A Sin City Savior's Quest To Cure The Common Hangover
An enterprising anesthesiologist, clad in black scrubs and armed with a magic IV, isn’t just making sure that the high-roller money that comes to Vegas stays in Vegas. He’s dedicated his life to the noble pursuit of pleasure without pain.
In a luxury high-rise condo above the Las Vegas Strip, Dr. Jason Burke is inserting an IV catheter into the inner bend of Sancho Van Ryan's elbow. "Let me put this in your left arm so you can text if you want."
Van Ryan, 30, works in the Las Vegas nightlife industry, producing events, providing concierge services, and generally helping to create the sort of Vegas magic that happens on dance floors rather than showroom stages. Burke, 42, works in the Las Vegas nightlife industry too, except that he keeps daylight hours. On his website, he describes himself as "the first physician in the United States to formally dedicate his career to the study and treatment of veisalgia." In nonmedical parlance: He is our eminent hangover specialist.
We're just 15 hours into 2013, and Burke and his staff have already treated 20 people with Vegas-sized New Year's Eve hangovers. Van Ryan and three of his friends, who are all splayed out on an expansive U-shaped sectional that seems purpose-built for stylish group-hangover recovery, are numbers 21–24. (One woman in attendance is abstaining from treatment — she prefers the headache to a needle.)
Burke runs Hangover Heaven, a medical practice that aims to take morning-after treatment beyond hair of the dog and pickled herring, via a menu of intravenous cocktails designed to wash away your sins. The entry-level choice, the $99 Redemption Package, includes one liter of hydration fluid and one of the following: Zofran (for nausea), Toradol (for headaches), or a blend of vitamins and antioxidants. The top-shelf choice, the $199 Rapture Package, includes up to two liters of hydration fluid, Zofran, Toradol, Pepcid (for heartburn), vitamins and antioxidants, a 30-minute hit of pure oxygen, a Super B shot (billed on Hangover Heaven's website as "similar to a B12 shot, but five times better"), and antioxidant and vitamin pills to go.
Since introducing the service in April 2012, Burke has treated more than 2,300 people. Sometimes he treats them in a 45-foot bus whose previous owners were a Christian gospel band fronted by a trio of brothers named Shandon, Brandon, and Landon. Sometimes he treats them in his strip-mall office in a part of town known as Naked City. And sometimes he makes house calls.
That's what he's doing now, helping to combat the effects of a New Year's Eve celebration that stretched until 6 a.m.. As Burke prepares Van Ryan and his friends all for Rapture transfusions, he's assisted by Greg Koehler, who works full-time for the North Las Vegas Fire Department as a firefighter/paramedic and does an occasional shift with Hangover Heaven on his off days.
Burke is tall and lanky, with slicked-back, longish dark auburn hair tucked into a small ponytail. He wears black surgical scrubs with his name emblazoned above his chest in tiny embroidery that matches his cobalt-blue nitrile rubber gloves. Koehler is also dressed in black and wearing a pair of the blue gloves. His official Hangover Heaven T-shirt reads, "I FEEL LIKE JESUS ON EASTER MORNING." (This particular marketing slogan, when initially unveiled, resulted in an angry calls from four local religious groups, plus the delivery of a cross on Hangover Heaven's doorstep.) In their all-black garb, the two men look like elite medical ninjas, well-versed in the dark arts of party triage.
A shiny aluminum canister resting on the room's orange shag rug is there to feed supplemental oxygen to the patients via nasal cannulas. Over the next half hour, as the various medications in the IV lines begin to tame upset stomachs and downsize headaches, the energy level in the room begins to pick up. Someone asks why the IV bags have a light yellowish tinge. (It's from the vitamins they contain.) Others trade observations about last night's party. In the background, the antics of Will Ferrell and Zach Galifianakis in The Campaign fill a giant flat-screen.
"Hey, doc," Van Ryan asks. "How many days in a row can you do this?"
According to Pliny the Elder, ancient Bromans who'd had a few too many obtained relief by decapitating, skinning, then deep-frying a canary, which they subsequently devoured, bones and all. Hangover cures have gotten better since then, at least for canaries.
Dozens, maybe hundreds, of packaged cures are currently on the market, and no tiny birds are harmed in their manufacture. Hangover Joe's, which bills itself as "the nation's #1 Hangover Relief Product," touts the flower of the kudzu plant as its key ingredient. An "official licensed product for the movie The Hangover," it has generated more than $5 million in revenues between 2010 and 2012. HFP Hangover Prevention Formula, which has been around for more than a decade and whose "sales have continued to increase year after year," according to Gerald Stefanko, the CEO of the company that produces it, features 800 IU of prickly pear extract per capsule.
Others in the field include Drinkin' Mate, a fizzy tablet made from guava leaf extract, and Blowfish, another fizzy tablet that includes "a powerful combo of aspirin and caffeine that relieves your headache and wakes you up." There's Forget Hangovers, which delivers a 75 milligram dose of vitamin B1 into your bloodstream directly through your skin. There's GTox, a "detox shot that contains Glucarate, a patented ingredient for Phase-II liver detoxification," which is a product endorsed by Dennis Rodman, former star of VH1's Celebrity Rehab and Sober House, and a widely acknowledged expert on Phase-II liver detoxification.
So far, none of these products has received approval from the FDA as an effective cure for hangovers, and scientific studies have had varied results. (While many news outlets reported in 2011 that Blowfish had received specific FDA approval, this was not true — it simply features an ingredient, aspirin, that the FDA has approved as effective for pain relief.)
In 2004, Jeffrey Wiese, a physician who serves as the associate dean for graduate medical education at Tulane University, published a study in the Archives of Internal Medicine concluding that an extract from the prickly pear cactus had a "moderate effect on reducing hangover symptoms." A year later, a frequently cited paper published in the British Medical Journal reviewed hangover-related studies conducted between 1951 and 2005 and found that "no compelling evidence exists to suggest that any conventional or complementary intervention is effective for preventing or treating alcohol hangover." (Its conclusion regarding Wiese's study: It "reported no intergroup differences for [its] main outcome measures.")
One feature most of these products do have going for them is that they're cheap: Drinkin' Mate and Blowfish both cost around $1 per tablet. Forget Hangovers is $2 to $3 per patch. HFP Hangover Prevention Formula goes for about $3 per capsule. What this means, of course, is that Burke's cocktails are roughly 30 to 200 times the price of the competition, and he doesn't take insurance. And yet he has as many customers as he can accommodate.
Of the over two dozen people he and his six staffers will end up serving on New Year's Day, six are shuttled to the Hangover Heaven office space in Naked City, where the tiny reception area has T-shirts, caps, and shot glasses for sale, and the treatment room features leather armchairs, a flat-screen TV, a life-size cardboard cutout of Galifiankis from The Hangover, and a very soothing painting of a sunset. The others, like Van Ryan and his friends, receive house calls. Another couple from Hawaii who were treated at the office were there on the recommendation of the woman's boss, who'd used the service on his own vacation to Las Vegas.
But it was a 28-year-old guy from Los Angeles — he asked that we not use his name — who paid the highest compliment. He'd tried Hangover Heaven in August with good results, so when his New Year's Eve revelries left him feeling too hungover to sleep, he booked a last-minute appointment. After spending a little over an hour watching a James Bond movie in the tranquil darkness of Hangover Heaven's treatment room, he was heading back to his room at the Venetian in the shuttle van. "Every red light pissed me off so bad this morning," he joked to the driver, Paul. "That's how bad I wanted to get to your office."
As an undergrad at the University of North Carolina, Chapel Hill, Burke was a Classical Studies major, writing papers about town planning in ancient Greece. Then he went to medical school, also at UNC. In 2001, he completed his residency at Duke University and started working as a board-certified anesthesiologist in hospital emergency rooms, intensive care units, and private surgery centers.
It wasn't a career track you'd think would lead to detoxing bachelor-party casualties in a clinic that gets four miles per gallon, but that's what happened. Blame it on Vegas. And 2-year-olds.
Burke came to Las Vegas in 2005, when his wife, who is also a doctor, obtained a position at a clinic there. Burke continued working as an anesthesiologist, and at some point it occurred to him that many of the symptoms that afflict patients after receiving anesthetics during surgery are similar to those that accompany hangovers: dehydration, nausea, headaches. To help his patients feel better as they recovered, Burke often gave them IV hydration along with intravenously administered painkillers and anti-nausea medication.
Burke also tended to suffer from bad hangovers when he drank. "It's always been that way," he says on the phone couple weeks before my New Year's visit. "I'm in a Bordeaux Society; if I drink three glasses of wine, I get a pretty significant hangover. I like wine, I like to go out and have a good time, so that has always frustrated me."
It frustrated him so much, in fact, that he began to wonder if the regimen he gave his patients recovering from surgery would work for him too. "A number of anesthetic medications affect the same receptors that alcohol does," he says. Eventually, he took home an IV bag, the tubing, and the medications and stored them in his home office. One day, after thinking about it for several months, he decided it was time to experiment.
Hangovers make you feel miserable, Burke explains, because of four primary factors: dehydration, inflammation, acute alcohol withdrawal, and something called glutamine rebound, which occurs when the body tries to produce glutamine, a natural stimulant, at a higher-than-normal rate. "The glutamine rebound is what gives some people the shakes and the anxiety. When I have a hangover, I wake up at five in the morning and I can't go back to sleep."
On this particular morning, Burke had the day off. His wife was on duty, so it was his job to shepherd their two high-energy toddlers all day, a responsibility that seemed daunting in his physically depleted state. "I was like, 'This is the morning. I've got eight hours of a 2-year old and a 4-year-old ahead of me. I'm not going to make it.'"
Burke set up an IV bag in his office and inserted a catheter into his foot. "That's really the only place that's easy to start an IV on yourself," he says. "I let probably 300 or 400 cc's of fluid in." The hydration offered some relief, but not enough to declare victory over his hangover. "I said, 'OK, it's time to put the drugs in. Let's see what's going to happen with this.'"
First, he added Zofran, an anti-nausea medicine. "After about 10 minutes, the nausea started melting away." Then, he added Toradol. "When I get hangovers, it feels like there's a vice on my head." The impact of the Toradol was dramatic, however. "Literally, within three minutes, it was like someone had unscrewed the vice. I was like, 'Good God, I can't believe I've been suffering all these years when I could have been done with it in 30 minutes."
Burke found this breakthrough both exciting and unsettling. Nature is a vengeful god, and hangovers are often characterized as a natural law of sorts, the body's expression of its preference for temperance. Without hangovers as penance, would Burke lose all sense of restraint at his wine dinners? "Anesthesiologists have issues with drug abuse," he notes. "When I was a resident, there were two residents that had to go into rehab for abusing medication — because you're sitting there with all these narcotics around you, all these extremely powerful narcotics. So it was like, 'Is this really a road I want to go down, treating myself with IV medication?'"
At the same time, a hangover that once would have kept him dragging for 10 to 12 hours could be largely vanquished within 45 minutes. On an individual basis, this was a pretty big deal. Writ globally, it was huge. A study published in the November 2011 issue of the American Journal of Preventive Medicine estimated that impaired workplace productivity resulting from excessive alcohol consumption totaled $74.1 billion in 2006, and that workplace absenteeism cost another $4.2 billion that year.
Meanwhile, as Jeffrey Wiese wrote in a study, "Hangover has never been shown to effectively deter alcohol consumption … and no evidence shows that alleviation of hangover symptoms would result in further consumption." In fact, hangover sufferers often drink more in their efforts to take the edge off with an "eye opener," aka hair of the dog. Wiese also pointed to previous studies that showed that hangovers can impair visual-spatial skills, dexterity, driving ability, managerial skills, and task completion.
At the very least, an effective hangover cure could help alleviate millions of hours of human suffering. Ultimately, Burke decided, hangovers are a legitimate medical condition, not a moral judgment. "It's dehydration and inflammation. Treating it isn't really a whole lot different than treating people who get dehydrated from food poisoning." For Burke, then, treating himself — and others — with IV medication was a road he did indeed want to go down. In a giant bus, no less.
Intrigued by the possibilities of turning his treatment into a business, he began to research the potential market. The natural approach was to treat people in their hotel rooms or homes. When you're hungover, inertia reigns. But in-room visits would be expensive. Treating hangovers via IV hydration is labor-intensive and time-consuming. To make in-room visits economically viable, Burke figured he'd have to charge around $500, and at that price, he believed the number of customers would be too low to sustain a business.
To him, it made more sense to offer easy transportation to some fixed location. He found a building across from the Hard Rock, but the rent was expensive — $5,000 a month — and the landlord wanted a five-year guaranteed lease. That's when he had his epiphany. "I knew I needed some form of transportation," he says. "So then I thought, What if I treated people on the transportation?"
His first idea: Buy a used bloodmobile. That wasn't strong enough, though. He wanted something bigger, something with more presence, something that would attract people's attention and convey the notion that this business wasn't just some fly-by-night operation. A bus had gravitas. Even in a city filled with pyramids and exploding volcanoes, a 45-foot bus filled with tourists getting IV jump-starts in the middle of rush-hour traffic would be hard to overlook. "If I took the lease, I could have been on the hook for hundreds of thousands of dollars. With the bus, I could invest $125,000 and give it a whirl," he says. "If things didn't work out, I would still have a bus to sell."
Through a broker in Tennessee, he located a 1993 Eagle M-15 that was on the market for $80,000. It had been owned by a Christian gospel band, the Beene Family, that had recorded tracks like "Joy Comes in the Morning" and "We'll Soon Be Done with Troubles and Trials" — a pretty good provenance for a vehicle that would soon be offering electrolytic salvation to Sin City's wretched, and retching, fallen.
Burke bought the bus and started doing renovations. He also began obtaining all the necessary licenses from skeptical government agencies and hiring personnel. Finally, he needed a name for his new business. "I was thinking of something that would have 'IV' or 'hydration' in it, something medical," he says. "But my wife said that would make people nervous. She said, 'Make it fun or people aren't going to show up.'"
At around noon, things slow down a bit. A couple staffers are out at an in-room. Those in the office wait for the phone to ring. "It's mostly the big guys with tattoos who pass out from the needles," says Crystal Willis, a medical assistant who has lived in Las Vegas for five years.
A short while later, a guy wearing a backward fitted cap, a baggy black puffer jacket, and black Chuck Taylors comes through the clinic's front door. He doesn't have an appointment. He didn't even call ahead.
"How much does this cost?" he asks.
"There are different choices," receptionist Jen Busque tells him.
"How long does it take?"
"About an hour."
"OK," he says. "I'll be back in a second."
He goes outside to let whoever brought him here know he's going to go ahead and do it, then he comes back inside.
"I need to see your ID," Busque says, and indeed, he looks young enough to be carded. He's 26.
He ends up choosing the midrange option, the Salvation package, at $159, and subsequently enters the treatment area. In time, he will drift off to sleep, but for now, he looks miserable, shaky, and sweaty, with a greenish cast to his skin.
And no doubt there are thousands more like him all over Las Vegas at this very moment. Every year, approximately 40 million people from around the world come here, and they don't come for the hangovers. They come because Las Vegas is a city that makes everything fun. The hotels have roller coasters attached to them, the laundromats feature slot machines, the pools have evolved into all-day nightclubs, and the party never stops.
And alcohol is the lubricant that keeps the machinery running smoothly. In November 2012, the Las Vegas Review-Journalreported that local cabbies say that a top request from newly arrived visitors is to "stop at a liquor store on the way to the hotel." Every year, Las Vegas makes a little less from gambling, and more and more from the sale of food, beverages, and related offerings. In 2011, according to the Nevada Gaming Control Board, beverage sales rose 11% from the previous year. In 2012, they rose another 9%. Total beverage sales at the city's major casinos is now $1.44 billion. (This figure includes the value of alcohol that casinos give away for free to gamblers.) That's nearly twice as much as it was just 10 years ago.
The new Las Vegas whale is not a gambler who spends all night betting stacks of hundred-dollar chips at the craps table. He's an endurance partier who rents out a $20,000 VIP cabana for a pool party and keeps the heat levels bearable by constantly misting his companions with $1,000 bottles of bubbly. Tao Las Vegas, which Bloomberg Businessweeksingled out as the most profitable restaurant in America in 2010, takes in about 75% of its revenue from alcohol sales. "You get a bottle for $10 and sell it for $400," partner Paul Goldstein told the magazine. Billionaire casino magnate Steve Wynn has been betting on booze and nightlife as well. "The margins are fabulous," he said in 2010. "You know we have 65 percent profit margins in these departments, better than blackjack in many respects."
But people don't just come to party in the new Las Vegas. Partying has become a competition, an almost parodistic form of performance art. People drink and dance all day at poolside day clubs, then hit the nightclubs for more. They boost their bliss with MDMA, or molly, and keep fatigue at bay with Red Bull and Adderall. They toss back Jager Bombs and Spark Plugs, but eventually all the fun crashes to a halt and the dry heaves start.
A 2000 Annals of Internal Medicine report noted that many previous studies had shown that along with alcohol consumption, "Other factors that increase the severity of hangover include lack of food consumption, decreased quality and quantity of sleep, increased physical activity while intoxicated, dehydration, and poor physical health."
In other words, it's hard to imagine a terrain better equipped to induce hangovers than Las Vegas. It's in the middle of a desert. (Hello, dehydration.) The daytime outdoor dance parties serve as foreplay for the nighttime indoor dance parties. (Hello, again, dehydration, and also lack of sleep.) Restaurants abound, and yet for many young pleasure-seekers, the four food groups consist of Adderall, vodka, 5-Hour Energy shots, and Advil. "We saw some really weird hangovers when the Electric Daisy Carnival was here," Burke notes, referring to a three-day dance music festival that took place at the Las Vegas Motor Speedway in June 2012. "There was a lot of roofie-ing going on."
As routine and severe as Las Vegas hangovers have become, they're also glitches in the fun factory's assembly lines, instances where people who would otherwise be spending money turn into clammy, dry-heaving drags on the economy. They skip meals at the city's restaurants. They fail to make bets in the city's casinos. The last thing you want to do when your head feels like someone stuck a pair of scissors in it is fire off 200 rounds of an AK-47 at Machine Guns Vegas. The second to last thing you want to do is take a helicopter tour of the Grand Canyon. Every day in Las Vegas, in short, hangovers cause a mini-recession.
So in April 2012, when Dr. Burke came rolling down the Strip in a 45-foot bus adorned with soothing blue-and-white graphics that evoke what heaven might look like if God took his inspiration from old-school rave fliers, people noticed. Some saw him as the neurological cavalry. Others wondered what rough beast was now slouching toward the Bellagio.
"I think it's somewhere between hokey and ridiculous," exclaimed Arthur Caplan on Fox News. Today show host Matt Lauer scolded, "You're going to let somebody stick a needle in your arm because you had too much to drink? That is a bad idea."
In the Las Vegas Journal Review, Dr. Dahlia Wachs, a Las Vegas physician and radio show host, expressed concern over Burke's use of Toradol and Zofran. At Forbes.com, New York City ER physician Robert Glatter wrote that hangovers are "a good reminder of the evils of consuming too much alcohol."
According to Burke, even the casinos and nightclubs were wary of his business at first. And certainly Hangover Heaven was shifting some paradigms. No one had ever offered non-emergency IV therapy in the middle of Las Vegas traffic. No one had routinely applied medications like Zofran and Toradol to a condition that had traditionally been treated with nothing stronger than whiskey or fried canaries.
And yet it wasn't as if Dr. Burke had entered Dr. Frankenstein or Dr. Jekyll territory. The medications he uses are regularly prescribed for patients in numerous other contexts. And IV therapy in general is increasingly common. An article in a 2002 issue of the Alternative Medicine Review estimated that more than 1,000 doctors in the U.S. were administering "Myers' cocktails" at that point — an IV regimen featuring magnesium chloride, B vitamins, and various other ingredients that is supposed to mitigate fatigue and depression. In 2010, EF MEDISPA, a chain of health spas in the U.K., began offering a variety of "Drip and Chill" intravenous cocktails to its upscale clientele.
In May 2012, a few weeks after Burke launched Hangover Heaven, Rihanna tweeted a photo of an IV stuck into her arm after a fan asked her why she hadn't tweeted any updates recently. While the singer didn't offer any explanation about the photo, which was reportedly taken in a New York hospital, fans started speculating that she had gotten a "party girl drip," i.e., the sort of vitamins-and-nutrients IV infusions that are growing popular at places like EF MEDISPA.
Amidst this larger trend toward more accessible IV therapies, Burke stands out for two reasons. On the one hand, Hangover Heaven commercializes such techniques even further, turning medical treatment into a form of entertainment, an opportunity to have an only-in-Vegas experience, complete with souvenir shot glass.
On the other hand, Burke is medicalizing the process as well, adding powerful medications to the mix and perhaps even more consequentially, bringing a long-term, clinical mindset to his efforts. Indeed, while Burke may have a bit more Barnum in him than your average anesthesiologist, he's still a trained medical doctor with years of experience, always down to party and/or measure C-reactive protein markers until the brink of dawn.
Big picture, he doesn't just want to make conventioneers feel better one busload at a time. He wants to solve the mystery of hangovers and create the ultimate cure. Every time Burke or his staffers treat a patient, they start with an intake form. Vital signs are checked. Medical histories are probed. Headache, nausea, and overall hangover levels are assessed.
In part, this process is just standard medical practice, a means of ensuring that prospective patients are fit for the therapies Hangover Heaven offers. If a patient's vital signs are unusual, if they mention certain medical conditions, Hangover Heaven may decline treatment and recommend other options.
Over time, however, the information that Hangover Heaven collects on patients is becoming an increasingly useful database of information. Historically, there has been relatively little formal research into hangovers and potential treatments for them. In a 2008 essay for The New Yorker, Joan Acocella suggests why: Research costs money, and the kinds of institutions that typically fund medical research — foundations, universities, and government organizations— are apparently not rushing to subsidize the pursuit of a morning-after pill for martinis.
"Studying hangovers isn't easy," Burke notes. "It's not like high blood pressure, a condition people have for decades, where you could study it whenever." Instead, it's a condition that only occurs as a result of certain behaviors that are themselves somewhat painstaking to produce (i.e., you have to get drunk). And then it only lasts for a relatively short duration before it goes away. "You've only got a narrow window to study it, and that's why Las Vegas is a good place for hangover research," he says. "It's got such a high incidence of hangovers."
While Hangover Heaven isn't conducting clinical research — yet — it is amassing a substantial body of information in the course of its efforts. Burke can't use this information in a publishable study; he'd need to get consent from patients to do that, and also approval from an institutional review board, an independent committee whose mandate is to protect the rights and safety of research participants. But he can use it internally, for quality control purposes and simply to see what patterns emerge.
He can tell you, for example, the average starting score for a hangover (7) and the average ending score (1.6). He can tell you the average age of men who use the service (41) and the average age of women (32).
"We've been looking at the numbers since we've started and making adjustments," he says. "We also follow up [with patients] a couple days later, to make sure they stayed feeling well the rest of that day."
In the early days of Hangover Heaven, he says, some patients reported that their hangover symptoms were coming back six to eight hours after their treatment. "That's when we added intravenous vitamins and intravenous antioxidants. Once we did that, the hangover didn't come back anymore. We also added in our B-complex shot. I'm on my sixth different version of that. As we've been continually tweaking the formula, I've had to adjust dosage of intravenous vitamins and adjusted the dosage of the anti-inflammatory. I'd say I've adjusted the treatment protocol 10 to 12 times."
Some other adjustments have been necessary as well. "The bus is great because it's very stable, but it's kind of like an aircraft carrier," Burke says. It had trouble getting into some parking lots. In the summer, when temperatures in Las Vegas can top 100 degrees, it got hot, even though Burke installed multiple air conditioners.
The bus is also expensive to operate, so when Burke realized how much business Hangover Heaven was going to attract — originally he'd imagined it as a weekends-only operation — he ended up getting office space in a part of town that consists mostly of strip clubs and auto parts stores. Now Hangover Heaven is open seven days a week. A few months ago, the mailbox store next to the office went bust, so Burke has taken that space over too.
Burke says he's gotten dozens of inquiries about franchising Hangover Heaven in other cities, and other medical professionals have begun to offer similar services in other cities as well. The Revive Hydration Clinic in Chicago opened in December 2012 and offers IV hydration with "whichever medications, vitamin additives, antioxidants, or additional fluids" a physician deems appropriate. Reviv South Beach, a clinic in Miami Beach, offers Ultravive, a "recovery infusion" designed to "combat the effects of acid reflux, fatigue, nausea, headaches as well as other effects of alcohol consumption." But for now, Burke's grand experiment is thriving in the ultimate lab.
"God, I can't hear you," a voice crackles over the intercom. "Who are you?"
Burke is standing outside the front door of a private villa at the Rio, in a building where everything except the palm tree rising up in the center of a four-story interior courtyard appears to be made of marble.
"This is Dr. Burke. From Hangover Heaven."
But apparently the suite is so large that whoever is on the other end of the intercom doesn't realize that three of Burke's staffers are already inside somewhere, treating his fellow suite-mates. After a little more back-and-forth, Burke gives up and uses his cell phone to call Crystal Willis, who eventually appears at the door and lets him in.
Inside the suite's main living room, a group of friends have begun to materialize from various bedrooms and congregate in a giant oval living room that seems as if it has swallowed a small house.
"I'm ready to feel like a million bucks!" exclaims a young, wavy-haired woman as she strides into the room with a smile on her face.
A couple of her friends are already connected to IVs, and Greg Koehler and another Hangover Heaven staffer, registered nurse Amanda Pfahler, continue to set up more while Willis completes intake forms for the patients.
Hangover treatment, it seems, is pretty much the opposite of a get-rich-quick scheme. It's slow, painstaking work, and over the next hour, as Burke and his three-person crew treat this group of seven, they're constantly monitoring IV lines, checking medications, and answering questions from the patients.
At one point, Koehler finds a diamond ring someone had dropped on the floor the previous evening. Shortly after that, a pair of waiters arrive and begin to set up an impressive breakfast buffet. The soothing scent of bacon wafts into the room, but no one can get up and serve themselves because they're still attached to their IVs.
"Wake me up when my bag is done," the wavy-haired woman says as she pulls a blanket up under her chin. That moment will come soon enough, and yet it's also clear that even top-of-the-line Rapture cocktails can't offer instant relief. The process takes time. The process takes manpower. At its current top capacity, Hangover Heaven can only treat around 40 or so patients a day. To truly address the problem on a national or worldwide level, another approach is needed.
"A hangover is a multifactorial problem," Burke says. "There's not just one thing that you can target. But the inflammation is definitely the major issue. I think it is going to be easier to upregulate the body's processing power, to process the alcohol and metabolites out of the body faster, than it will be to deal with the inflammation and aftermath."
In other words, the ideal solution is some kind of nutritional supplement that you take before you start drinking — which is to say, a product not unlike the dozens of products that are already crowding the market. Burke, however, says he wants to take a more rigorous, scientific approach to product development. To this end he's created the Hangover Research Institute (HRI), an organization for which he eventually hopes to attain nonprofit status.
In part, Burke imagines HRI as an educational organization. "I firmly believe that Las Vegas is the place to go for people to have a good time and enjoy themselves," he says. But he's also seen some extreme behavior in his eight months of operation, including one guy who turned a large wedge of his finger into garnish while slicing limes in his suite at Encore.
Another issue that concerns him is polypharmacology — aka mixing alcohol with other drugs. "People don't understand half-lives and formulations," he explains. "OxyContin is a slow-release formulation, but people split a tablet in half and share it with each other, and all the sudden that slow release has been defeated. The last thing any of these casinos or nightclubs wants is to have somebody die at one of the pool parties because they took an Adderall to get energized, then they drank a bunch of alcohol, then they wanted to go to sleep, so a friend of theirs broke an OxyContin in half and they took that. The Adderall wears off as the OxyContin's peaking, they still have the alcohol onboard, and then they die."
In addition to imparting information like that, Burke envisions HRI as a research lab where he can do clinical research in a controlled environment. The kind of drinking that typically results in hangovers tends to take place in very uncontrolled environments. When people are drinking in the wild, they combine different kinds of alcohol. They eat or don't eat. Other variables that play a role in determining hangover severity include the degree of physical activity that occurs while drinking, the amount and quality of sleep that follows, and the impact of other intoxicants a person may ingest.
But testing in a controlled environment is also the only way to see what impact specific vitamins or supplements have on parameters associated with hangovers. "We're going to measure serum inflammatory markers and acetaldehyde levels and that kind of thing," Burke says. "We're going to do liver function tests."
While Burke's initial focus will be on the supplement formula he currently provides in pill form to Hangover Heaven patients who choose the Rapture package, he said he'd ideally like to test a wide range of substances, including ones like prickly pear extract, milk thistle, and various others that are often incorporated into packaged hangover cures. "I want to test everything so we'll finally see what really works."
Of course, the same challenge that faces other hangover researchers will face Burke too: Someone has to pick up the tab. But, once again, his locale could conceivably play a critical role. Instead of looking to the usual suspects —foundations, universities, and government agencies — Burke is hoping spirits manufacturers, the local nightclub industry, and maybe even some casinos will underwrite his efforts.
This makes a perfect kind of sense. Casinos have been giving away free booze for years. If any place on the planet should be the hangover research capital of the world, it's Las Vegas. Indeed, even if the local nightclubs and casinos don't quite see it that way and don't get involved, the city will continue to give Burke access to the most crucial component of his research: people with hangovers. And who knows? Maybe hangover sufferers will rise up and, in some sort of crowdsourced funding campaign a la Kickstarter, underwrite Burke's research themselves. If ever there were a cause to unite idealistic college kids and twentysomethings en masse, this would be it.
"I think it's probably about a three- to five-year process," he says. "That's what it's going to take to find something efficacious as well as something that's not going to cause serious side effects."
And it's not going to be one thing that works 100% for everyone, Burke explains. There will be different protocols for different people. Some might need to take the supplements three days before the night they actually go out drinking. Others might need the supplement as a shot rather than in pill form. "There also needs to be that educational component," he reiterates. But with enough testing, he believes, we just may be able to cure the common hangover in our lifetime.
Until that idyllic future happens, there's still much to admire about current progress in the field. Back in that luxury high-rise on the Strip, for example, the last four patients of New Year's Day are well into their treatment and feeling much better. They're snuggling under blankets. They're joking about how trashed the place looked in the morning before the cleaning ladies came. They're even learning a little bit about nutrition.
"Who wants a B12 shot?" Burke asks. "It keeps your tryptophan levels up." A short while later, he tells them about the supplements they get as part of the package, two tiny bottles of pills he's leaving for each of them. "Take the yellow ones during the daytime. Take the blue ones at night."
"We should put these in our care packages we give to our clients," Van Ryan remarks. "We should put the whole service on our menu of options people can choose. Do they want bottle service? Do they want hangover recovery?"
And of course, he's right. Redemption cocktails may not be the ultimate, instant miracle cure that eliminates hangovers before they ever happen, no IVs necessary, but in a way they offer something just as revolutionary: They're medical treatment as entertainment, medical treatment as luxury indulgence. If you're a working stiff, get a $10 package of Drinkin' Mate tablets. If you're a high roller, get Redemption cocktails in-room, where trained medical personnel will carefully monitor your recovery process and heal you with exclusive VIP medications you can't just get at the corner liquor store.
In this model, recovery becomes its own phase of the party, a communal experience to share, a tweetable moment. Indeed, right now, the four patients have taken out their phones and started snapping photos of one another. "Hey, doc," one of them asks. "Will you stand behind us in a pic, so it's official?"
Poses are assumed, cameras are aimed, everyone smiles. The party ended hours ago, but the fun never stops.