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.

Beyond lung cancers, air pollution fine particulate matter (PM2.5) is increasing mortality for breast as well as liver cancers, according to a global study led by the Union for International Cancer Control (UICC), including researchers from the Indian Council of Medical Research (ICMR).

The important study showed that long-term exposure to PM2.5 increases the overall risk of developing cancer and the chances of dying from it compared with those living in cleaner environments.

For every 10 micrograms per cubic meter (µg/m³) increase in PM2.5 exposure, the overall risk of cancers increases by more than 11 per cent. At the same time, the risk of death also increases by more than 12 per cent for every 10 µg/m³ increase in PM2.5 exposure.

The researchers argued that while other common risk factors like tobacco and alcohol are being targeted with notable progress, air pollution is silently eroding the gains being made.

“We have made huge strides in reducing deaths from cancer, but polluted air is silently undermining that progress. It is a risk people cannot opt out of, and one that disproportionately affects women, children, and people living in poverty,” Cary Adams, CEO, UICC.

“The cancer community continues to make progress in addressing other major risk factors, including tobacco use, alcohol consumption, and viral, bacterial, or parasitic infections such as HPV and HBV that cause cervical and liver cancers. It is increasingly clear that air pollution must also be recognized as a major and preventable factor that increases the risk of developing cancer and of dying from the disease,” added Dr Elisabete Weiderpass, Director, IARC.

Risks of PM2.5: Beyond Lung Cancer

The study, based on data from 42 meta-analyses and systematic reviews published between 2019 and 2024, showed significantly strong associations for liver, colorectal, and breast cancers.

As per recent data from the International Agency for Research on Cancer (IARC), PM₂.₅ exposure contributes to 434,000 lung cancers per year, accounting for more than a quarter of preventable lung cancers in women and nearly one in six in men.

In addition to lung cancer risk, the study noted that the rising levels of PM2.5 are associated with

• a 32 per cent higher incidence of liver cancer
• an 18 per cent increase in the odds of developing colorectal cancer.

• a 12 per cent higher overall risk of dying from cancer,
• a 20 per cent higher risk of death from breast cancer,
• a 14 per cent from liver cancer,
• a 12 per cent from lung cancer.

Who Is At A Higher Risk

According to the researchers, people living in low- and middle-income countries bear the greatest overall burden. These countries frequently lack the resources to reduce pollution at source or to provide timely access to cancer prevention, diagnosis, and treatment.

The challenge is compounded by the projected rise in global cancer cases, expected to increase from 20 million in 2022 to 35 million by 2050. People at risk include:

• Women and children, particularly in settings where solid fuels are used for cooking and heating.
• Women exposed to household air pollution face a 69 per cent higher risk of lung cancer, alongside increased risks of cervical cancer.
• Outdoor workers and communities living near industrial facilities are also at heightened risk, with exposure often concentrated in economically deprived areas.

What Actions Are Required?

The researchers underscored that the evidence presented in the report is already sufficient to justify decisive action to reduce exposure to polluted air. They called upon policymakers to make required changes across energy, transport, industry, and urban planning to reduce the risk of cancer from air pollution.

The study urged the need for properly implementing effective interventions that are well-established. These include:

• Stronger emissions standards and enforcing the WHO air quality Standards
• A transition to clean energy and clean cooking
• Improved urban design by investing more in green infrastructure
• Expanded air-quality monitoring in High-Risk Areas
• Update cancer control plans.

During the summer, it is important to stay hydrated, but for kidney patients, excessive intake of fluids is just as dangerous as not drinking enough. Most people are encouraged to drink extra fluids during hot weather; however, patients with chronic kidney disease (CKD) and those on dialysis must exercise greater control over their daily hydration and fluid intake because their bodies cannot effectively excrete excess fluids, leading to potential complications.

What is overhydration?

Dr Anupam Roy, Additional Director – Nephrology and Kidney Transplant at Aakash Healthcare Multi-Specialty Hospital, Dwarka, said, “Overhydration occurs when the body retains more fluid than it is able to eliminate. For kidney patients, overhydration typically leads to fluid overload as a result of excessive fluid accumulation in the body. Early signs of fluid overload may include swelling in the feet, ankles, and/or face. If not treated, fluid may continue to build up and cause the lungs to fill with fluid, resulting in shortness of breath and difficulty lying down. If left untreated, gaseous exchange in the lungs will be impaired, and the patient will require immediate medical treatment for pulmonary oedema (a life-threatening complication).”

What happens when you are overhydrated?

The effect of excess fluid on the heart and blood pressure is considered a significant concern. Excess fluid results in additional strain on the cardiovascular system, leading to high blood pressure. This extra workload may also increase the risk of serious complications (e.g., heart failure) for individuals who already have hypertension or heart disease. Dialysis patients are at particular risk of developing complications since they rely on regularly scheduled treatments to remove excess fluid. Excessive fluid consumption between dialysis sessions may complicate and increase the discomfort associated with removing excess fluid during dialysis.

How does overhydration affect kidney disease patients?

Overhydration may also cause an imbalance in electrolytes, such as sodium. Consuming a large amount of water without adequate intake of electrolytes could dilute sodium in the bloodstream, resulting in hyponatraemia. Symptoms of hyponatremia vary from mild (nausea and headaches) to severe (confusion, seizures, and, in extreme cases, coma). This condition can potentially be life-threatening for kidney disease patients, who often have difficulty maintaining an optimal balance of electrolytes.

Many people forget that they can obtain fluids from certain foods and drinks, such as soup, yogurt, watermelon, and tea or juice. In the summertime, people tend to consume these types of foods and drinks more often, which can cause them to exceed the recommended daily fluid intake. Many also believe that drinking extra water will flush toxins out of their system; however, when the kidneys are not functioning properly, excess fluids can be difficult to remove from the body.

How much water should kidney patients drink?

Dr Roy said that proper hydration for someone with kidney disease needs to be planned carefully. The amount of fluid a person can consume depends on their stage of kidney disease, urine output, and whether they are on dialysis. Some simple strategies can help maintain proper hydration: use small cups for drinks, consume fluids throughout the day rather than all at once, avoid foods high in salt (as these increase thirst), and track daily fluid intake.

The main reason for drinking fluids is to ensure the right amount is consumed; therefore, the most important aspect of hydration is maintaining balance. Maintaining this balance can help prevent complications and allow individuals to remain as healthy as possible. When kidney patients understand their hydration needs and receive proper guidance during the summer, they can avoid causing further harm by placing additional strain on their bodies.

The U-WIN (Universal Immunization Win) platform has been transformative and has helped India tackle the concerning burden of zero-dose children, said Dr NK Arora, an immunization expert and member of the National Technical Advisory Group on Immunisation in India (NTAGI).

In an exclusive conversation with HealthandMe during World Immunization Week 2026, Dr Arora, Executive Director of The INCLEN Trust International, traced the journey of the U-WIN portal and explained how it has strengthened vaccine uptake in the country.

U-WIN is a digital platform and app to help people find vaccination centers near their residences, manage vaccination appointments at health facilities, and maintain vaccination records.

Dr Arora noted that the U-WIN portal created a digital ecosystem that played a critical role in registration, appointment scheduling, vaccine tracking, and real-time monitoring.

The Origin Of U-WIN

U-Win was launched in October 2024 and is available in 12 languages, including English.

Dr Arora, also the chair of the COVID-19 and HPV vaccine working group, shared that during the deadly COVID pandemic in 2020—around July—it became very clear that to vaccinate 140 crore people, some kind of IT platform is needed that will track individuals who had been vaccinated, especially when they needed their second dose, and later, booster doses.

“Everything started somewhere around July 2020, and by January 2021, we had the Co-WIN platform. By mid-April, things were streamlined. The platform gives us a long list of individuals who have been vaccinated. It also helps to know who has been left out of the vaccination.

“It is like a registry of human beings who are getting immunized. And we could send reminders, we could send certificates, and we can also tell the individual when to get their second and third dose,” the expert said.

He noted that as COVID became less intense toward the end of 2021, serious discussions began on using the same platform for routine immunization. This is where the concept of U-WIN came in 2022. It has now been piloted and is gradually being used.

U-WIN: Closing the Gap For Missed and Zero-Dose Children

The UWIN now has the mechanism to ensure that immunization is completed for everyone who registers. One user can register up to 10 people in one mobile number, including citizens/guardians, pregnant women, infants (0-1 years), children (1-7 years), and adolescents (7-19 years).

“The key issue is that tracking provides two or three important inputs. First, it ensures that everyone is getting vaccinated and that it is not dependent on memory. There is a proper record—whether a person or child has received vaccines and what their current status is, including whether the schedule is complete,” Dr Arora said.

“Second, one of the main reasons for missing or delaying the next dose was that mothers often did not remember. Fathers contributed very little to this process, but they also became involved because of the reminder system,” he added.

Another important role of U-WIN is tackling the so-called zero-dose children—those who have never been vaccinated.

“About 4–5 per cent of our eligible population falls into this category, meaning they have not received even the first pentavalent dose. On the face of it, 4–5 per cent may not seem like a huge problem. But when we look at the absolute numbers—out of 26 million—it translates into a very large number, which we cannot afford to miss. So tracking helps identify these children through the micro-plan system”.

U-WIN Enables Life-course Immunization

Also read: World Immunization Week: Vaccines Are Like Insurance, They’re Safe—Take Them, Says Dr NK Arora

“When a child is vaccinated, we know when boosters are due—at one and a half years, then at five years. But none of us remembers this. Even among well-informed parents, this is often forgotten. This system helps address that gap,” Dr. Arora said.

Further, when the same individual becomes eligible for vaccines like HPV—typically between 9 and 14 years—there is again a gap that needs to be addressed.

Certification is another benefit, as it creates a documented process, particularly for programs like oral polio vaccination.

Dr. Arora highlighted that in case of any future pandemic-like situation that requires repeated vaccinations, “we have a mechanism in place”.

“This IT platform has truly transformed the system. There is also a lot of discussion about using similar platforms for TB patients, pregnant women, and other flagship programs like non-communicable diseases. So, for India, digitalisation is at its best when we talk about U-WIN.”