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.

Standing up suddenly from your bed, sofa or chair can sometimes cause a brief “head rush”, you may feel light-headed, notice your vision dimming, feel weak or even slightly unsteady. While this can feel alarming, there is a simple physiological explanation for why it happens.

When you stand up, gravity causes some of your blood to temporarily move towards your legs and abdomen. This reduces the amount of blood returning to the heart. Within seconds, the autonomic nervous system usually steps in by tightening the blood vessels and adjusting the heart rate to maintain blood pressure and ensure enough blood reaches the brain.

When A Sudden Drop In Blood Pressure Becomes A Concern

A brief drop in blood pressure during this transition can be normal. However, if the drop is too significant or the body is unable to compensate properly, it can lead to dizziness, blurred vision, weakness and, in some cases, fainting. Orthostatic hypotension is clinically defined as a sustained fall in systolic blood pressure of at least 20 mmHg or diastolic blood pressure of at least 10 mmHg within three minutes of standing.

Several factors can contribute to this, including dehydration, heat, prolonged inactivity, blood loss and medications that lower blood pressure. Recurrent episodes can also be linked to problems with the autonomic nervous system, including autonomic involvement in Parkinson’s disease and other neurodegenerative disorders.

Also read: The Silent Killer: Why More Indians Need To Pay Attention To Liver Cancer

How To Prevent The Head Rush And When To Seek Help

One simple precaution is to avoid changing positions too quickly, especially after lying down for several hours. Sitting on the edge of the bed for a few moments before standing gives the cardiovascular system time to adjust. Moving your feet or tightening your leg muscles before getting up may also help improve blood flow back to the heart. If you start feeling dizzy, it is safer to sit or lie down rather than trying to walk through it.

An occasional, very brief episode may simply be the body’s normal response to a sudden change in posture. However, frequent episodes, fainting, falls, palpitations or persistent dizziness should not be ignored and warrant medical assessment, particularly in older adults or people taking multiple medications.

Dr Sachin Adukia Sr Consultant M.B.B.S., MD (General Medicine), DNB (Neurology), LH Hiranandani Hospital

Gastroesophageal reflux disease (GERD), commonly known as acid reflux, occurs when stomach contents flow backward into the esophagus, causing heartburn, regurgitation, chest discomfort, and sometimes chronic cough or hoarseness. This happens because the lower esophageal sphincter (LES), a muscle that normally prevents backflow, becomes weak or relaxes inappropriately, allowing acid to irritate the food pipe repeatedly. If left untreated, persistent reflux can lead to inflammation (esophagitis), ulcers, scarring, and in rare cases, pre-cancerous changes known as Barrett’s esophagus.

The global prevalence of GERD has been increasing in recent years, with around 14 % of adults worldwide affected according to recent meta-analyses. In India, community studies show notable rates, with higher prevalence in urban populations compared to rural areas and estimates ranging from about 8 % in some regions to higher figures in cities, reflecting shifting lifestyles. In Kolkata, according to Dr. Pradipta Sethy, Director, Gastroenterology, Manipal Hospital, EM Bypass and Mukundupur, the major patients are women, mostly pre-menopausal and menopausal, between the ages of 30-55 years. This rise can be attributed to several interconnected lifestyle and environmental factors.

One major contributor is dietary change. Traditional diets rich in fiber and whole foods are increasingly replaced by high-calorie, processed, and high-fat foods, along with frequent consumption of spicy and fried items. These foods can relax the LES and increase gastric acid production, making reflux more likely. In addition, habitual late-night meals followed by lying down soon after eating are common in urban settings and further promote reflux episodes.

Obesity and sedentary lifestyles are also important risk factors. Excess abdominal fat increases pressure on the stomach, forcing acid upward into the esophagus. Many adults with GERD in India and globally have overweight or central obesity, a trend growing alongside reduced physical activity. Stress and irregular eating patterns that accompany modern work life are additional contributors, often exacerbating symptoms and prompting unhealthy habits like caffeine or alcohol use, both of which can aggravate acid reflux.

Thankfully, GERD can often be managed effectively through simple lifestyle modifications. Eating smaller, more frequent meals and avoiding known trigger foods such as citrus fruits, chocolate, caffeine, and high-fat foods can reduce reflux episodes. Waiting 2–3 hours after eating before lying down and elevating the head of the bed during sleep helps keep acid in the stomach by using gravity to support digestion. Maintaining a healthy weight through regular physical activity reduces abdominal pressure, while quitting smoking and limiting alcohol intake supports LES function and esophageal health. Managing stress with techniques such as meditation or yoga further helps control symptoms by improving overall digestive function.

In conclusion, the rise of GERD in India mirrors global trends driven largely by dietary shifts, obesity, and modern lifestyle pressures. While medication is valuable for many patients, sustainable improvements often begin with these evidence-based lifestyle changes that address the root causes of acid reflux and improve long-term digestive health.

Rashes are common in children and can occur for many reasons. Most are harmless and settle on their own, but some may need medical attention. Knowing the warning signs can help parents decide when home care is enough and when to consult a doctor.

Why Do Rashes Happen?

Children’s skin is sensitive and can react to heat, friction, allergens, insect bites, irritants or infections. Common causes include heat rash, eczema, contact dermatitis, insect bites and viral infections such as chickenpox, hand-foot-and-mouth disease and roseola.

A rash can look worrying, but the child’s overall condition is often as important as the appearance of the rash itself.

When Home Care May Be Enough

If your child is active, reasonably comfortable, feeding and drinking well, and otherwise appears well, a mild rash can often be managed at home.

Home care may be appropriate when the rash:

• Is mild and limited to a small area
• Is not spreading quickly
• Causes only mild itching or discomfort
• Occurs without concerning symptoms
• Looks consistent with a known condition such as heat rash or eczema

Avoid applying multiple creams, powders, antiseptics or home remedies, as these may irritate the skin or make the rash harder to assess. Medicines or steroid creams should not be used without medical advice. Your paediatrician can recommend suitable treatment based on your child’s age, weight and the likely cause of the rash.

When Should You See a Doctor?

Seek medical advice if your child has:

• A rash with fever, particularly if the child appears unwell, unusually sleepy, less responsive or is becoming progressively worse
• A red or purple rash that does not fade or become lighter when pressed firmly with a clear glass, especially if the child has fever or appears unwell
• A rapidly spreading rash
• Large blisters, peeling skin or a painful/tender rash
• Signs of a secondary skin infection, such as increasing redness, warmth, swelling, pain or pus
• A new or unexplained rash in a newborn or young infant, especially if accompanied by fever, poor feeding or unusual sleepiness
• Unusual sleepiness, weakness, poor feeding or reduced drinking
• A rash that is getting worse, keeps recurring or does not improve with appropriate home care

Seek Emergency Care Immediately If

A rash is accompanied by:

• Difficulty breathing or swallowing
• Swelling of the lips, mouth, face or tongue
• Extreme sleepiness, marked weakness or a child who is difficult to wake
• Rapid deterioration in the child’s overall condition
• A concerning non-fading red or purple rash in a child who appears unwell

What Parents Should Remember

Most childhood rashes are temporary and harmless. However, it is important to look beyond the rash itself.

Note when the rash started, where it first appeared, whether it is spreading and whether your child has fever or other symptoms. A photo of the rash can also help your paediatrician understand how it has changed over time.

Trust your instincts. If your child seems unusually unwell, is getting worse or something simply does not feel right, it is always better to seek medical advice rather than waiting.

A Simple Rule for Parents

Home care may be enough if your child is well, active and comfortable. Seek medical attention if the rash is accompanied by significant illness, rapid worsening or any warning signs.

By Dr Navin Bhatia, Senior Consultant & HOD – Paediatrics & PICU, PB Health