Alarming Reality Of Extreme Drinking On Holidays And Occasions
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.
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.
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.
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.
High-intensity drinking impacts not only physical health and mental well-being but also social relationships.
- Alcohol poisoning
- Severe dehydration and electrolyte imbalances
- Hypoglycemia
- Risky sexual behavior
- Injuries and accidents
- 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
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.
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.
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You can feel fine and still have a heart that is slowly changing. Researchers at Imperial College London and the MRC Laboratory of Medical Sciences say millions of people could be living with hidden inflammation that does exactly that. They say the changes can start years before any symptoms show up.
"Our study, which is the largest of its kind, suggests that millions of people could be living with hidden inflammation, which is slowly changing their heart and causing long-term damage," said Professor Declan O'Regan, British Heart Foundation Chair of Cardiovascular AI at Imperial College London.
The study was published in the European Journal of Preventive Cardiology. The team looked at data from nearly 480,000 adults in the UK Biobank, a large health database, Imperial says. They measured a blood marker called glycoprotein acetyls, or GlycA for short, which the paper uses to measure chronic inflammation. They also used heart scans and genetic data.
People with the highest levels of inflammation, the top 20%, had a 43% higher risk of heart attack and stroke than those with the lowest levels, the bottom 20%, according to Imperial.
Imperial adds that higher levels also went with changes in the heart itself. These included thicker heart walls, smaller heart chambers and poorer filling of the heart. The researchers say such changes can build quietly for years before possibly leading to heart failure.
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Chronic inflammation is a long-term, low-level activation of the immune system, Imperial explains. It has been linked to cancer and diabetes, and is increasingly seen as a driver of heart disease.
According to Imperial, higher inflammation was strongly linked to poorer social and economic circumstances and to mental distress, as well as to smoking and excess body fat.
"The surprising thing was how much social factors and mental health are linked to inflammation and damage to the heart, as well as more well-known risk factors like smoking and inactivity," O'Regan said. He added that there was also a strong genetic factor, "with some people being naturally more resilient or susceptible to the inflammatory damage that comes from different lifestyles."
The study named proteins from the interleukin-1 and TNF families as likely drivers of the damage, Imperial says. Several are already targeted by drugs in clinical trials, which Imperial says raises hopes that anti-inflammatory treatments could help prevent heart disease before symptoms begin. The researchers say combining inflammation blood tests with genetic risk scores could help find the people who would benefit most from early action.
There is earlier proof that this idea can work. In the 2017 Canakinumab Anti-inflammatory Thrombosis Outcomes Study, or CANTOS trial for short, led by Paul Ridker and published in the New England Journal of Medicine, 10,061 people who had already had a heart attack, and had high inflammation, were given canakinumab or a placebo. The paper concluded that at the 150 mg dose, given every three months, canakinumab led to fewer repeat cardiovascular events than the placebo, independent of any drop in cholesterol. But those were heart attack survivors, not people without symptoms.
What to keep in mind
The study reports links, and the researchers describe inflammation as one possible pathway to heart damage. They also stress that being genetically susceptible, or living in hard circumstances, does not mean a person will develop heart disease, and that much can be done to prevent long-term inflammation.
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A few floaters, a brief flash of light or mild blurring across your vision may seem harmless at first. But when these changes appear suddenly without any probable cause, they may signal a bigger problem. On World Retina Day, experts explain when your retina needs urgent medical attention.
The retina is the light-sensitive layer at the back of the eye, which plays a crucial role in maintaining healthy eyesight. Some retinal conditions may develop without obvious symptoms in early stages, while others can present suddenly and threaten your eyesight if treatment is delayed.
“Retinal health is fundamental to maintaining clear vision and preserving quality of life, yet many retinal conditions can develop silently, without obvious warning signs in their early stages,” Dr Rajesh Kapoor, Medical Director, Suruchi Eye Hospital, Navi Mumbai told HealthandMe.
“By the time a person begins to notice blurred or distorted vision, dark spots, flashes, floaters, or other visual changes, the condition may already require urgent medical attention. This is why we need to shift our approach from waiting for symptoms to prioritizing awareness, regular comprehensive eye examinations and timely consultation with an ophthalmologist.”
Floaters can look like tiny dots, lines, specks or cobweb-like shapes moving across your field of vision. They are easier to notice when looking at a bright background.
Flashes, on the other hand, can look like brief streaks or bursts of light. They may occur even when there is no actual source of light around you.
Occasional floaters can occur for reasons that are not always serious. However, a sudden increase in floaters or the sudden appearance of flashes should not be dismissed, especially if there are other changes in vision. One of the conditions doctors want to rule out in such situations is retinal detachment.
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“Retinal detachment is a serious condition which requires urgent medical attention and occurs when the retina, the light sensitive layer at the back of the eye pulls away from its normal position,” Dr Mudit Tyagi, Scientific Chair, VRSI and Head, Smt Kanuri Santhamma Center for VitreoRetinal Diseases, L V Prasad Eye Institute, Hyderabad told HealthandMe.
There are several possible causes of retinal detachment. According to Dr. Tyagi, they include injury to the eye, high myopia and certain eye diseases.
When the retina separates from its normal position, its ability to function properly can be affected. The longer the condition remains untreated, the greater the concern about permanent vision loss.
The symptoms of retinal detachment can vary, but certain changes should warrant immediate medical attention.
A dark curtain or shadow across the field of vision is concerning because it can represent a portion of the visual field being lost.
Dr. Tyagi said, “The urgency of recognising retinal detachment can’t be overstated. If you have sudden flashes of light, a dramatic increase in floaters, or a dark shadow or curtain across your field of vision, don’t ignore it, even if there is no pain.”
The absence of pain should not be misconstrued as a non-emergency. A retinal problem can occur without the kind of discomfort people usually associate with an eye emergency.
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Retinal detachment is not a condition where it is advisable to wait and see whether symptoms settle on their own. “Retinal detachments, if detected in time and operated early enough can result in a good recovery of vision,” Dr Tyagi said.
He added, “It is important, therefore, to be vigilant and see an eye care specialist as early treatment can help avoid preventable loss of vision. So, timely recognition and diagnosis followed by right treatment can help save vision.”
This is why sudden visual changes deserve attention even if they seem minor initially.
Some people may need to be particularly proactive about retinal health. Dr. Kapoor said individuals with diabetes, increasing age, a family history of retinal disease or other risk factors that may affect retinal health should be more careful and alert.
Diabetes can affect the blood vessels supplying the retina and lead to diabetic retinal disease. Regular eye examinations can help identify changes before vision is significantly affected. Dr Kapoor also stressed that screening should not necessarily wait until symptoms appear.
“Advances in retinal imaging, diagnostics and treatment today provide ophthalmologists with valuable opportunities to identify and manage several retinal conditions at an earlier stage. However, technology can make its greatest impact when people seek eye care at the right time.”
A sudden change in vision does not automatically mean that a person has retinal detachment. But because some retinal conditions can progress rapidly, it is important to have sudden symptoms assessed rather than trying to determine their cause on your own.
Dr Kapoor said: “Through greater public awareness and proactive screening, we can encourage people to take retinal health more seriously. Protecting sight begins with understanding that healthy vision should never be taken for granted—because when it comes to the retina, we should not wait for a problem to become noticeable before taking action.”
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After surgery, radiotherapy could significantly decrease the chances of an atypical meningioma returning, according to a new international phase 3 trial published in The Lancet.
The findings come from the ROAM/EORTC-1308 trial, the first randomised controlled trial to directly test whether patients with a completely removed atypical meningioma benefit from receiving radiotherapy or whether regular scans and observation are enough.
The results could help settle a treatment question that has remained uncertain for years.
Meningiomas are the most common brain tumours in adults. They develop from the meninges, the protective membranes surrounding the brain, and spinal cord.
An atypical meningioma is classified as a WHO grade 2 tumour. Unlike grade 1 meningiomas, that generally grow slowly, grade 2 tumours are more likely to grow again after surgery.
Even when surgeons manage to remove the entire visible tumour, microscopic tumour cells may remain, sparking a risk of recurrence.
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The ROAM/EORTC-1308 trial enrolled 157 patients whose atypical meningiomas had been completely removed surgically. They were randomly assigned to either:
After a median follow-up of about five years, the difference in recurrence was significant. 14% of patients in the radiotherapy group experienced a recurrence, compared to 30% in the observation group. In other words, the risk of recurrence was reduced by nearly half with postoperative radiotherapy.
Additionally, at five years, about 80% of patients receiving radiotherapy remained free of recurrence, compared to about 64% of those who were monitored without immediate radiotherapy.
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Until now, doctors have had to weigh two approaches after complete surgical removal of an atypical meningioma.
One option is to give radiotherapy immediately, hoping to destroy microscopic tumour cells that surgery may have missed. The other is to monitor the patient with regular brain scans and use radiotherapy if the tumour returns.
The uncertainty existed as strong randomised evidence showing whether immediate radiotherapy actually reduced recurrence had been lacking. The trial helps cement that evidence.
The researchers say that treatment decisions still need to be made jointly by doctors and patients, taking into account possible side effects and the long-term consequences of radiation treatment. Serious radiation-related complications were uncommon in the trial.
The study also did not establish whether the recurrence benefit extends beyond five years. This means that longer follow-up will be needed to gather more evidence. According to the researchers, the findings are expected to shape national and international treatment guidelines.
The options may extend for patients who have undergone complete removal of a WHO grade 2 atypical meningioma. Rather than contemplating “Should we simply watch and wait?”, they can consider moving to a more evidence-based discussion about whether postoperative radiotherapy should be offered upfront.
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