Mixing different types of alcohol is not inherently worse for you than sticking to one drink. What actually matters is the total amount of alcohol you consume, how fast you drink it, and whether you eat beforehand. The popular saying “beer before liquor, never been sicker” has been directly tested in a controlled study, and it didn’t hold up.
The “Beer Before Liquor” Myth
A study published in the American Journal of Clinical Nutrition enrolled 90 adults between the ages of 19 and 40, randomly assigning them to drink beer then wine, wine then beer, or only one type of beverage. All participants drank to the same breath alcohol level. After a washout period, the groups swapped their drinking order and repeated the experiment.
The result: there was no correlation between hangover symptoms and whether subjects drank only wine, only beer, or switched between them in either order. The best predictors of a bad hangover were simply how drunk the person felt and whether they vomited. The order and type of drinks didn’t matter once total alcohol intake was the same.
Why Mixing Feels Worse
If the science says mixing doesn’t matter, why does it feel like it does? A few things are going on. First, switching between drinks makes it harder to track how much you’ve actually consumed. A standard drink in the United States contains about 14 grams of pure alcohol, whether that’s a 12-ounce beer, a 5-ounce glass of wine, or a 1.5-ounce shot of liquor. When you’re alternating between these very different serving sizes, it’s easy to lose count and simply drink more than you realize.
Second, your liver can only process about 7 grams of alcohol per hour, which works out to roughly one standard drink per hour. Anything beyond that stacks up in your bloodstream regardless of what type of glass it came in. Mixing drinks often happens at parties or social events where the pace of drinking is faster, so the problem isn’t the mixing itself. It’s the speed and volume.
Congeners and Hangover Severity
One real factor that influences how bad you feel the next day is the concentration of congeners in your drinks. Congeners are chemical byproducts of fermentation and aging that give darker spirits their flavor and color. Bourbon, for example, contains significantly more congeners than vodka, which is considered the “cleanest” spirit with the fewest of these byproducts. Wine and beer generally contain higher amounts of congeners than distilled spirits.
If you spend the evening drinking bourbon, then switch to red wine, then have a dark beer, you’re layering multiple high-congener beverages on top of each other. That combination can produce a worse hangover than drinking the same total amount of alcohol from a low-congener source like vodka. But again, the issue isn’t that you mixed. It’s the total congener load.
Carbonation Speeds Things Up
Mixing alcohol with carbonated beverages like tonic water or soda can affect how quickly alcohol enters your bloodstream. In one study, two-thirds of participants absorbed vodka mixed with carbonated water significantly faster than vodka mixed with still water. The carbonation appears to push alcohol through the stomach lining more quickly, which means you may feel the effects sooner and more intensely than expected. This is worth knowing if you’re alternating between flat and fizzy drinks throughout the night.
Sugary Mixers and Dehydration
Sugar in cocktail mixers doesn’t directly cause worse hangovers. Your body is efficient at processing glucose, so the sugar itself isn’t the culprit. The real problem, according to researchers at Baylor College of Medicine, is that sugary drinks taste better and go down more easily, which tends to increase how much you drink overall. Sugary alcoholic drinks also don’t hydrate you. Since alcohol already acts as a diuretic, causing your body to produce more urine than the volume of liquid you’re taking in, pairing it with sweet mixers that don’t provide real hydration can leave you more dehydrated.
Eating before and during drinking helps significantly. You absorb alcohol more rapidly on an empty stomach, and skipping meals while drinking can cause your blood sugar to drop, which worsens hangover symptoms like fatigue, shakiness, and headache. Having carbohydrates in your system gives your body its preferred fuel source and helps stabilize blood sugar levels.
Mixing Alcohol with Caffeine
One type of mixing that does carry distinct risks is combining alcohol with caffeine, whether through energy drinks, espresso martinis, or coffee-based cocktails. Caffeine doesn’t reduce alcohol’s effects on your body. It masks them. You feel more alert and energetic than you actually are, which leads to drinking more and becoming more impaired without realizing it. The CDC notes that this combination is associated with higher blood pressure, irregular heartbeat, and increased dehydration. People who mix alcohol with energy drinks are more likely to binge drink and more likely to report unwanted or risky behavior compared to those who drink alcohol without caffeine.
Mixing Alcohol with Medications
The one area where “mixing” genuinely becomes dangerous is combining alcohol with medications. Alcohol interacts with the same liver enzyme system that processes common painkillers like acetaminophen (Tylenol). Regular drinking changes how your liver handles these drugs, potentially increasing the risk of liver damage even at normal doses. Many prescription medications, including sleep aids, anti-anxiety drugs, and blood pressure medications, have their effects amplified or altered by alcohol in ways that can be unpredictable and serious.
What Actually Determines a Bad Hangover
The controlled research points to a short list of factors that actually predict how you’ll feel the next morning, and “mixing drinks” isn’t on it. What matters is total alcohol consumed, how quickly you drank it, whether you ate food, how hydrated you stayed, the congener content of your beverages, and your individual biology. A person who drinks five glasses of the same white wine will feel worse than someone who has one beer, one glass of wine, and one cocktail over the course of an evening.
If you do choose to drink multiple types of alcohol, paying attention to the total number of standard drinks and keeping pace with water between rounds will do far more for you than any folk rule about which drink to start with.