{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,17]],"date-time":"2026-05-17T06:07:53Z","timestamp":1778998073827,"version":"3.51.4"},"reference-count":25,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2020,1,9]],"date-time":"2020-01-09T00:00:00Z","timestamp":1578528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>The 2010 Alcohol Hangover Research Group consensus paper defined a cutoff blood alcohol concentration (BAC) of 0.11% as a toxicological threshold indicating that sufficient alcohol had been consumed to develop a hangover. The cutoff was based on previous research and applied mostly in studies comprising student samples. Previously, we showed that sensitivity to hangovers depends on (estimated) BAC during acute intoxication, with a greater percentage of drinkers reporting hangovers at higher BAC levels. However, a substantial number of participants also reported hangovers at comparatively lower BAC levels. This calls the suitability of the 0.11% threshold into question. Recent research has shown that subjective intoxication, i.e., the level of severity of reported drunkenness, and not BAC, is the most important determinant of hangover severity. Non-student samples often have a much lower alcohol intake compared to student samples, and overall BACs often remain below 0.11%. Despite these lower BACs, many non-student participants report having a hangover, especially when their subjective intoxication levels are high. This may be the case when alcohol consumption on the drinking occasion that results in a hangover significantly exceeds their \u201cnormal\u201d drinking level, irrespective of whether they meet the 0.11% threshold in any of these conditions. Whereas consumers may have relative tolerance to the adverse effects at their \u201cregular\u201d drinking level, considerably higher alcohol intake\u2014irrespective of the absolute amount\u2014may consequentially result in a next-day hangover. Taken together, these findings suggest that the 0.11% threshold value as a criterion for having a hangover should be abandoned.<\/jats:p>","DOI":"10.3390\/jcm9010179","type":"journal-article","created":{"date-parts":[[2020,1,10]],"date-time":"2020-01-10T04:06:51Z","timestamp":1578629211000},"page":"179","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":35,"title":["Sensitivity to Experiencing Alcohol Hangovers: Reconsideration of the 0.11% Blood Alcohol Concentration (BAC) Threshold for Having a Hangover"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6455-2096","authenticated-orcid":false,"given":"Joris C.","family":"Verster","sequence":"first","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"},{"name":"Institute for Risk Assessment Sciences (IRAS), Utrecht University, 3584CM Utrecht, The Netherlands"},{"name":"Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L. Darren","family":"Kruisselbrink","sequence":"additional","affiliation":[{"name":"Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS B4P 2R6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Karin A.","family":"Slot","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Aikaterini","family":"Anogeianaki","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sally","family":"Adams","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath BA2 7AY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0887-6958","authenticated-orcid":false,"given":"Chris","family":"Alford","sequence":"additional","affiliation":[{"name":"Psychological Sciences Research Group, University of the West of England, Bristol BS16 1QY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lizanne","family":"Arnoldy","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Elisabeth","family":"Ayre","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephanie","family":"Balikji","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8626-0521","authenticated-orcid":false,"given":"Sarah","family":"Benson","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gillian","family":"Bruce","sequence":"additional","affiliation":[{"name":"Education and Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3178-7067","authenticated-orcid":false,"given":"Lydia E.","family":"Devenney","sequence":"additional","affiliation":[{"name":"School of Psychology, Life and Health Sciences, Ulster University, Coleraine, Co. Londonderry BT52 1SA, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4002-3947","authenticated-orcid":false,"given":"Michael R.","family":"Frone","sequence":"additional","affiliation":[{"name":"Department of Psychology, University at Buffalo, The State University of New York, Buffalo, NY 14203, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0367-3281","authenticated-orcid":false,"given":"Craig","family":"Gunn","sequence":"additional","affiliation":[{"name":"Addiction and Mental Health Group, Department of Psychology, University of Bath, Bath BA2 7AY, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Heffernan","sequence":"additional","affiliation":[{"name":"Department of Psychology, Faculty of Health and Life Sciences, Northumbria University, Newcastle upon Tyne NE1 8ST, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kai O.","family":"Hensel","sequence":"additional","affiliation":[{"name":"Cambridge Biomedical Campus, Department of Paediatrics, Addenbrooke\u2019s Hospital, Cambridge University Hospitals NHS Foundation Trust, Cambridge CB2 0QQ, UK"},{"name":"Faculty of Health, Department of Paediatrics, Center for Clinical &amp; Translational Research (CCTR), Witten\/Herdecke University, 58455 Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anna","family":"Hogewoning","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0367-3281","authenticated-orcid":false,"given":"Sean J.","family":"Johnson","sequence":"additional","affiliation":[{"name":"Psychological Sciences Research Group, University of the West of England, Bristol BS16 1QY, UK"},{"name":"Centre for Trials Research, Cardiff University, Cardiff CF14 4YS, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Albertine E.","family":"van Lawick van Pabst","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0016-9151","authenticated-orcid":false,"given":"Aurora J.A.E.","family":"van de Loo","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marlou","family":"Mackus","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5119-332X","authenticated-orcid":false,"given":"Agnese","family":"Merlo","sequence":"additional","affiliation":[{"name":"Education and Social Sciences, University of the West of Scotland, Paisley PA1 2BE, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ren\u00e9 J.L.","family":"Murphy","sequence":"additional","affiliation":[{"name":"Centre of Lifestyle Studies, School of Kinesiology, Acadia University, Wolfville, NS B4P 2R6, Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lauren","family":"Owen","sequence":"additional","affiliation":[{"name":"Department of Psychology, School of Health and Society, University of Salford, Salford 5 M6 6PU, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily O.C.","family":"Palmer","sequence":"additional","affiliation":[{"name":"Department of Medicine, Imperial College London, London W12 0NN, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Charmaine J.I.","family":"van Rossum","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4484-5462","authenticated-orcid":false,"given":"Andrew","family":"Scholey","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Chantal","family":"Terpstra","sequence":"additional","affiliation":[{"name":"Centre for Human Psychopharmacology, Swinburne University, Melbourne, VIC 3122, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6764-6891","authenticated-orcid":false,"given":"Vatsalya","family":"Vatsalya","sequence":"additional","affiliation":[{"name":"Department of Medicine, University of Louisville, Louisville, KY 40202, USA"},{"name":"Alcohol Research Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"Hepatobiology &amp; Toxicology Center, University of Louisville, Louisville, KY 40202, USA"},{"name":"National Institute on Alcohol Abuse and Alcoholism, NIH, Bethesda, MD 20892, USA"},{"name":"Robley Rex Louisville VAMC, Louisville, KY 40206, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sterre A.","family":"Vermeulen","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michelle","family":"van Wijk","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Utrecht Institute for Pharmaceutical Sciences (UIPS), Utrecht University, 3584CG Utrecht, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7113-4020","authenticated-orcid":false,"given":"Ann-Kathrin","family":"Stock","sequence":"additional","affiliation":[{"name":"Cognitive Neurophysiology Department of Child and Adolescent Psychiatry, Faculty of Medicine of the TU Dresden, University of Dresden, D-01307 Dresden, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,1,9]]},"reference":[{"key":"ref_1","first-page":"148","article-title":"Development of a definition for the alcohol hangover: Consumer descriptions and expert consensus","volume":"9","author":"Mackus","year":"2016","journal-title":"Curr. Drug Abuse Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"248","DOI":"10.1093\/alcalc\/ags029","article-title":"Alcohol hangover symptoms and their contribution to overall hangover severity","volume":"47","author":"Penning","year":"2012","journal-title":"Alcohol Alcohol."},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"Van Schrojenstein Lantman, M., Mackus, M., van de Loo, A.J.A.E., and Verster, J.C. (2017). The impact of alcohol hangover symptoms on cognitive and physical functioning, and mood. Hum. Psychopharmacol., 32.","DOI":"10.1002\/hup.2623"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"116","DOI":"10.2174\/1874473711003020116","article-title":"The Alcohol Hangover Research Group consensus statement on best practice in alcohol hangover research","volume":"3","author":"Verster","year":"2010","journal-title":"Curr. Drug Abuse Rev."},{"key":"ref_5","unstructured":"National Institute of Alcohol Abuse and Alcoholism (2019, December 01). Rethinking Drinking. Alcohol and Your Health. Calculators, Available online: https:\/\/www.rethinkingdrinking.niaaa.nih.gov\/tools\/calculators\/Default.aspx."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"67","DOI":"10.15288\/qjsas.1970.s5.067","article-title":"Experimental induction of hangover","volume":"5","author":"Chapman","year":"1970","journal-title":"Q. J. Stud. Alcohol"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"253","DOI":"10.2174\/187447370604140616120736","article-title":"Can hangover immunity really be claimed?","volume":"6","author":"Verster","year":"2013","journal-title":"Curr. Drug Abuse Rev."},{"key":"ref_8","first-page":"14","article-title":"Hangover resistance in a Canadian university student population","volume":"5","author":"Kruisselbrink","year":"2017","journal-title":"Addict. Behav. Rep."},{"key":"ref_9","doi-asserted-by":"crossref","unstructured":"Van de Loo, A.J.A.E., Mackus, M., van Schrojenstein Lantman, M., Kraneveld, A.D., Garssen, J., Scholey, A., and Verster, J.C. (2018). Susceptibility to alcohol hangovers: The association with self-reported immune status. Int. J. Environ. Res. Public Health, 15.","DOI":"10.3390\/ijerph15061286"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"547","DOI":"10.15288\/jsa.1981.42.547","article-title":"Prediction of blood alcohol concentrations in human subjects. Updating the Widmark Equation","volume":"42","author":"Watson","year":"1981","journal-title":"J. Stud. Alcohol Drugs"},{"key":"ref_11","doi-asserted-by":"crossref","unstructured":"Verster, J.C., Kruisselbrink, L.D., Anogeianaki, A., Alford, C., and Stock, A.K. (2020). Relationship of alcohol hangover and physical endurance performance: Walking the Samaria Gorge. J. Clin. Med., 9.","DOI":"10.3390\/jcm9010114"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"835","DOI":"10.1007\/s00213-014-3715-y","article-title":"Effects of mixing alcohol with energy drink on objective and subjective intoxication: Results from a Dutch on-premise study","volume":"232","author":"Verster","year":"2015","journal-title":"Psychopharmacology"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"200","DOI":"10.1002\/hup.2529","article-title":"The effects of alcohol mixed with energy drink (AMED) on subjective intoxication and alertness: Results from a double-blind placebo-controlled clinical trial","volume":"31","author":"Janssen","year":"2016","journal-title":"Hum. Psychopharmacol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"161","DOI":"10.2147\/SAR.S119361","article-title":"Characteristics of social drinkers with and without a hangover after heavy alcohol consumption","volume":"7","author":"Hogewoning","year":"2016","journal-title":"Subst. Abuse Rehab."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"270","DOI":"10.1037\/a0024706","article-title":"Hangover sensitivity after controlled alcohol administration as predictor of post-college drinking","volume":"121","author":"Rohsenow","year":"2012","journal-title":"J. Abnorm. Psychol."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"925","DOI":"10.15288\/jsad.2012.73.925","article-title":"Low sensitivity to alcohol: Relations with hangover occurrence and susceptibility in an ecological momentary assessment investigation","volume":"73","author":"Piasecki","year":"2012","journal-title":"J. Stud. Alcohol. Drugs"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"345","DOI":"10.1093\/ajcn\/nqy309","article-title":"Grape or grain but never the twain? A randomized controlled multiarm matched-triplet crossover trial of beer and wine","volume":"109","author":"Geis","year":"2019","journal-title":"Am. J. Clin. Nutr."},{"key":"ref_18","first-page":"S23","article-title":"Psychological factors affecting hangover severity","volume":"38","author":"Arnoldy","year":"2019","journal-title":"Drug Alcohol. Rev."},{"key":"ref_19","doi-asserted-by":"crossref","unstructured":"Verster, J.C., Slot, K.A., Arnoldy, L., Van Lawick van Pabst, A.E., van de Loo, A.J.A.E., Benson, S., and Scholey, A. (2019). The association between alcohol hangover frequency and severity: Evidence for reverse tolerance?. J. Clin. Med., 8.","DOI":"10.3390\/jcm8101520"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"1788","DOI":"10.1111\/j.1530-0277.1998.tb03981.x","article-title":"Five-Shot Questionnaire on Heavy Drinking","volume":"22","author":"Sillanaukee","year":"1998","journal-title":"Alcohol. Clin. Exp. Res."},{"key":"ref_21","unstructured":"Derogatis, L.R. (1975). Brief Symptom Inventory, Clinical Psychometric Research."},{"key":"ref_22","first-page":"575","article-title":"The RT-18: A new screening tool to assess young adult risk-taking behavior","volume":"4","author":"Kuipers","year":"2011","journal-title":"Int. J. Gen. Med."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"9231","DOI":"10.18632\/aging.102446","article-title":"Should population-based research steer individual health decisions?","volume":"11","author":"Hensel","year":"2019","journal-title":"Aging"},{"key":"ref_24","doi-asserted-by":"crossref","unstructured":"Verster, J.C., van de Loo, A.J.A.E., Adams, S., Stock, A.K., Benson, S., Alford, C., Scholey, A., and Bruce, G. (2019). Naturalistic study design in alcohol hangover research: Advantages, limitations, and solutions. J. Clin. Med., 8.","DOI":"10.3390\/jcm8122160"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Scholey, A., Benson, S., Kaufman, J., Terpstra, C., Ayre, E., Verster, J.C., Allen, C., and Devilly, G. (2019). Effects of alcohol hangover on cognitive performance: A field\/internet mixed methodology approach. J. Clin. Med., 8.","DOI":"10.20944\/preprints201902.0107.v1"}],"container-title":["Journal of Clinical Medicine"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/1\/179\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,13]],"date-time":"2025-10-13T13:19:18Z","timestamp":1760361558000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2077-0383\/9\/1\/179"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,9]]},"references-count":25,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2020,1]]}},"alternative-id":["jcm9010179"],"URL":"https:\/\/doi.org\/10.3390\/jcm9010179","relation":{},"ISSN":["2077-0383"],"issn-type":[{"value":"2077-0383","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,9]]}}}