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.

As pollution season creeps back in Delhi, N95 masks outdoors and air purifiers are once again most likely to become the primary go-to protective measures for the public.

Both are known to lower exposure to harmful particles significantly, but neither can completely nullify the health risks of polluted air. So before you invest in an air purifier or buy a dozen N95 masks, understand how much you will be protected as you step out during smog everyday.

How Much Protection Does An N95 Mask Offer?

Also read: Delhi Pollution: What Are The Different Types Of Anti-Pollution Masks?

A properly fitted N95 respirator can filter at least 95% of airborne particles under standard environment. That makes it substantially more protective against fine particulate matter like PM2.5 than regular surgical or cloth masks.

But just wearing an N95 does not mean you are breathing toxins-free air. Its effectiveness depends heavily on fit. Gaps around the nose, cheeks or chin can let polluted air to bypass the filter.

An N95 also does not protect equally against every pollutant. It is designed primarily to filter particles, not gases like nitrogen dioxide or ozone. So if you spend most of your time outdoors during severe pollution, wear a well-fitted, certified respirator to reduce exposure.

Protection from PM2.5 is key as these particles are small enough to seep deep into your lungs and, in some circumstances, even cross over to enter the bloodstream. Long-term exposure to PM2.5 has been associated with cardiovascular disease, respiratory disease and other serious health problems.

Is An Indoor Air Purifier Enough To Tackle Outdoor Pollution?

The effectiveness of an air purifier depends significantly on the purifier, the size of the room and how it is used. A purifier equipped with a HEPA filter can remove fine particles from indoor air. When outdoor PM2.5 levels are high and polluted air enters homes through windows, doors and ventilation systems, this could be one of the best ways to protect yourself.

However, simply switching on a purifier in a large room does not guarantee clean air. The purifier needs to have sufficient clean air delivery rate (CADR) for the size of the room.

Keeping doors and windows closed during periods of extreme outdoor pollution can also help reduce the amount of polluted air entering. Filters need to be replaced according to the manufacturer's recommendations because a heavily loaded filter can reduce performance.

Also read: Delhi Air Pollution Is Back: What Days Of Poor AQI Can Do to Your Lungs

One of the limitations is that HEPA filtration primarily addresses particles. A purifier needs additional technologies, like an activated-carbon filter, to reduce some gaseous pollutants, and even then it cannot remove every pollutant completely.

For Delhi's pollution season, these two measures address different exposure issues. N95 masks help reduce inhalation of polluted particles while outdoors. Air purifiers help lower indoor concentrations of particulate matter. Using both can therefore provide greater protection than relying on either measure alone.

People with asthma, COPD, heart disease or other respiratory and cardiovascular conditions, as well as children and older adults, can be more vulnerable to the effects of air pollution.

Even healthy people can experience symptoms like coughing, throat irritation, wheezing, eye irritation and breathing discomfort when pollution levels rise.

Dry eyes are common among people who spend long hours on screens, and lubricating eye drops are often used for relief. But using the wrong drops, keeping an opened bottle for too long or even sharing eye drops can create problems.

Estimates suggest that up to 50% of adults experience dry-eye symptoms, making artificial tears a common part of self-care. But persistent symptoms should not simply be treated indefinitely without identifying the underlying cause.

So, how often can you use eye drops, and what should you keep in mind?

We spoke to Dr. Ritika Sachdev, Director at Centre for Sight, New Delhi, to understand the common mistakes people make while using eye drops.

Eye Drops For Dry Eyes: When Should You See A Doctor?

Dr. Ritika said persistent or bothersome dry eye symptoms should be assessed by a doctor because dryness can have several causes.

These may include:

• Eyelid inflammation
• Allergies
• Contact lens use
• Makeup
• Incorrect spectacle power causing eye strain

“Sometimes even not wearing your right spectacle power contributes to eye strain which can be misread as dry eye,” she said.

Lubricating drops can help support dry eyes, but prolonged use should be discussed with an eye specialist.

Using Eye Drops For Long? Check For Preservatives

Also read: Eye Drop Recall: Nearly 750,000 Products Pulled Over Sterility Concerns in US

Several eye-drop products have been recalled in the US in recent years over contamination and other safety concerns. This makes proper storage, handling and hygiene particularly important when using eye drops.

Dr. Ritika cautioned that some eye drops contain preservatives that may worsen dryness when used for a long time.

“Many of the eye drops have preservatives which if used over a long period of time actually cause more dry eye,” she said.

According to her, preservative-free drops or those with very mild preservatives may be preferable for people who need regular use.

Don't Keep An Open Eye Drop Bottle Forever

"Once opened, an eye drop bottle can become contaminated if it is not handled or stored properly," Dr. Ritika said.

The expert advised:

• Note the date when you open the bottle.
• Follow the product's storage instructions.
• Do not let the bottle tip touch your eye.
• Discard the bottle according to the manufacturer's instructions.
• Do not continue using an opened bottle indefinitely.

“Once the bottle is open, it often may get contaminated,” she said. “If it gets contaminated, it is a source of infection.”

Read More: Andrew Huberman’s Sleep Trick: Can Eye Movements Help You Fall Back Asleep?

How Many Eye Drops Should You Use?

More drops do not mean more relief.

“The capacity of the eye is only one drop,” Dr. Ritika said.

Putting two or three drops at once can cause the excess to spill onto the surrounding skin and simply waste the product. One properly administered drop is generally enough at a time, she said.

Avoid Squeezing Your Eyes After Using Drops

Dr. Ritika said people often squeeze their eyes tightly after putting in drops because they think this will keep the medicine inside. But squeezing can push the drop back out.

Instead:

• Gently pull down the lower eyelid.
• Place the drop into the eye.
• Avoid touching the bottle tip to the eye.
• Do not squeeze the eyes tightly immediately afterward.

Why Do Eye Drops Sometimes Reach The Throat?

Some people experience an unpleasant sensation in the throat after using medicated eye drops.

Dr. Ritika explained that tears can travel from the eye through the tear duct to the nose and then the throat.

She suggested gently pressing near the inner corner of the eye for a while after applying the drop to reduce this drainage.

Never Share Your Eye Drops

Sharing eye drops may seem harmless, particularly within families, but Dr. Ritika advised against it.

If the bottle tip accidentally touches an infected eye, the bottle can become contaminated and potentially transmit infection when used by someone else.

“Eye drop is something that is for your personal hygiene and it should therefore be kept by you and used by you,” she said.

For millions of individuals who are living with diabetes across India, protecting long-term vision can start with a simple, timely retinal screening. However, regular screening remains a challenge for many because access to specialist eye care services can be limited, particularly outside major urban centres.

In 2021, India was estimated to have 101 million people living with diabetes and 136 million with prediabetes, highlighting the scale of the country’s metabolic health challenge. On World Sight Day, we discuss another layer to this challenge. Bringing diagnostic capabilities closer to where patients live and seek care can help bridge the gap between early detection and specialized care.

Why Must Retinal Screening Move Beyond Specialist Clinics?

A significant gap in public awareness continues to hinder early intervention. Data indicates that 85% of people with diabetes are unaware that the condition can impact their vision and have never undergone a retinal examination.

Consequently, many patients reach eye-care facilities only after vision changes have occurred. One study found that 45% of patients suffering from diabetic retinopathy have already experienced vision loss even before being diagnosed. This highlights the significance of screening before symptoms appear. Bringing screening closer to primary-care settings can facilitate earlier detection of retinal changes and allow for prompt referral to an eye-care specialist.

Although diabetic retinopathy significantly contributes to preventable vision loss, retinal health extends beyond diabetes. Retinal conditions frequently advance without noticeable symptoms, making increased awareness, regular screening and timely access to specialist care crucial for safeguarding vision.

Also read: World Sight Day: The Hidden Link Between Diabetes & Blindness - Why Good Vision Doesn't Mean Healthy Eyes

Can Technology Expand Screening Access?

Modern diagnostic technology provides a scalable solution to overcome geographic and capacity constraints. Artificial intelligence enabled retinal imaging can rapidly analyse retinal scans in non-specialist settings, identifying subtle retinal changes that may require further clinical evaluation.

Similarly, Optical Coherence Tomography (OCT) based assessments provides detailed, non-invasive imaging when deeper evaluation is needed provides detailed, non-invasive imaging when deeper evaluation is needed. Integrating appropriate imaging technologies into screening and referral networks can help frontline healthcare teams to conduct preliminary evaluations efficiently, while allowing ophthalmologists to focus their expertise where it is most needed, which is complex diagnoses and advanced care.

Also read: Eye Twitching: Is It Just Stress Or Something Serious?

What Role Do Community-Based Models Play?

Medical technology can fulfil its promise when it meets people where they already are. Placing a diagnostic hub or screening resources closer to neighbourhood health centres, local diabetes clinics and wellness centres can turn routine visits into opportunities for earlier detection.

Local, trained healthcare workers are able to easily catch any red flags in high-risk patients and direct them straight to an eye specialist long before minor issues turn into permanent vision loss. Such community-based models can make screening more convenient, particularly for people who may otherwise face geographical, time or access barriers to specialist care.

Strengthening the Future of Eye Care

The aim of community-based screening is not to take the place of specialists, but to help patients reach them sooner. By combining awareness, portable imaging and technology-enabled screening with clear referral pathways, patients who need further evaluation can be identified earlier and directed to the right level of care.

As India continues to strengthen its approach to eye health, bringing screening closer to communities can make it easier to detect retinal problems early, when there is still an opportunity to protect vision.

By Dr Vishali Gupta, President - Vitreo Retinal Society of India (VRSI) and Head - Retina, PGIMER, Chandigarh