicit order of the President.

Also, I'm not going to address emergency situations here - I'm not qualified, and neither are you. If you're worried that a friend may have over-consumed to the point of danger, then get them to an Emergency Room or other medical help or call 911, right fucking now. Believe me, how stupid you'll feel while talking to the ER doctor is nothing compared to how you'll feel when explaining what happened at you friend's funeral.

But, meanwhile, nobody tells young people the simple facts of life when it comes to recreational drug abuse (and yes, alcohol is a drug). This is not only stupid, it's dangerous - some fairly innocuous things turn out to be dangerouss, like: taking an acetaminophen pain reliever (like Tylenol(tm)) with alcohol can kill you. So here are some basics:

Be Smart

First, welcome to adulthood. Now you're legally allowed to do things that can maim or kill yourself and adults aren't obligated to stop you. So pay attention to what you're doing and don't assume; find out for yourself.

All of the following assumes that you're not as dumb as a rock and therefore you made sure you have somebody else to drive you home. I shouldn't have to actually say this, but hope springs eternal, and so does youthful stupidity, so: don't drink and drive.

The rules of thumb below are just that, rules of thumb. None of them are guaranteed to keep you out of trouble if you're determined to get yourself into it. Most of them (the consumption-oriented rules) are irrelevant if you're just having a beer at a picnic or something. And "having a beer at a picnic" doesn't mean a couple of six-packs. Pay attention. Keep track. Learn how your body reacts to alcohol. Act accordingly.

Rules of Thumb

Here are a bunch of rules of thumb. I'll list them, then try to explain them:

  • a spoonful of sugar makes the medicine go down
  • beer before liquor, never sicker; liquor before beer, never fear
  • never mix the grape and the grain
  • cheap booze tends to mean worse hangovers
  • make a plan before you get fucked up; don't change it when you're fucked up
  • stop the world, I want to get off
  • try to bring a zoo-keeper
  • if you wake up and feel great, be afraid, be very afraid
  • never never never mix alcohol and other drugs
  • never never never take Tylenol while drunk
  • don't get stoned when you're drunk
  • don't smoke dope when you're stoned
  • always hydrate; before, during, after drinking
  • a drunken stupor is not sleep
  • never drink on an empty stomach
  • don't buy illegal substances from strangers
  • nothing is free

    A Spoonful of Sugar Makes the Medicine Go Down

    Generally speaking, a single serving of beer (12oz), wine (6oz) or liquor (1.5oz) has the same amount of alcohol. This is important to remember - a drink is a drink is a drink - but that's not all there is to it. The volume difference and the mixers - especially sugary mixers - can have a real effect on your pacing; your pacing is what determines how much alcohol gets into your stomach, how fast, which determines how fucked up you get and how quickly you get there; and how fucked up you are determines how likely you are to fuck something up - usually starting with drinking even more when you should be slowing down.

    Beware of front-loading, especially with sugary drinks, because they can be quite easy to chug, and the sugar can speed the alcohol into your digestive system. (Diet soda mixers, on the other hand, actually magnify the impact of alcohol, according to some for-real medical sites I've read).

    It's quite possible to suck down six Long Island Iced Teas, one after other, and get two blocks down the street before the darkness rises up and grabs you. Then you get to spend the next day listening to your friends say things like "I can't believe what you said to her last night!" and saying "What did I say? What?"

    Don't try to "catch up", it's too easy to mis-gauge the front-loading, and that leads to un-fun situations.

    Speaking of front-loading, this can be another variation on "don't drink and drive" - don't pound back a couple more shots and then hop in the car to race home before the alcohol takes effect. It's still stupid, and taking the chance of getting the timing wrong is just as illegal as being drunk when you get behind the wheel. You can get pulled over and arrested while still relatively sober, stuck in a jail cell and tested for blood alcohol level half an hour later, when the full force of those shots is in your veins, and you're still on the hook for DUI. The judge will not be amused.

    Note: All Beers Are Not Created Equal. What I wrote above (a drink is a drink etc) is generally true, but these days there are a lot more microbrews on the market. Besides the fact that most of them taste better, some of them also have very high alcohol levels (for beer). While typical mainstream piss has 3% to 5% alcohol, a microbrew can have 9% or even higher. Use your brain.

    Beer Before Liquor, Never Sicker; Liquor Before Beer, Never Fear

    The stronger alcohol is, the easier it is to fuck up on the amount of alcohol you're consuming.

    Note: The rhyme makes it easier to remember, but "never fear" is always bullshit when it comes to drugs (yes, alcohol is a drug).

    I've seen a few different articles where people claim it's the carbonation making the alcohol get absorbed faster, and other articles claiming there's no medical basis for this saying at all. The reality as far as I know is, it has nothing to do with physiology or biochemistry and everything to do with artificial stupidity.

    See my comments on pacing, above; if you start off with beer and get drunk, now is not the time to switch gears to the trickier-to-regulate strong alcohol. Start playing with stronger booze, and by that time your discretion and judgement will be fucked, your rate of consumption will out of control, and before you know it you'll be puking your guts out.

    Oh, and speaking of puking; puking is your body's way of letting you know you fucked up. If you feel a need to puke, then do it; your body needs to get rid of the alcohol before it hurts you worse. Yes, your friends will laugh at you. If you don't like that, don't fuck up next time.

    If your friend starts puking, especially at the end of a long night of drinking, don't just point and laugh (though you should make sure to make fun of him for fucking up; just do it later, like the next time he heads out to do some drinking). Make sure he's okay; make sure he doesn't choke on his own vomit (you really don't want to be explaining this one at his funeral).

    If you're feeling nice (or if you have to share a ride home with him or her) try to hold their hair out of the way while they're puking, and get them some water to rinse their mouth out, afterward.

    Never Mix The Grape And The Grain

    This means "don't mix drinking wine (grape-derived) and drinking beer or whiskey (grain derived)." Mixing is generally considered to be a good way to make sure you'll be puking at some point later in the night. This is generally true - the more variety in what you drink in a given session, the more you're likely to run into problems. Brandy, for example, is fruit-based, but I'd lump it in with the "grape" category.

    I'm not sure of the basis for this one; I can only assume it's either about the interactions of sugary fruit-based alcohols vs. non-sugary grain-based alcohols, or it may be that the different congeners and other contaminants (sulfites in wine, for example) interact to make the overall effect worse. Or maybe it's just that it makes it too hard to keep track and keep your consumption under control.

    Cheap Booze Tends To Mean Worse Hangovers

    Remember what I said about congeners? They tend to be worse in cheaper booze, primarily because of the same reasons the booze is cheaper - cheaper ingredients, cheaper quality control in the production process which leads to more of the contaminants that lead to worse hangovers.

    Also, older booze (if not stored properly) tends to oxidate and break down to produce extra acetaldehyde, one of the chief byproducts of your body's normal alcohol-metabolizing process, and also one of the causes of hangover effects.

    This article gets into the chemistry pretty well:

    http://weeklywire.com/ww/01-04-99/tw_chow.html

    More on hangovers at the end, in the section titled Oh My God I Drank What?.

    Make A Plan *Before* You Get Fucked Up; Don't Change It *When* You'e Fucked Up

    Do I really have to explain this?

    Stop The World, I Want to Get Off

    There's an old joke "If the world is spinning and your palms and armpits are bleeding, you're not using twist-offs". Spins are a sign that you're definitely well-intoxicated.

    Obviously at this point you don't need more alcohol; you may want to keep your current drink handy and pretend sip at it, just to keep somebody else from bringing you another drink.

    At this point you might want to take a nap or (if you're home now) go to sleep. Don't. The world will keep spinning and you'll wake up (if you're lucky) in a pool of vomit. If you do find yourself drifting off, make sure you're not face-up, so at least you won't choke on your own vomit. You may want to drag a wastebasket over next to you, in case you wake up vomiting.

    My personal rule of thumb is, if the world is spinning and I can't stop it without seriously concentrating, then it's not time to go to sleep yet. Stay up, drink water, eat bread, walk around to stay awake if necessary. Wait for the spins to die down.

    Eating bread isn't going to actually "fix" the alcohol, but it will both give your stomach something to work on and help settle it down; if there's alcohol still in your stomach the bread will absorb the alcohol and slow down your digestion of the alcohol. This won't sober you up, it'll just stretch out the drunkeness over a longer period of time. Liquids (soup, water, etc) don't help much for this but they do help fight off dehydration, which is ongoing as your body tries to flush the poison (alcohol) out of your system.

    If the world is spinning and I can't stop it no matter how hard I try, it's is a pretty good sign that I've been stupid. If you were that stupid, you may have been even stupider and front-loaded, so it may be a good idea to skip the bread for now and first try to vomit up any undigested alcohol that's still in your stomach.

    Be careful with this, though, don't force yourself to vomit, apparently you can hurt yourself. You can also hurt yourself by forcing yourself not to vomit, by the by, so don't be so fucking macho. Besides, if your body wants to get rid of something that badly, maybe you should listen.

    Try To Bring A Zoo-Keeper

    Obviously you have a designated driver. If you're lucky, he's got his shit together and will also act as zoo-keeper, keeping you and your friends from doing stupid things.

    In general, if there's a problem situation - either you or somebody else - don't fuck around, get a sober person involved. You are, by definition, impaired, therefore your judgement is fucked, therefore get somebody whose judgement isn't fucked.

    Besides, it'll sound better when the police arrive.

    Never Never Never Mix Alcohol And Other Drugs

    In general, mixing drugs is a stupid idea. Mixing prescription drugs and alcohol is stupid. Mixing illegal drugs and alcohol is stupid, hell, mixing Tylenol and alcohol is stupid (see below).

    If You Wake Up And Feel Great, Be Afraid, Be Very Afraid

    The easiest way to avoid a hangover is to stay drunk, and that's probably just what you've done. You may also be sober but just on the cliff-edge of the hangover. Doing anything that affects the balance of hydration in your body - eating food, for example - may push you right over the edge into a killer hangover.

    The best thing you can do at this point is get somebody to deliver you some takeout chinese food, rent some videos, drink a lot of water or gatorade (I recommend mixing half water and half gatorade) and expect to spend the next several hours on the couch in misery.

    Never Never Never Take Tylenol While Drunk

    The active ingredient in Tylenol is acetaminophen. Taking acetaminophen and alcohol at the same time can kill you by destroying your liver. And that's if you're lucky. If not, it won't kill you, you'll just have to shit in a bag for the rest of your life.

    Hell, do some googling on this and you'll come up with some really scary information. One site said it takes five days for alcohol to fully metabolize and leave the liver, and longer for acetaminophen. So avoid taking it even after you've sobered up the next day.

    http://www.propublica.org/article/tylenol-mcneil-fda-use-only-as-directed

    Always Hydrate; Before, During, After Drinking

    Heading out to drink in a dehydrated state is a sure recipe for misery. Drink water. If you're out drinking and you're starting to feel dry-mouthed, drink more water. When you decide you've had enough alcohol, drink some more water. When you get home from drinking, drink even more water. Make sure you have water next to your bed for when you wake up (I like to keep a one-liter squeeze bottle by my bed in general, because I tend to wake up thirsty even when I haven't been drinking).

    A Drunken Stupor Is Not Sleep

    You can fall over into your bed, drunk, sleep for twelve hours and wake up exhausted. Sleep is complex and I won't go into what meager knowledge I have of it here, but just plan ahead.

    Never Drink On An Empty Stomach

    Drinking a glass of milk or whatever other stupid ideas won't keep you from getting drunk, but it is definitely a good idea to start the night with some solid food. If you can't do that, then order some bar food while you're drinking. If you drink on an empty stomach the alcohol will rush straight to your bloodstream and you'll get seriously drunk - and likely you won't realize it's happening until you've already sucked down several drinks, and you're front-loaded.

    Don't Get Stoned When You're Drunk

    Naturally I don't advocate illegal drug use, yadda yadda yadda.

    But, in the eventuality that you're already drunk and somebody offers you a joint, give it a pass. Here's the thing... remember what I said about "spins" up above? Being stoned doesn't make the spins worse, it just makes you stop caring about them... and you'll be throwing up pretty soon after.

    Don't Smoke Dope When You're Stoned

    It doesn't make you more high, it just burns up your dope. In some rare cases high-test dope may make you higher, but believe me, you don't wanna go there unless you know what you're doing.

    Don't Buy Illegal Substances From Strangers

    Let me put it this way... would you take a prescription drug because some random idiot suggested it? Whine all you want about the FDA keeping the secret cure for cancer off the market, but the simple fact of the matter is that we take the quality and reliability of our legal drugs for granted, thanks to the excellent job the FDA does. Make damn sure you know and trust the source -- both their integrity and their competence -- before putting a substance in your body.

    There Is No Such Thing As A Casual Heroin User

    This goes for a lot of other drugs too, of course. It's kind of mind-boggling that people even try heroin, or crack, etc, unless they're just flat out suicidal. My only guess is that it's sheer ignorance. Hence this article.

    Nothing Is Free

    When somebody hands you something that has consequences - particularly if it's going to put you in a vulnerable state - think about why they're doing it.

    To quote what a friend's mother told her in her early teens: "If older people want to give you drugs; think about why they aren't hanging out with people their own age..."

    Driving With Drunks

    If you're the Designated Driver, my hat's off to you. Next time you're not driving, I'll buy you a drink. Here are a couple tips to make your life easier:

    Avoid the Drunk Rush Hour

    Just because you're sober and in control of your vehicle doesn't mean that other asshole is. So avoid the "rush hour" of drunks heading home at closing time. When exactly this is depends on where you live; when I was in college the law required bars to stop serving at 2am and clear the patrons out of the place by 2:30am. Most bars stopped serving at ten minutes till two. Some bars kicked everyone out promptly at 2:00am, others let people drag their feet till 2:25am.

    So I made a habit of either getting on the road early enough to get home before the drunks got to their cars, or finding a way to kill time (all night diners are good for this) for an hour or two so the drunks had a chance to get home and off the road.

    Pay Attention!

    In general, you're not just designated driver, you're also usually the zoo-keeper. Think of yourself as a combination of a sheepdog and a Secret Service agent (and kindergarten teacher). Your job is to both herd your collection of drunks and to keep an eye out for possible risks or obstacles.

    Plan ahead; pick out a rally point where you'll all meet when it's time to leave, and pick a time to leave. When it's getting towards that time, start looking around and make sure everybody's more or less in sight

    If you can, plan ahead and figure out who's best equipped to manage your other drunks and put them in charge. That usually means whoever's the best combination of least-drunk, and most-competent. If you have to, figure that out when it's time to head out.

    Shut the Fuck Up

    Be extra attentive while driving. First, there may be drunks on the road, second, there's a tendency to be distracted by the drunks in your car. Be laid back; you don't want to work yourself into a frenzy and you don't want to get into the antics yourself.

    Don't be shy about telling people to shut the fuck up if they're distracting you, particularly if they're drunk (subtle hints don't tend to work on fucked up people). If they won't shut the fuck up or stop playing grabass, don't be shy about pulling over until you get things calmed down.

    Hopefully your drunk manager will take the hint and do any yelling necessary, leaving you free to concentrate on watching out for drunk drivers.

    Keep the Windows Rolled Down

    If you're at all uncertain about the drunkeness level of your riders, keep the windows rolled down during the ride. First, the fresh air may help them avoid losing it. Second, if they do lose it and can't manage to wait until you've pulled over, you want them to be able to just lean out the window and vomit. Washing puke off your car door is a lot better than washing it off your floors and seats.

    If one of your riders has a problem, check for other vehicles and pedestrians first, then pull over as quickly-but-smoothly as you can, park the car and get the door open so they can lean over and vomit. If they have long hair, make sure somebody holds it out of the way, unless you feel like driving the rest of the way home with even more vomit smell in your car.

    People Are Different

    Some people are really obvious drunks, some people are sneaky drunks. I've had intelligent conversations with people I would swear are only mildly drunk, until I found out the next day they couldn't remember how their door key got snapped in two the night before.

    So don't take it for granted that unslurred words and a steady gait means they're sober.

    Also, be wary of riders who may be front-loaded - they may get out the door of the bar and into the car just fine, then lose it on the way home.

    Sobering Up

    I didn't put this in the first version of this article, because I thought it was too obvious. Then I remembered that they took sex education out of the schools and realized nothing is too obvious.

    Contrary to any bullshit you may have heard, time is the only cure. There is no way to sober up a drunk faster than just letting his body process out all of the alcohol.

    Drinking coffee doesn't help - now you just have an alert drunk.

    Drinking water won't help sober them up, but it might be a good idea anyway.

    Walking around doesn't help.

    Eating doesn't help sober somebody up, although it might be helpful in slowing down the alcohol getting from their stomach into their bloodstream. This is sometimes useful, for example if they front-loaded several drinks and then you realized they were already drunker than you want to deal with.

    Note: This is NOT NOT NOT a treatment for a dangerously drunk victim. Alcohol poisoning is a very real risk and not something you should try to fix with folk remedies.

    Also, if you realize you're already too drunk and you just pounded down several drinks, it might be worth trying to make yourself vomit up the drinks so the alcohol doesn't go into your body. Be careful - trying too hard to vomit (or trying too hard not to vomit) can be harmful.

    Oh My God. I Drank What?

    A hangover is a number of different things, all of them generally miserable. Two of the biggest are a dehydration headache and nausea.

    The nausea can come from an abused stomach lining. Low blood sugar can be another factor, and vitamin depletion, and other contaminants: congeners, most common in dark liquors; some people say the sulfites in wine, though the scientists say that's unproven.

    I'm going to boil this down here and then explain in detail below:

    One, drink lots of water, before, during and after. Especially be careful not to start a night of drinking already dehydrated, that'll really hurt.

    Two, DO NOT TAKE acetaminophen (Tylenol). See the section above on Tylenol.

    Three, the morning after, get some rehydrating done before you eat.

    Four, have a small snack right off the bat, because your blood sugar is probably low, but keep it small because of rule 3.

    Dehydration

    Dehydration is pretty obvious. Most of the alcohol you consume gets broken down into acetaldehyde and your body gets rid of most of the acetaldehyde by flushing it away in your urine, which is why we have the old saying "remember, you're only renting the beer..."

    The best way to deal with dehydration is to not get dehydrated.

    The second best way is to rehydrate as fast as possible.

    Drink water. Before you go out drinking, while you're drinking, before you go to bed when you get home, before you do anything else when you wake up.

    Common advice is to alternate water and alcohol when you're drinking, and of course drink some water when you get home, and drink some water immediately when you get up.

    It's a REALLY good idea to make sure you're not dehydrated BEFORE you go out drinking - some of the most memorable hangovers I've ever had were from a fairly mild night of drinking, when I had allowed myself to get dehydrated during the day (hot weather, exercise, etc).

    Similarly, it's not how drunk you get, it's how much alcohol you drink. You can drink mildly all afternoon and late into the night, never getting really beyond "one beer drunk", and still earn yourself a killer hangover the next day (especially if it's a summer afternoon and you're sweating a lot as well as drinking).

    When you first wake up, do NOT consume a lot of food before you hydrate. Your body uses a lot of water to digest food, and it has to pull that water from the rest of your body. That can easily turn a slight hangover into a bad hangover.

    Having said that, your blood sugar is probably low, so it's not a bad idea to eat something (pop tarts, whatever), just don't make it a big meal before you make some progress on rehydrating.

    A lot of people find that slightly sugary drinks (typically 6% is enough - watered down sports drink is a good way to do this) make it easier to rehydrate because drinking lots of water tends to make them urinate more often. However, bear in mind that the morning after your body needs to both replace lost water and to flush away the acetaldehyde. So urinating more often is a good thing.

    Other Symptoms, Hangover Food and Other Stuff

    A hangover can make you feel hot while you're actually chilled. You may sweat a lot (especially in the hangover phase). Don't throw off the covers, pile them on. If you let yourself get cold, it can make the other symptoms worse.

    There's not much you can do about the abused stomach lining, but the nausea also might be caused by low blood sugar, in which case eating food might actually help reduce it.

    Eggs are a really good idea. They contain a lot of cysteine, which helps counteract the acetaldehyde. A big omelet full of cheese and whatever else is a pretty good hangover breakfast.

    While drunken or hungover you'll tend to want to eat fatty, greasy food. Greasy hamburgers or pizza or late night breakfast at the diner are popular choices when you're actually out out drinking. Grilled cheese sandwiches are popular morning-after breakfasts. There's no evidence that fatty foods are better for a hangover, but then again it's calorie-dense without being a really large meal, so it might not be the worst idea.

    Some sites I've read blame this booze-induced fat craving on on galanin. Booze makes your body produce more galanin, galanin increases appetite for fats. You might plan ahead and eat a couple handfuls of nuts - peanuts, almonds, cashews walnuts, trail mix, whatever - before you go out, to preempt this fat craving. Or do it after you get home, so you're not craving so much in the morning.

    Vitamin depletion is probably not a major factor in hangovers, but it's always worth addressing. For most vitamins (check the packaging, and be wary of fat-soluble vitamins, like vitamin D) taking vitamins is generally one of the safest safest things you can do, as long as you also drink enough water with them, so your body can flush away any excess vitamins. Since you plan to be flushing away acetaldehyde already, no problem!

    Vitamin B-6 or B-Complex is a popular hangover folk remedy. Supposedly there are studies that back this up, but the few medical sources I found said these studies weren't that strong. Brewer's yeast is a common folk remedy... mainly because brewer's yeast is high in vitamin B.

    Other Sources

    Here's a pretty cool site with info about drinking:

    http://www.goaskalice.columbia.edu/2244.html

    And here's one that gets pretty entertaining about hangover effects (my favorite is "...when [your brain] starts to shrink due to water loss, pain-sensitive filaments connecting the outside membranes to the inside of the skull become stretched..."):

    http://www.ratebeer.com/Story.asp?StoryID=386

    And of course, our old friend Wikipedia:

    http://en.wikipedia.org/wiki/Hangover

    This one talks about a substance called cysteine:

    http://www.soyouwanna.com/site/syws/hangover/hangoverfull.html

    So I did some googling on cysteine:

    http://chemistry.about.com/cs/medical/tp/aatp122102a.htm

    http://www.whatreallyworks.co.uk/start/factsheets.asp?article_ID=181

    That's about all I have to say. Good luck and remember not to be stupid. Or at least try to be smart about being stupid.


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