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.

Delhi's air quality deteriorated significantly after Diwali. Several monitoring stations recorded ‘severe’ air quality on Monday morning (November 9) after a night of Diwali festivities which resulted in widespread emission of firecracker smoke. It worsened the situation in a city already grappling with soaring air pollution due to vehicular exhaust, construction dust and stubble burning in neighbouring states.

Due to this, Delhi residents, who continue to breathe polluted air, may face symptoms like scratchy throat, coughing and irritation. But how can you tell whether your sore throat is caused by pollution or an infection that needs medical attention?

How Does Air Pollution Cause A Sore Throat?

Polluted air contains particulate matter, including PM2.5, as well as gases and other irritants. When inhaled, these pollutants come into contact with the lining of the nose, throat and respiratory tract, triggering irritation and inflammation.

Dr. Rahul Sharma, Director, Pulmonology & Critical Care, Fortis Greater Noida told HealthandMe, “People exposed to high levels of pollution may experience throat irritation, dryness, a burning sensation, frequent coughing and discomfort while swallowing. These symptoms may be more noticeable in people who spend long hours outdoors and are difficult to control.”

People with asthma, allergies or existing respiratory conditions may be more sensitive to these pollutants.

Dr Sharma added, “Pollution can also aggravate existing respiratory conditions like asthma and allergic airway disease. It is important to remember that a sore throat is not always due to infection; environmental exposure can also be a cause.”

Also read: El Niño Could Worsen Dengue, Malaria And Heat Illness: Why WHO Declared A Health Emergency

Pollution-Related Sore Throat Or Infection?

The symptoms can overlap, so a sore throat alone cannot establish its cause. However, certain accompanying signs may offer clues. Experts help us understand when a sore throat is a result of inhaling particulate matter.

Dr. Sushil Upadhyay, Consultant Pulmonologist, Kailash Deepak Hospital, Delhi told HealthandMe, “Throat irritation as an early sign. A scratchy throat is the canary in the coal mine for lung inflammation. It is the first sign that your airways defenses are overwhelmed and deep inflammation is starting.”

A pollution-related sore throat is more likely to involve dryness, scratchiness, coughing and irritation of the eyes or nose.

Dr Samir Garde, Director of Dept of Pulmonology and Lung Transplant, Gleneagles Hospital, Parel, told us, “Pollution-related irritation usually causes a dry or scratchy throat, coughing and eye irritation, which may worsen outdoors or during periods of poor air quality.”

An infection, on the other hand, may be accompanied by fever and other symptoms. They may include body aches, swollen lymph nodes, painful swallowing, tonsil inflammation or white patches on the tonsils. Viral infections can also cause a runny nose, cough and fatigue.

Dr Upadhyay said, “The flu brings high fever, body aches, and extreme exhaustion. If staying inside an air-conditioned, filtered room clears your throat, it's pollution. Otherwise, think of it as flu.”

A bacterial infection such as strep throat may cause sudden throat pain, fever and difficulty swallowing, sometimes without a cough.

Also read: New COVID-19 Variant PJ.2.1 Spreads Globally: WHO Says Symptoms Resemble Cold, Flu

When Should You See A Doctor?

A mild sore throat often improves within a week. However, medical evaluation is recommended if you have difficulty breathing, cannot swallow, are drooling because you cannot swallow, or experience rapidly worsening symptoms.

Dr Upadhyay said, “Do not ignore a sore throat if it moves to your chest. If you develop wheezing, severe breathlessness or a fever, you need a medical evaluation immediately. Seek help right away if you are gasping for air or cannot finish a single sentence in one breath.”

Persistent hoarseness, a lump in the neck or a mouth ulcer lasting more than three weeks should also be evaluated.

Dr Garde recommended, “Seek medical attention if there is chest tightness, high fever or persistent symptoms. Severe breathlessness, bluish lips or difficulty speaking due to breathing problems require immediate emergency care.”

Also read: Delhi AQI Crosses 2,000 Mark After Diwali: What Happens To Your Body Within Hours Of Exposure?

How Can You Protect Your Throat During Severe Pollution?

According to the doctors, while pollution levels remain high, reducing exposure is important. They recommend:

• Avoid outdoor exercise and limit unnecessary time outside.
• Wear a well-fitting N95 or N99 respirator when going outdoors.
• Keep windows closed during periods of high outdoor pollution and use a HEPA air purifier if available.
• Drink enough water to prevent throat dryness.
• Gargle with warm salt water to soothe irritation.
• Avoid smoking, incense and other indoor sources of smoke.

Do not start antibiotics just because your throat hurts. Antibiotics do not treat throat irritation due to pollution or viral infections. They should only be used when prescribed for a confirmed bacterial infection under doctor’s supervision.

Delhi AQI After Diwali

The city's average Air Quality Index (AQI) reached 406 on November 9, placing it in the 'severe' category, according to the Central Pollution Control Board (CPCB).

But private monitoring platform AQI.in reported an AQI of 2,283, classifying the air quality as ‘hazardous’. The reading showcased a grim post-Diwali pollution peak, an issue that has turned into an annual environmental crisis.

The stark difference in readings is because India’s AQI scale is limited to 500 while other private air quality monitoring platforms measure higher readings. So even if CPCB’s data shows 500 AQI, it can mean that the amount of harmful pollutants could be much higher.

The Supreme Court had implemented restrictions on celebrating Diwali with firecrackers by limiting time between 6 am and 7 am and 8 pm and 10 pm on November 7 and 8 and allowing only green crackers. However, firecrackers were reportedly burst beyond permitted hours.

Ahead of World Diabetes Day observed on November 14, singer Nick Jonas recently opened up about living with type 1 diabetes for almost 21 years. Diagnosed at the age of 13, Jonas spoke about his daily decision-making that revolves around managing the condition. From monitoring blood glucose levels to adjusting insulin doses around meals and physical activity, Jonas expressed the emotional challenges of living with the disease.

In an open letter written for Dexcom's A Letter to Diabetes campaign, Jonas described the condition as an ongoing part of his everyday life. “Twenty-one years, and you haven’t changed a bit,” he wrote, addressing diabetes.

He also explained how frequently he has to monitor his glucose levels and make treatment decisions. “Staring at my phone to see where my glucose is. Reaching for my pump to bolus because I’m about to eat something with 17 carbs. Those are just a couple of the hundreds of little decisions I make every week,” Jonas wrote.

He described diabetes as “an ongoing conversation between your body, your mind, and your devices.”

The singer also recalled the emotional challenges of living with a chronic condition. However, he said that speaking openly about diabetes helped him find a sense of community and connect with others experiencing similar challenges.

What Is Type 1 Diabetes?

Also read: Can Ozempic, Mounjaro Drugs Protect The Brain? What A New Review Found

Type 1 diabetes is a chronic autoimmune condition in which the body's immune system mistakenly attacks and destroys beta cells that produce insulin in the pancreas.

Insulin is a hormone that helps move glucose from the bloodstream into cells, where it is used for energy. When the body produces little or no insulin, glucose builds up in the blood, resulting in high blood sugar levels.

Type 1 diabetes is different from type 2 diabetes as the latter occurs due to insulin resistance and can be a result of genetic and lifestyle factors. In short, type 1 diabetes is not caused by eating excessive carbohydrates and sugar, obesity or leading an inactive lifestyle.

Type 1 diabetes can also develop at any age, although it is frequently diagnosed during childhood or adolescence.

Symptoms Of Type 1 Diabetes

Also read: High-Fibre Diet Outperforms Metformin In Blood Sugar Control And Weight Loss, Study Finds

Symptoms can develop quickly, sometimes over a few weeks. Common warning signs include:

• Excessive thirst: Constantly feeling thirsty even after drinking water.
• Frequent urination: One may feel the urge to urinate frequently as the kidneys attempt to remove excess glucose through urine.
• Unexplained weight loss: The body starts breaking down fat and muscle for energy when it cannot use glucose properly.
• Increased hunger: Cells are unable to access enough glucose for energy.
• Extreme fatigue: High blood glucose and reduced energy availability can cause chronic tiredness.
• Blurred vision: Changes in blood glucose can affect the fluid balance in the eyes.

If type 1 diabetes is not diagnosed and treated on time, it can lead to diabetic ketoacidosis (DKA), a life-threatening complication.

Warning signs including nausea, vomiting, abdominal pain, deep or rapid breathing, fruity-smelling breath and confusion need immediate medical attention.

Management Of Type 1 Diabetes

Managing type 1 diabetes involves maintaining blood glucose levels within a specific target range to reduce the risk of both high and low blood sugar. Treatment includes:

1. Insulin Therapy

People with type 1 diabetes need insulin throughout their lives. It may be administered through multiple daily injections or an insulin pump which delivers insulin continuously.

2. Regular Glucose Monitoring

Blood glucose can be monitored using instant finger-prick tests or continuous glucose monitoring (CGM) devices. CGM systems use a sensor to track glucose levels throughout the day and night.

3. Dietary Management

People with type 1 diabetes need to understand how carbohydrates affect blood glucose levels so they can adjust insulin doses accordingly.

4. Physical Activity

Exercise is encouraged, but physical activity can affect glucose levels depending on its intensity, duration, timing and the amount of insulin in the body. People may need to adjust their food intake or insulin doses to reduce the risk of hypoglycaemia.

5. Regular Medical Follow-ups

Routine assessments help monitor glucose control and identify complications affecting the eyes, kidneys, nerves and cardiovascular system.

Type 1 diabetes diagnosis does not mean a person has to give up their career, travel, exercise or other ambitions. But living with this condition involves planning and attention to blood glucose levels, food, medication and physical activity.

Jonas has spoken about the importance of not allowing the condition to define his life. In an earlier interview with NIH's MedlinePlus Magazine, he shared a message for others living with type 1 diabetes, “Know that you can still do anything you want to do with your life.”

There is no cure for type 1 diabetes currently but advances in insulin delivery, glucose monitoring and research into therapies that preserve or replace insulin-producing cells are expanding treatment possibilities.

Pregnancy is often something women prepare for months in advance. They discuss nutrition, exercise, supplements, medical check-ups and what to expect as their bodies change. Menopause, however, rarely receives the same attention. It is often treated as a stage that women will simply reach one day and somehow manage along the way.

But menopause is also a major transition in a woman’s life, and being prepared for it can help make the experience easier to understand and manage.

Menopause itself is defined as the point when a woman has gone 12 consecutive months without a menstrual period. However, the transition usually begins earlier, during perimenopause, when changing hormone levels can lead to irregular periods, hot flashes, night sweats, sleep problems, mood changes and other symptoms. These changes can begin several years before menopause itself.

Preparation does not mean trying to prevent menopause or “balance” hormones before it happens. Most healthy women do not need supplements or hormones simply because menopause is approaching. Instead, preparation is about understanding what is happening and building a strong foundation for health.

What can women do before menopause?

Also read: At 58, She Mistook Memory Lapses For Menopause Brain Fog, But Tests Revealed Alzheimer’s Risk

Regular physical activity is one of the most useful habits to establish. Weight-bearing and resistance exercises can help maintain bone strength and muscle mass, which become increasingly important in midlife and beyond. Exercises that improve balance, coordination and proprioception, or the body’s awareness of its position and movement, can also support mobility and help reduce the risk of falls as women age.

Nutrition is equally important. A well-balanced diet should provide adequate protein along with essential vitamins and minerals. Calcium and vitamin D are particularly important for bone health, while a varied diet rich in vegetables, fruits, whole grains, pulses, nuts and other nutrient-dense foods can support overall health. Maintaining a healthy weight is also beneficial during this transition.

It is equally important to pay attention to cardiovascular and metabolic health. Regular checks of blood pressure, cholesterol and blood sugar can help identify common non-communicable diseases early. Avoiding smoking, staying physically active and maintaining healthy lifestyle habits can also support long-term health.

Preventive healthcare should not be overlooked either. As women enter midlife, keeping up with age-appropriate cancer screenings and routine health check-ups becomes an important part of looking after their health. The appropriate screening schedule can vary depending on age, family history, personal risk factors and local guidelines, so these should be discussed with a healthcare provider.

Just as importantly, women should become familiar with their own symptoms. Changes in periods, sleep, mood, body temperature, sexual health or concentration should not automatically be dismissed as “just ageing.” Keeping track of symptoms can help women recognise patterns and have more productive conversations with their healthcare provider.

Medical support is also an important part of preparation. Not every woman will experience menopause in the same way, and treatment is not automatically necessary. However, when symptoms begin to interfere with sleep, work, relationships or everyday life, hormonal and non-hormonal treatment options can be discussed with a doctor.

Perhaps the biggest change we need is in how we talk about menopause. It is not an illness, nor is it something women should simply suffer through in silence. It is a natural stage of life, but that does not mean its symptoms or its wider effects on health should be ignored.

Preparing for menopause is ultimately less about predicting exactly what will happen and more about entering this stage with knowledge, healthy habits and access to the right medical support. Women spend years preparing for major changes in their bodies. Menopause deserves that same attention.

By Dr Ponny M S, Consultant - Gynaecologist & Laparoscopic Surgeon, Apollo Adlux Hospital, Keralam