With the holiday season high, there is festive cheer, family gatherings and also an undeniable increases in alcohol consumption that fills the air. Christmas and New Year's Eve celebrations to spring break and bachelor parties and sporting events that bring together huge crowds for celebrations mean that drinking becomes synonymous with partying. But behind the revelry lies a much darker behavior: high-intensity drinking.

Alcohol is the most widely used substance in the United States; it has been reported that 84% of adults aged 18 and older reported lifetime use. Moderate drinking is socially acceptable, but high-intensity drinking is an alarming trend. The behavior of consuming eight or more drinks over a few hours for women and 10 or more for men exceeds binge drinking and significantly increases risk for harm.

High-intensity drinking is far from being just a mere passing concern; it is instead a public health crisis. The burden is even greater as 29 million people in the United States suffer from alcohol use disorder. That has caused over 140,000 deaths annually while accounting for 200,000 hospitalizations and 7.4% of visits to emergency departments in the United States. However, only 7.6% of these affected get treated, thus forming a glaring gap in handling this concern.

What Is High-Intensity Drinking?

High-intensity drinking is a dangerous escalation from traditional binge drinking, characterized by consuming double or triple the standard binge amounts. While binge drinking involves four or more drinks for women and five or more for men, high-intensity drinkers often surpass these levels, leading to blood alcohol concentrations (BAC) exceeding 0.2%—a level that significantly impairs judgment and motor skills.

According to Dr. George Koob, the director of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), high-intensity drinking is one of the factors that intensify the risks of injuries, overdose, and death. It is also very highly associated with the onset of AUD, since the chance of addiction increases with increased alcohol consumption per occasion.

Blackouts and Memory Loss Risks

One of the most troubling consequences of high-intensity drinking is alcohol-induced blackouts, periods of amnesia where individuals may appear functional but are incapable of forming memories. Blackouts occur when alcohol disrupts the hippocampus, the brain region responsible for memory formation.

Blackouts are often categorized into two types:

1. Fragmentary Blackouts: Characterized by spotty memory, where recalling certain details can trigger partial recollection.

2. En Bloc Blackouts: Significant amnesia for hours, wherein no memory is created at all, even if tried to be recalled.

Aside from memory loss, intense binge drinking is linked with poor decision-making, violence, injury, and conflicts in personal relationships.

Why Holidays and Special Events Are Hotbeds for Excessive Drinking

Holidays and celebrations create the perfect storm for high-intensity drinking. According to research, adults drink nearly double the amount of alcohol during holidays like Christmas and New Year's Eve than they do at any other time of the year. It is during these periods of social gathering, holiday stress, and seasonal sadness that people drink in excess.

For college students, experiences like spring break and 21st birthdays increase the danger. Some studies indicate that students, especially those who travel with buddies to spring break, indulge in more alcohol and make more serious decisions than any student who remains at home or goes with their family to other destinations. Sporting events are, too, notorious for promoting drunk consumption, especially among male customers. Alcohol consumption usually goes high during Super Bowl Sunday, thus leading to games day violence and arrests.

Consequences of Heavy Intensity Drinking

High-intensity drinking impacts not only physical health and mental well-being but also social relationships.

Acute Risks

- Alcohol poisoning

- Severe dehydration and electrolyte imbalances

- Hypoglycemia

- Risky sexual behavior

- Injuries and accidents

Chronic Risks

- Liver damage, alcoholic hepatitis, and cirrhosis

- Cardiovascular diseases such as arrhythmias and cardiomyopathy

- Neurological damage, including memory deficits and blackouts

- Progression to alcohol dependence or AUD

Psychological Impact

High-intensity drinking is strongly linked with increased risks of depression, anxiety, and suicidal ideation. Poor decision-making during episodes can lead to long-lasting consequences, including damaged academic, professional, or personal outcomes.

How to Address the Problem

Combating high-intensity drinking requires education, early intervention, and accessible treatment options. The NIAAA has defined high-intensity drinking to be distinct from binge drinking and has called for targeted approaches to decline prevalence and associated harms.

One promising treatment option is naltrexone, which a medication helps control alcohol cravings. Encouraging in preliminary evidence, more extensive clinical trials will be necessary to ascertain its efficacy more specifically in high-intensity drinkers.

As we head into the holiday season and other special occasions, it is important to heighten awareness of the dangers of high-intensity drinking. A good understanding of long-term consequences and seeking help when alcohol-related issues arise can be the difference between life and death. Celebrations should be about joy and connection, not about the gateway to harm.

If you or someone you know drinks at dangerous levels or have an alcohol use disorder, there is help available. Remember, for suspected cases of alcohol poisoning, dial 911. In this way, we can foster healthier relationships with alcohol and create safer environments for everyone.

H1N1 cases are rising across several Indian states, with infections, hospitalisations and deaths being reported. However, the Indian Council of Medical Research (ICMR) has said the increase is not unusual and that no new strain is driving the current rise.

The ICMR has clarified that the circulating Influenza A (H1N1) pdm09 viruses have been present in India since 2025 and that no new strain has been identified.

ICMR Director General Dr Rajiv Bahl has said H1N1 accounts for nearly 98% of Influenza A cases currently detected in India, while H3N2 accounts for around 2-3% of cases.

Health authorities have urged people not to panic but to remain alert, particularly if symptoms become severe or persist.

States Reporting H1N1 and Influenza Cases

Delhi

Delhi has reported 138 new H1N1 cases in the last 24 hours, taking the cumulative number of H1N1 cases this year to 2,446, the Delhi government said on Wednesday.

The total number of Influenza A cases has reached 3,177 as the city continues to see a rise in seasonal influenza infections.

Maharashtra

Maharashtra is witnessing a significant surge in Influenza A (H1N1) cases, with the 2026 tally already surpassing the total recorded throughout the previous year.

As of August 21, the state had reported 1,109 H1N1 cases, compared with 942 cases in all of 2025.

Mumbai and Pune remain the primary centres of reported infections, together accounting for around 65% of the state's total cases.

Uttarakhand

Uttarakhand has reported 49 confirmed H1N1 cases and five deaths as of late August 2026, prompting a heightened health alert.

The state has also reported 103 dengue cases, including 49 confirmed cases from Dehradun.

Karnataka

Karnataka has recorded 4,212 laboratory-confirmed influenza cases, including H1N1 cases, across 32 districts since January, with the majority of active cases concentrated in Bengaluru.

That compares with 4,583 cases in 2025 and 3,903 cases in 2024.

Kerala

Kerala has reported 7,421 influenza cases and 88 deaths this year, with most fatalities reported among people over 50.

These figures refer to influenza overall and should not be treated as H1N1-specific cases or deaths.

What Does H1N1 Usually Feel Like?

According to the Ministry of Health and Family Welfare, fever and systemic symptoms generally last around three days, although they can persist longer. Cough and weakness may continue even after the fever settles.

Dr GC Khilnani, Chairman, PSRI Institute of Pulmonary, Critical Care & Sleep Medicine, PSRI Hospital, New Delhi, told HealthandMe that common symptoms include body aches, sore throat, headache and fever, which can sometimes be high-grade.

Nausea, vomiting and occasional chest pain may also occur. The illness can be relatively short-lived and may last around three to five days in many cases.

H1N1 Red Flags You Shouldn't Miss

Certain symptoms should not be managed casually at home. These include:

Fever accompanied by breathlessness

Chest pain

Increasing weakness

Confusion

Bluish lips or nails

A noticeable fall in oxygen levels

These symptoms may indicate more serious respiratory involvement and require prompt medical assessment.

Who Needs to Be Particularly Cautious?

Although influenza can affect people of any age, certain groups are more likely to develop severe illness. These include young children, older adults, pregnant women and people with asthma or other chronic lung conditions, heart disease, diabetes or kidney disorders.

People with weakened immune systems are also at greater risk of complications. This includes cancer patients, particularly those receiving chemotherapy or other treatments that suppress immunity.

“An oncology patient may not always develop a dramatic set of symptoms at the beginning. Chemotherapy can affect blood counts and reduce the body's ability to mount an effective response to infection. That is why a new fever or respiratory symptom during treatment deserves earlier attention than it might in an otherwise healthy person,” says Dr Ankur Nandan Varshney, Sr. Medical Oncologist, Medanta Hospital, Noida, told HealthandMe.

Which Tests Are Actually Needed?

Not everyone with a cough and fever needs an H1N1 test. Testing is generally guided by symptoms, severity, risk factors and the clinical situation.

If the doctor suspects influenza and confirmation is needed, testing is usually done using a respiratory sample collected through a nasal or nasopharyngeal swab. Molecular methods such as RT-PCR can identify the influenza virus and help confirm the diagnosis.

“For a cancer patient, I would not look at the H1N1 report in isolation. A CBC with differential, particularly the neutrophil count, can be clinically important during chemotherapy. Depending on symptoms, oxygen saturation and examination findings, the doctor may also recommend a chest X-ray or CT scan to look for pneumonia or other lung complications,” explains Dr Varshney.

Don't Wait for Symptoms to Become Severe

People who are more susceptible to complications should seek medical advice early rather than relying on repeated home tests or taking medicines without guidance.

While many seasonal influenza infections improve on their own, individuals with weakened immunity or other underlying risk factors need closer monitoring and should contact their doctor promptly if symptoms appear or start getting worse.

“Especially in patients undergoing cancer treatment, the aim should be to identify deterioration early rather than wait until breathing becomes difficult,” said Dr Varshney.

How Can You Prevent H1N1 Infection?

Simple precautions can help reduce the spread of seasonal influenza:

Wash your hands regularly with soap and water.

Cover your mouth and nose when coughing or sneezing.

Avoid close contact with people who are sick.

Stay home when experiencing flu-like symptoms.

Improve ventilation in shared indoor spaces.

Avoid touching your eyes, nose and mouth with unwashed hands.

Amid a significant surge in H1N1 cases in India, experts say the flu can affect more than just the respiratory system—it can also cause eye symptoms.

H1N1, a strain of influenza A virus, is usually associated with fever, cough, sore throat, body ache, fatigue and other respiratory symptoms. It spreads mainly through respiratory droplets when an infected person coughs, sneezes or talks. However, influenza can sometimes affect areas beyond the respiratory system, including the eyes.

Some people may develop watering, redness, irritation, photophobia or dryness during a flu infection. While these symptoms may improve as the flu resolves, sudden changes in vision should not be ignored.

How Does H1N1 Affect the Eyes?

Speaking to HealthandMe, Dr. Sfurti Maan, Senior Consultant, Internal Medicine, Shalby International Hospital, said that in most cases, eye symptoms are mild and settle with appropriate care. One of the more noticeable problems is viral conjunctivitis.

“The eyes may become red and watery, with burning, irritation or mild discharge. More intense inflammation may cause swelling of the eyelids or conjunctiva,” the expert said.

A person may also develop light sensitivity or general discomfort in the eyes.

Another possible finding is a bright-red patch on the white portion of the eye. This is called a subconjunctival hemorrhage and can sometimes occur after severe coughing or vomiting.

When Should You See A Doctor?

Most H1N1-related eye problems are limited to conjunctivitis. However, rare cases of deeper eye inflammation, including uveitis, retinitis and optic nerve involvement, have also been reported. These complications are uncommon but can affect vision.

“If someone has influenza and develops persistent blurred vision, severe eye pain, marked sensitivity to light or a sudden drop in vision, that should not be treated as routine conjunctivitis. These symptoms need an eye examination,” Dr. Sfurti said.

Dr. Poninder Kumar Dogra, Senior Consultant, Ophthalmology at ShardaCare – Healthcity, said people with influenza should see an ophthalmologist if they experience:

• Sudden loss of vision

• Blurred or double vision

• Flashes of light

• An increase in eye floaters

• Vision problems when looking close up

• Substantial eye pain

• Intense redness or redness around the eye

• An unusual increase in photophobia with discharge

What About Contact Lens Wearers?

Contact lens wearers may develop eye pain, redness and changes in vision. Contacts should not be worn, and an eye examination should be arranged until the eyes have been investigated and an ophthalmic practitioner says they can be worn again.

Fluid loss, dehydration and fever during the flu can cause dryness and discomfort. Various medications may also cause dry eyes.

How Can You Prevent Eye Symptoms?

Annual flu vaccination is one of the key ways to reduce the risk of influenza. Others include:

• Good hand hygiene,
• covering the mouth and nose while coughing or sneezing,
• avoiding close contact with people who are sick
• staying home when unwell.

Dr. Sfurti advised people with flu symptoms to also avoid touching or rubbing their eyes, particularly with unwashed hands. If conjunctivitis is present, sharing towels, tissues, pillows or personal eye-care products should also be avoided.

“It is important not to panic just because H1N1 can affect the eyes. Serious ocular complications are very rare. The important thing is to recognise the warning signs. If there are only redness, watering and mild irritation, it is usually not a reason for alarm. But any significant change in vision deserves prompt medical attention.”

Dr. Poninder told HealthandMe that antibiotic drops or steroids should never be self-prescribed without seeing an ophthalmologist, as they can potentially delay diagnosis or affect the diagnosis of another condition.

Redness with a slight amount of discharge, discomfort or irritation with transient dryness that gradually resolves may not require an ophthalmologist referral. However, sudden loss of vision, intense pain, extreme redness and progressing inflammation should be checked.

It usually starts small, a sting during a bowel movement, a smear of blood on tissue, an ache that feels like it will pass on its own. The instinct is to go for an old antiseptic ointment or a painkiller left over from something else. For a few days, it works. The pain eases, the bleeding stops showing up, and the natural conclusion follows, it's healed. Then, weeks or months later, it comes back. The same cream goes on, the same tablet gets swallowed, and the cycle repeats, each round quietly convincing the patient that this is something to manage rather than consulting a doctor.

Why Repeated Self-Medication Can Delay The Right Diagnosis?

That cycle is where the real cost shows up. Every round of self-medication is also a round of postponed diagnosis, pain, bleeding, or discharge gets suppressed instead of investigated, and a fissure or fistula that could have been caught and treated early is left to become chronic instead. It's a more common pattern than it should be: a 2025 study on haemorrhoidal symptoms found that only 30.8% of patients had sought medical advice at all, citing embarrassment and fear of invasive examinations as the main barriers.

An anal fissure is a small tear in the lining of the anal canal. Many improve with the right conservative care, soft stools, and medication suited to that specific case. What concerns me is when a patient keeps self-treating through repeated episodes. A fissure that keeps coming back usually means something underlying hasn't been resolved, however many times the symptoms have been calmed down.

Also read: Ulcerative Colitis vs Crohn’s Disease: 8 Key Differences Every Person Must Know

Why Recurring Symptoms Should Not Be Self-Diagnosed?

Another common mistake is assuming that recurring symptoms are caused by the same condition as before. A fissure two years ago cleared up with a certain cream, so when something similar happens now, the same tube comes back out. But recurring symptoms don't automatically mean the same condition has returned. Fissures, fistulas, and haemorrhoids can look remarkably alike from the outside, which is exactly why self-diagnosis is unreliable more often than people expect.

None of this means every twinge needs a procedure, or that patients should panic at the first uncomfortable day. Plenty of cases genuinely settle with timely, conservative management. The real skill is recognising when self-care stops being enough.

If pain, bleeding, swelling, pus, or discharge keeps returning or never fully clears, that's the signal to get it looked at, not medicated into silence again. A proper specialist assessment can pin down what's actually happening and whether the right next step is conservative treatment, medication, or a procedure.

For anyone dealing with a fissure or a fistula, the goal isn't just to make the symptom vanish for a while. It's understanding why it showed up in the first place. Temporary relief feels like progress, but it isn't recovery.