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Punch Drunk: The Worst Hangover You Will Ever Have

Mike Tyson appearing "punch drunk"

Punch Drunk Syndrome is condition seen in combat sport athletes, considered to be caused by repeated cerebral concussions and characterized by weakness, staggering, slowness of muscular movements, slurred speech, and mental dullness. The name of the condition is justified by its comparison to, if not the exact replication of a hard night of drinking alcohol, without the implied enjoyment of a night out on the town.

Signs of Punch Drunkenness 

After a hard fight or sparring session it is not unheard of for a competitor to have a headache and feel exhausted. The indication of being “punk drunk” really presents itself hours later when nausea and vertigo set in.

Here is a rundown of some of the most common symptoms for both punch and alcohol induced hangovers

1. Headache

2.  Weakness

3. Nausea/Vomiting

4. Fatigue

5. Vertigo/Double Vision

6. Mental Dullness/Confusion

7. Disorientation as to time, date, or place

8. Speech Impairment

9. Lack of Coordination

10.  Partial Amnesia


Slug Nutty and Cookoo: Medical History of the Punch Drunk

Medical journals written nearly 100 years ago note a rare but serious form of dementia that was linked to repetitive head injuries in boxing. The dementia was appropriately named, “Boxer’s dementia,” this same condition is also sometimes referred to as being “punk drunk.”

A study published in the October 13, 1928 Journal of the American Medical Association states, “For some time fight fans and promoters have recognized a peculiar condition occurring among prize-fighters which, in ring paralance, they speak of as “punk drunk.” Fighters in whom the early symptoms are well recognized are said by the fans to be “cookoo,” “goofy,” “cutting paper dolls,” or “slug nutty.”

The article goes on to say, “In some cases periods of slight mental confusion may occur as well as distinct slowing of muscular action. The early symptoms of punk drunk are well known to fight fans, and the gallery of gods often shout “cuckoo” at a fighter. I know of one fight that was stopped by the referee because he thought one of the fighters was intoxicated.”

The Serious Side of Punch Drunkenness

Even in the 1920’s “punch drunk” was a term that was linked to brain damage, Parkinson’s Disease and Alzheimer’s.  Though technology has progressed with time, the findings are virtually the same, but also include some shiny new terminology.

A medical term that relates to Boxer’s Dementia is Chronic Traumatic Encephalopahty (CET), and encompasses the long-term effects of repeated head trauma in the form of brain disorder. It may also be called “dementia pugilistica,” which is a variant of CET. The effects of CET are frightening and have caused multiple competitors to leave the game in both boxing and MMA and well as sports such as professional wrestling, football, baseball and hockey.


The Concussion

Often punch drunkenness is considered to be synonymous with having a concussion. This may or may not be the case, but a concussion is not to be taken lightly, and symptoms are often the same. Concussions are graded on a three- point scale used as a basis for treatment decisions.

  Grade 1:  no loss of consciousness, transient confusion, and other symptoms that resolve within 15 minutes

    Grade 2:  no loss of consciousness, transient confusion and other symptoms that require more than 15 minutes to resolve

Grade 3:  loss of consciousness for any period

Days or weeks after the accident, the person may show signs of: Headache, poor attention and concentration, memory difficulties, anxiety, depression, sleep disturbances and/or light and noise intolerance

When these symptoms occur it is called “post-concussion syndrome,” and an athlete should never return to training activities until all symptoms are gone.

MMA Fighter Andrei Arlovski sustaining a severe concussion
MMA Fighter Andrei Arlovski sustaining a severe concussion

Coping With the Hangover

The phrase “punch drunk” has adapted over decades to mean the immediate or short-term effect of repeated head injury as it usually relates to a singe incident (practice or competition) involving trauma. Without delving into the long-term CET concerns, being punch drunk can be a set back.

Just like with any hangover, it can be hard to function once symptoms set in. With a pounding head, churning stomach and spinning universe it can be difficult to function. It is important that, in anticipation of a hard sparring session or competition that one is prepared to pay the consequences. It is also important to know when enough is enough. If you are out of sick days at work and you are getting blasted repeatedly, you may want to consider calling it a night early. Of course, one option that is often overlooked is the option of headgear. Professionals wear headgear in practice. The future of your fight career may depend on it.

There are no specific remedies for the punch drunk hangover, but the same things that work for an alcohol hangover are most likely to get the job done . . . as much as the job can be done. Everyone has their own coping method, for a tough night on the town, but the most trusted remedies are rest and hydration. The best prevention is not to get hit.