Beer Before Liquor: Does Drinking Order Really Make You Sicker?

The age-old adage “beer before liquor, never been sicker; liquor before beer, you’re in the clear” has been passed down through generations of drinkers. This popular phrase suggests that the order in which you consume alcoholic beverages can determine whether you’ll wake up with a pounding headache and nausea or feel relatively fine.

But is there any scientific truth to this widely-believed drinking rule? Or is it simply a myth that has persisted through word of mouth and anecdotal experiences? Understanding the facts about alcohol consumption and hangovers can help you make better decisions about drinking and potentially reduce unpleasant after-effects.

This comprehensive guide examines the science behind drinking order, explores what actually causes hangovers, and provides evidence-based strategies for minimizing hangover symptoms.

The Origins of the Beer Before Liquor Saying

The exact origins of this popular phrase remain unclear, but several theories attempt to explain how this belief became so widespread in drinking culture.

One common explanation relates to typical drinking patterns. Many people start their evening with lower alcohol content beverages like beer or wine, gradually progressing to stronger spirits as the night continues. When they feel sick later or experience a severe hangover the following morning, they may attribute their discomfort to the drinking order rather than the total amount of alcohol consumed.

Another theory focuses on alcohol absorption rates. Because liquor contains significantly higher alcohol concentration than beer—typically 40% alcohol by volume compared to 4-6% in most beers—some believe that ending the night with hard liquor can cause a rapid spike in blood alcohol concentration. This sudden increase, added to already elevated levels from earlier beer consumption, could theoretically push someone over the edge into hangover territory.

Conversely, the theory suggests that starting with liquor and finishing with beer might create a more gradual increase in blood alcohol levels, potentially reducing hangover severity. However, as we’ll explore, scientific evidence doesn’t support this reasoning.

What Science Says About Drinking Order and Hangovers

Despite the widespread belief in this drinking rule, scientific research reveals that the order in which you consume alcoholic beverages has minimal impact on whether you’ll experience a hangover.

Alcohol absorption begins immediately when alcohol reaches your stomach and continues as it moves through your digestive system. Once consumed, all alcohol is absorbed into your bloodstream relatively quickly, typically within 30 minutes to 2 hours, depending on various factors. By the time hangover symptoms appear—usually several hours after your last drink—your body has already absorbed all the alcohol from the previous night, regardless of the order in which you drank it.

A study published in the American Journal of Clinical Nutrition found that mixing different types of alcoholic beverages doesn’t influence hangover severity any more than sticking to one type of drink. The research concluded that total alcohol consumption, not drinking order or beverage variety, is the primary predictor of hangover intensity.

The key factor determining hangover severity is your peak blood alcohol concentration and the total amount of alcohol your body must process. Whether you reach that peak by drinking beer followed by liquor, liquor followed by beer, or only one type of beverage throughout the evening makes little difference to your hangover outcome.

However, there’s one important caveat: if a particular drinking pattern consistently leads you to consume more total alcohol, it may indirectly increase your hangover risk. For example, if switching from beer to liquor late in the evening causes you to drink more overall because you lose track of your consumption, you’re more likely to feel worse the next day.

What Actually Causes Hangovers

Understanding the true causes of hangovers can help you make more informed decisions about alcohol consumption and better prevent unpleasant symptoms.

Hangovers result from multiple physiological processes that occur as your body metabolizes alcohol and deals with its toxic effects:

Dehydration and Electrolyte Imbalance

Alcohol acts as a diuretic, causing increased urination and fluid loss. This leads to dehydration, which contributes to common hangover symptoms like headache, dizziness, and thirst. Additionally, excessive urination depletes important electrolytes like sodium, potassium, and magnesium.

Acetaldehyde Accumulation

When your liver breaks down alcohol, it produces acetaldehyde, a toxic compound that’s even more harmful than alcohol itself. While your body works to convert acetaldehyde into harmless substances, temporary buildup of this toxin can cause nausea, vomiting, and sweating.

Inflammation

Alcohol triggers inflammatory responses throughout your body, including in your brain, digestive system, and other organs. This inflammation contributes to many hangover symptoms, including headache, difficulty concentrating, and memory problems.

Gastrointestinal Disturbance

Alcohol irritates the stomach lining and increases stomach acid production, leading to nausea, vomiting, and abdominal pain. It also slows digestion and can damage the intestinal barrier.

Blood Sugar Disruption

Drinking alcohol can interfere with blood sugar regulation, potentially causing low blood sugar levels that contribute to fatigue, weakness, mood disturbances, and shakiness during a hangover.

Sleep Disruption

Although alcohol may help you fall asleep initially, it significantly disrupts sleep quality by interfering with REM sleep and causing frequent awakenings. Poor sleep quality intensifies other hangover symptoms and leaves you feeling exhausted.

Real Factors That Influence Hangover Severity

While drinking order doesn’t significantly affect hangovers, numerous other factors play important roles in determining how you’ll feel the morning after drinking.

Total Alcohol Consumption

The most significant predictor of hangover severity is simply how much alcohol you consume. Higher blood alcohol concentrations are directly correlated with worse hangovers. The more you drink, the more your body must process, and the more pronounced your symptoms will be.

Drinking on an Empty Stomach

Food in your stomach slows alcohol absorption, leading to a more gradual increase in blood alcohol levels. When you drink without eating, alcohol moves rapidly from your stomach to your small intestine, where it’s absorbed much more quickly. This causes faster and higher spikes in blood alcohol concentration, increasing hangover risk.

Eating before and during drinking, especially foods containing protein, fat, and complex carbohydrates, can help moderate alcohol absorption and reduce hangover severity.

Frequency of Alcohol Consumption

Regular heavy drinkers often experience more severe hangovers than occasional drinkers. Research suggests that repeated episodes of heavy drinking may increase hangover sensitivity over time, though heavy drinkers may also develop some tolerance to certain hangover symptoms.

Genetic Factors

Your genes significantly influence how your body processes alcohol and responds to its effects. Genetic variations affect enzymes responsible for alcohol metabolism, including alcohol dehydrogenase and aldehyde dehydrogenase. These genetic differences can cause some people to experience worse hangovers than others after consuming the same amount of alcohol.

Genetics also influence other hangover-related factors, including susceptibility to dehydration, inflammatory responses, and how alcohol affects your sleep patterns.

Congeners in Alcoholic Beverages

Congeners are chemical compounds produced during fermentation and aging of alcoholic beverages. They contribute to the flavor, aroma, and color of drinks but can also intensify hangovers. Darker liquors like bourbon, whiskey, and red wine typically contain higher levels of congeners than clear spirits like vodka and gin or light-colored drinks like white wine.

Studies have shown that beverages with higher congener content tend to produce more severe hangovers when consumed in equal amounts to drinks with fewer congeners.

Hydration Status

Your hydration level before, during, and after drinking significantly impacts hangover severity. Starting the evening well-hydrated and alternating alcoholic drinks with water can help reduce dehydration and minimize hangover symptoms.

Smoking and Alcohol

Research indicates that people who smoke while drinking are more likely to experience worse hangovers compared to non-smokers. Smoking may intensify hangover symptoms through various mechanisms, including increased oxidative stress and inflammation.

Individual Tolerance and Susceptibility

Interestingly, approximately 20-25% of people who drink alcohol appear to be resistant to hangovers, experiencing few or no symptoms regardless of how much they drink. Scientists don’t fully understand why some people have this resistance, but it likely involves a combination of genetic, physiological, and behavioral factors.

Evidence-Based Strategies to Prevent Hangovers

While no method can completely eliminate hangovers except avoiding alcohol altogether, several evidence-based strategies can significantly reduce their severity.

Moderate Your Alcohol Intake

The most effective way to prevent hangovers is to drink in moderation. Current guidelines suggest no more than one standard drink per day for women and two for men. Staying within these limits or drinking less can help you avoid hangover symptoms entirely.

Eat Before and While Drinking

Never drink on an empty stomach. Consuming a substantial meal containing protein, healthy fats, and complex carbohydrates before drinking slows alcohol absorption. Snacking throughout the evening can help maintain steadier blood alcohol levels.

Stay Hydrated

Drink plenty of water before you start consuming alcohol, alternate alcoholic beverages with water throughout the evening, and drink water before bed. Proper hydration helps counteract alcohol’s diuretic effects and can significantly reduce hangover severity.

Choose Your Drinks Wisely

Consider selecting beverages with lower congener content, such as vodka or gin, rather than darker spirits. However, remember that total alcohol consumption matters more than the type of drink.

Pace Yourself

Your liver can only process approximately one standard drink per hour. Drinking more quickly than this causes alcohol to accumulate in your bloodstream. Slowing your drinking pace allows your body to metabolize alcohol more efficiently and helps prevent excessive blood alcohol levels.

Get Adequate Sleep

While alcohol disrupts sleep quality, getting as much rest as possible can help your body recover. Try to allow sufficient time for sleep after drinking rather than having early morning commitments.

Avoid Smoking

Since smoking while drinking is associated with worse hangovers, avoiding cigarettes during drinking occasions may help reduce next-day symptoms.

Consider Supplements

Some research suggests that certain supplements may help reduce hangover symptoms, though evidence is mixed. These include B vitamins, vitamin C, zinc, and specific herbal extracts. However, more research is needed to confirm their effectiveness.

When to Seek Medical Attention

While most hangovers are uncomfortable but harmless, certain symptoms warrant medical attention. Seek immediate medical care if you or someone you know experiences:

• Confusion or difficulty staying conscious
• Vomiting that won’t stop
• Seizures
• Slow or irregular breathing (fewer than 8 breaths per minute or gaps of more than 10 seconds between breaths)
• Blue-tinged or pale skin
• Low body temperature
• Inability to wake up

These symptoms may indicate alcohol poisoning, a potentially life-threatening condition requiring emergency treatment.

If you find yourself frequently drinking to the point of severe hangovers or struggling to control your alcohol consumption, consider speaking with a healthcare provider about potential alcohol use concerns.

Understanding Responsible Drinking

Beyond preventing hangovers, understanding responsible drinking practices is essential for long-term health and well-being.

Excessive alcohol consumption carries numerous health risks beyond hangovers, including liver disease, cardiovascular problems, increased cancer risk, weakened immune system, mental health issues, and potential for alcohol dependence.

Making informed choices about alcohol consumption involves understanding standard drink sizes, recognizing your personal limits, and knowing when to abstain entirely. Certain individuals should avoid alcohol completely, including pregnant women, people taking medications that interact with alcohol, individuals with certain medical conditions, and those in recovery from alcohol use disorder.

The Bottom Line on Beer Before Liquor

The popular saying “beer before liquor, never been sicker; liquor before beer, you’re in the clear” is essentially a myth. Scientific evidence doesn’t support the idea that drinking order significantly affects hangover severity.

The reality is much simpler: how much alcohol you consume, not the order in which you drink it, determines whether you’ll experience a hangover and how severe it will be. Other important factors include whether you’ve eaten, your hydration status, genetic factors, the types of alcohol you choose, and whether you smoke.

If you choose to drink alcohol, the best strategies for avoiding hangovers are drinking in moderation, staying well-hydrated, never drinking on an empty stomach, and pacing yourself throughout the evening. Remember that the only guaranteed way to prevent a hangover is to abstain from alcohol or limit consumption to very moderate amounts.

Rather than relying on old sayings and myths about drinking order, focus on evidence-based practices that support your overall health and well-being. If you have concerns about your alcohol consumption or experience frequent severe hangovers, consult with a healthcare provider for personalized guidance.

Sources:

• National Institutes of Health – Alcohol Absorption and Metabolism
• PubMed Central – The Alcohol Hangover Research Group Consensus Statement on Best Practice in Alcohol Hangover Research
• PubMed Central – Alcohol Hangovers: A Comprehensive Review
• National Institute on Alcohol Abuse and Alcoholism
• Centers for Disease Control and Prevention – Alcohol Use and Your Health