Severe hangover treatment in Phuket
A hangover in this climate is a different animal from a hangover at home, because you started the night already short of fluid and lost more overnight. Hangover treatment in Phuket is fluid, salts and something for the nausea — and a quick check that what you actually have is a hangover.
Why it hits harder here
You were already behind on fluid before the first drink, having spent the day sweating in ninety percent humidity.
Alcohol suppresses the hormone that tells the kidneys to hold water, so a night of drinking removes far more than it puts in. Add the heat and the deficit is substantial.
Then a hot bright morning, air conditioning that dries you out further, and a body that has slept badly because alcohol wrecks the second half of the night.
What is actually wrong with you
Dehydration and electrolyte loss, which produces the headache, the dry mouth and the dizziness.
Low blood sugar, which produces the shakiness and the fog. Stomach irritation, which produces the nausea. Poor sleep quality, which produces everything else.
And acetaldehyde, the compound alcohol breaks down into, which is genuinely toxic and is what makes you feel poisoned, because in a small way you are.
What works
Rehydration salts rather than plain water, because you have lost sodium and potassium as well as fluid. Sipped steadily rather than swallowed in one go.
Food, specifically carbohydrate, once the stomach will take it. Eggs, toast, rice, a plain noodle soup.
Paracetamol rather than nothing, and sleep if you can get it. Coconut water is a genuinely good option and is on every corner here.
What does not work
Another drink. It postpones the problem by a couple of hours and makes the afternoon worse.
Ibuprofen on an already irritated stomach, and paracetamol taken in excess. Stick to the labelled dose — the liver has had a night of it already.
Coffee, which dehydrates further, and a hot beach, which does the same. Both feel like they should help.
The drip, honestly assessed
Intravenous fluid works, and it works quickly, because it bypasses a stomach that does not want anything.
A litre of saline with an anti-emetic and an analgesic will turn a written-off day into a usable one, usually within the hour.
It treats the dehydration and the nausea and nothing else. It is not a repair for the liver and it is not something to build a week around — see IV drips.
When it is not a hangover
Fever, a stiff neck, confusion, severe abdominal pain, chest pain, repeated vomiting past midday, or symptoms getting worse rather than better through the day.
Dengue, food poisoning and heat exhaustion all present the morning after a night out and all get dismissed as a hangover — see dengue fever treatment.
The distinguishing feature is direction. A hangover improves as the day goes on. Almost everything else does not.
Alcohol poisoning, which is an emergency
Somebody who cannot be roused, is breathing slowly or irregularly, is cold and clammy, has blue lips, or has had a seizure.
Ring 1669. Put them on their side, stay with them, and do not leave anybody to sleep it off face-up — see emergency medical care.
Alcohol levels keep rising for a while after the last drink, which is why somebody who seemed merely very drunk at two in the morning can be in genuine trouble by four. Somebody should stay with them rather than checking in occasionally.
Adulterated drinks
Cheap spirits at some venues are not what the bottle says, and methanol contamination has caused deaths in this region.
Visual disturbance, severe abdominal pain, breathlessness or confusion out of proportion to what was drunk needs urgent assessment rather than a lie-down.
Drinks spiked with sedatives also happen. Sudden disproportionate drowsiness, memory loss, or waking somewhere unexplained is worth being seen about, and testing is possible.
The heat problem
A hangover and heat exhaustion overlap almost completely — headache, nausea, weakness, dizziness — and being hungover makes overheating far more likely.
The beach at midday the morning after is the worst available idea, and it produces a good proportion of the heat cases seen here.
Shade, fluid, and getting the fluid in before the sun rather than after — see heat exhaustion treatment.
Reducing it in advance
Alternate every drink with water. Eat before and during. Avoid the very cheap spirits, which contain more of the congeners that worsen a hangover.
A large glass of rehydration solution before bed does more than anything taken the following morning.
And drink less in the heat than you would at home, because the same quantity has a bigger effect on a body already short of fluid.
The other thing nobody mentions is that a hangover impairs judgement about heat and about water for most of the following day. A fair number of the heat cases seen here arrive in the afternoon having spent the morning on a beach feeling too rough to think about shade or a bottle of water, which is precisely when both mattered most.
Where to be seen
Bang Tao, Kata and Patong, at any hour, no appointment, and no commentary on the previous evening.
A doctor can also attend your room, which most people in this state prefer — see doctor hotel visits.
Where somebody turns out to have something else entirely, that gets identified rather than assumed away — see fever treatment.
Frequently asked questions
Why is it so much worse here?
You start dehydrated from the heat, alcohol removes more fluid, and you sleep badly. The deficit is far larger than at home.
Does a drip actually help?
Yes, and quickly, because it bypasses a stomach that will not cooperate. It treats dehydration and nausea and nothing beyond that.
Is water enough?
Rehydration salts are better. You have lost sodium and potassium too, and plain water alone does not replace those.
What about a drink to take the edge off?
It postpones the problem a couple of hours and makes the afternoon worse. Food and salts do more.
Can I take ibuprofen?
Better not, on an already irritated stomach. Paracetamol at the labelled dose — the liver has had enough for one night.
How do I know it is not something else?
A hangover improves through the day. Fever, worsening symptoms, stiff neck or severe pain means something else, and that needs seeing.
When is it an emergency?
Cannot be roused, breathing slowly, cold and clammy, blue lips or a seizure. Ring 1669 and put them on their side.
Someone’s drink may have been spiked.
Come in. Disproportionate drowsiness, memory loss or waking somewhere unexplained is worth assessing, and testing is possible.
Three clinics, none of which close
English-speaking doctors, on duty 24 hours a day. Phuket is bigger than visitors expect and the traffic is worse than the map suggests, so Takecare Medical Clinic works from three separate buildings rather than one: Bang Tao on the north-west coast, Kata in the south, and Patong between them. Each is open every hour of every day, takes people without an appointment, and asks nothing about residency or referrals.
Beyond the island, Takecare Medical Clinic is one of the Takecare Clinic group‘s clinics working across Phuket, Krabi and Chon Buri. That matters mainly for what happens afterwards: move on mid-treatment and the next clinic already holds the notes, so a handover is a call between colleagues rather than a folder you carry through an airport.
Getting seen, and how to choose a branch
There is somebody on the end of +66 81 718 9080 or WhatsApp 24 hours, every day. Say what has gone wrong and the reply will be honest about which of three things you are dealing with: come in now, this will keep until the morning, or skip us entirely and go where there is a surgeon. No appointment exists to be made, and there is no hour at which asking is a nuisance.
Pick whichever branch is nearest rather than whichever sounds largest — they run the same hours and carry the same equipment. Patong suits the west-coast beaches and Bangla Road, Kata covers Karon and the south, and Bang Tao serves Layan, Surin and Cherngtalay. Cannot get out to a clinic? Ask for a doctor hotel visit instead and somebody comes to your room. And if what you need turns out to be beyond any clinic, referral and hospital transfer is arranged from the same conversation. You are made stable before anybody moves you, a colleague rings ahead so the team on the other end knows what is arriving, and the transport is organised for you rather than handed over as one more thing to sort out.