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.

Recent photographs of former US President Donald Trump with the UK’s King Charles III have drawn attention after visible discoloration was observed on his left hand, raising fresh questions about his health.

While Trump’s right hand has appeared discolored in earlier public appearances—a concern previously downplayed by both the former president and the White House—the latest images show similar changes on his left hand as well.

“Trump's right hand has been in bad shape for a long time now, but this picture taken today shows discoloration on the back of his left hand," independent journalist Aaron Rupar wrote on social media platform X.

Speaking to HealthandMe, Dr. Amit Prakash Singh, Consultant - Internal Medicine at the CK Birla Hospital, Delhi, explained the possible underlying causes that can result in hand discoloration. He noted that the condition may be due to:

• Bruising (bleeding under the skin)

This appears as blue, purple, or black patches. It may occur due to minor trauma or sometimes even spontaneously. The use of blood thinners or antiplatelet agents like aspirin can increase the likelihood of bruising. With age, blood vessels become more fragile, making bruising more common.

• Low oxygen or poor circulation

• Swelling (fluid buildup in tissues)

• Infection or inflammation

Dr. Singh advised people "to be concerned if there is sudden swelling in one hand, severe pain or tightness, persistent blue or black discoloration, breathlessness, fever with redness and warmth, or numbness and weakness".

"A purple or blue patch often suggests bruising, blue fingers may indicate circulation or oxygen issues, puffy hands suggest fluid retention, and red, hot swelling points toward infection," the expert said.

However, there is no official medical update on the discoloration in Trump's left hand. Therefore, any claims remain speculative. But it is not the first time that various speculations have been going around about the health of Trump.

Also read: Heat Stroke or Heat Exhaustion? AIIMS Doctor Explains Key Symptoms, How To Prevent

In an interview with The Wall Street Journal, in January this year, the US President informed that he takes aspirin doses more than his doctors recommend, and that is the reason for the bruising seen on his right hand. He has repeatedly said that his health is in "excellent" condition.

In the interview, he said, "They say aspirin is good for thinning out the blood, and I don't want thick blood pouring through my heart."

Trump, now 70, was diagnosed with chronic venous insufficiency, a condition that occurs when veins have trouble moving blood back to the heart. He also showed signs of bruising on his hand, which many attributed to frequent handshaking and to the use of aspirin.

Aspirin may still be considered for some people under 60 or 70 who have a higher risk of heart disease, but this decision should be made carefully. Factors like high blood pressure, high cholesterol, diabetes, smoking history, or a strong family history can influence whether aspirin makes sense for an individual.

With temperatures rising sharply, experts at the All India Institute of Medical Sciences (AIIMS) have warned that young children are significantly more vulnerable to heat stress than adults, urging parents to take preventive measures and recognize early warning signs.

Despite morning showers offering some relief, the national capital still recorded temperatures close to 40°C.

How Extreme Heat Affects Young Kids

Shefali Gulati, Professor, Department of Pediatric Neurology at AIIMS, highlighted that children are predisposed to both heat and cold stress and also tend to get dehydrated more quickly. She noted that global temperatures have been rising over the past few decades, and cited 2020 data from UNICEF, which showed that 76 per cent of children under 18 in South Asia—around 460 million—are exposed to extremely high temperatures, with 83 or more days in a year exceeding 35°C.

Dr. Gulati explained that young children often exhibit early behavioral changes when affected by heat. These can include irritability,

• reluctance to engage in outdoor activities,
• restlessness,
• excessive sweating,
• uneasiness,
• weakness.

She added that heat exposure, when combined with air pollution, can worsen health conditions, particularly in children with lung diseases and asthma.

“Heat can affect all parts of the human body. It begins with irritability and can progress to exhaustion,” she said.

In more severe cases, heat stress may lead to brain exhaustion, loss of consciousness, seizures, dehydration, and electrolyte imbalance.

Dr. Gulati further explained that the human body maintains its core temperature through physiological mechanisms, but these are less efficient in young children. During dehydration, increased blood flow to the skin reduces supply to vital organs like the brain. In patients with pre-existing kidney issues, this can result in acute or chronic injury.

Children with conditions such as cerebral palsy and other neurological disorders may also experience worsening symptoms due to heat exposure.

Further, dehydration can additionally strain the cardiovascular system, thickening blood and leading to tachycardia, thereby affecting cardiac function.

Beyond children, pregnant women exposed to extreme heat may face risks such as preterm birth, neurodevelopmental problems, and cognitive issues in newborns.

Dr Gulati emphasized the importance of fluids, Oral Rehydration Solution (ORS), and small, frequent meals, along with reduced outdoor activity. Preventive measures include wearing loose clothing, avoiding direct sun exposure, and limiting outdoor activities during peak heat hours.

The Importance of Diet: Avoiding Sugary Drinks

Also read: Heat Stroke or Heat Exhaustion? AIIMS Doctor Explains Key Symptoms, How To Prevent

Parmeet Kaur, Chief Dietitian at AIIMS reiterated the importance of proper hydration, food safety, and dietary habits during extreme heat, warning that both children and adults face increased risk of dehydration and related complications.

“One has to avoid consuming extra sugary and salty foods, drinks, and snacks, because if one is consuming highly processed drinks or snacks loaded with sodium and sugar, it may lead to dehydration,” Kaur said.

"Hydration is key, and one should not wait to feel thirsty," she added, stressing the need to consume home-made and simple food.

For immediate management, homemade Oral Rehydration Solution (ORS) can be used, prepared with six teaspoons of sugar and half a teaspoon of salt in one liter of water.

However, she cautioned "against sugary drinks and packaged snacks like chips, explaining that high sugar and sodium content can worsen dehydration while giving a false sense of energy. While these products may create the impression of quick rehydration or an instant energy boost, they can instead contribute to greater fluid loss and increase the risk of severe dehydration.”

Instead, the expert recommended traditional cooling options such as bael sharbat, lassi, sattu, and gond katira. Ingredients like coriander, mint and onion were also suggested as part of summer dietary practices.

The dietician advised small, frequent meals that are easy to digest, including roasted and unsalted chana or peanuts, while avoiding heavy meals.

Food safety is another major concern during the summer. High temperatures increase the risk of microbial growth in stale or improperly stored food.

Kaur warned to "not consume food left at room temperature for more than two hours", as it can lead to microbiological growth. Sprouts were also flagged as potentially risky in hot weather.

Further, the expert also urged for "high heat cooking method with vegetarian food to be cooked at around 70°C, while non-vegetarian items require temperatures between 70°C and 80°C".

The expert reiterated the need to

• maintain hydration levels of approximately 2.5 to 3 liters per day.
• ensure electrolyte balance,
• take preventive action before body temperature rises.

Even as heatwave conditions continue to intensify across parts of the country, cases of heat-related illnesses are on the rise, leaving many confused between heat stroke and heat exhaustion.

While both are caused by prolonged exposure to high temperatures, their severity, warning signs, and management can differ significantly.

Speaking to HealthandMe, Dr. Naval Vikram, Professor, Department of Medicine, at the AII India Institute of Medical Sciences (AIIMS), explained the key symptoms to watch out for, how to tell the difference between the two conditions, and the simple yet crucial steps individuals can take to protect themselves during extreme heat.

“The general features of a patient with heat stroke are: first, his or her body temperature will be very high. It will not be around normal levels like 104, 105, or 106—it will be significantly elevated. Second, the person may be delirious, confused, or even in a state of unconsciousness or coma. The breathing will also be labored. These are the features of heat stroke,” Dr Vikram said.

On the other hand, a person with heat exhaustion remains conscious, but looks and feels very tired. The individual is also likely to experience

• body ache,
• muscle pain,
• headache,
• muscle cramp,
• body pain or fatigue.

"If this has happened after exposure to heat, it is similar to the feeling one gets after jogging, running, or playing for about half an hour and then feeling exhausted. If that same feeling occurs without doing any such activity, then it is a stage of heat exhaustion, because it is happening due to the heat,” Dr Vikram told HealthandMe.

Who Is More At Risk With Heat-related Problems?

The most vulnerable category for heat-related problems is the extremes of age—the younger children and older adults.

The expert noted that younger children may not be able to express their symptoms completely. They may not be able to tell you exactly what they are feeling.

At the other end, older adults often have multiple health issues—neurological conditions, diabetes, hypertension, and kidney problems.

"So multiple organs may already be affected to some extent. In such situations, if heat-related illness occurs, it becomes difficult to diagnose, especially if they already have neurological problems like confusion or altered behavior," Dr Vikram said.

With existing comorbidities, other organs may already be compromised, so the tipping point towards severity happens very quickly. In contrast, younger individuals generally have greater body reserves.

Therefore, people at the extremes of age are more vulnerable, also because it can sometimes be difficult to recognize and diagnose the condition in them.

How Can One Prevent?

While it may be impossible to avoid rising temperatures, the focus should be on how much you can protect yourself. The expert suggested measures such as:

• Try to avoid exposure to extreme heat as much as possible.

• In case of being exposed, make sure to cover yourself—cover your head and upper body, use an umbrella, stay hydrated, and take breaks in between.

• If you have to work in a hot environment for a couple of hours, take a break in a cooler or temperature-controlled environment for at least half an hour before resuming, rather than continuously working in the heat. These steps can help prevent heat-related problems.

• If symptoms do occur, and it is heat exhaustion, take rest and avoid further activity for some time.

• In more severe cases—if someone shows symptoms like loss of consciousness or very high body temperature—they should be taken to a hospital immediately. Do not try to manage such cases at home.”