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Alcohol has long been a part of social life in the United States. From celebratory champagne to casual beers over the weekend, drinking is woven into the fabric of American culture. But while moderate consumption may be normalized and even encouraged in certain settings, excessive alcohol use remains a critical public health concern. A new report by Drug Helpline reveals stark disparities in alcohol consumption across US states—highlighting regions with particularly high usage rates, and raising pressing questions about the health implications of these patterns.
Alcohol consumption in the US is both widespread and deeply ingrained. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), over 85% of adults have consumed alcohol at some point, and more than half of all adults report drinking in the past month. But it’s not just about frequency—binge drinking and high-intensity consumption have become alarmingly common.
Approximately 1 in 4 adults binge drink at least once a month, and those engaging in “high-intensity drinking” (twice the binge threshold) are 70 times more likely to need emergency healthcare. As a result, alcohol is responsible for nearly 1 in 5 ER visits and claims over 140,000 lives annually. The ripple effect isn’t just health-related—the economic cost of alcohol misuse was estimated at $249 billion in 2010, with 75% of that tied to binge drinking.
While alcohol is accessible nationwide, some states drink far more than others. Geography influences access, social norms, climate, tourism, and legislation around alcohol—all of which affect consumption patterns.
Despite being one of the smallest and least populated states, New Hampshire consistently tops the list for alcohol consumption. According to data from the NIAAA, residents consume more than 4 gallons of ethanol (pure alcohol) per capita annually—nearly double the national average.
One key reason is tax policy. New Hampshire has no sales tax and minimal excise taxes on alcohol, making it a magnet for out-of-state buyers from neighboring Massachusetts and Vermont. In fact, a significant chunk of alcohol sold in New Hampshire isn’t consumed by residents at all—but it still skews the per capita figures.
However, public health experts warn that easy access combined with low prices can still encourage higher in-state consumption, potentially contributing to increased alcohol-related harm over time.
With a modest population of under a million, Delaware might seem like an unexpected entry on this list—but its residents drink over 3.5 gallons of alcohol per capita annually.
The state also has a high prevalence of binge drinking, particularly among young adults. Proximity to major urban centers like Philadelphia and Baltimore makes Delaware a hub for weekend tourism, which adds to local alcohol sales. Moreover, the state reports concerning rates of alcohol-related driving fatalities, signaling a growing need for intervention.
Home to Las Vegas, Nevada’s position on this list comes as no surprise. The state’s vibrant nightlife, relaxed alcohol laws, and 24/7 availability contribute to an environment where drinking is not only accepted but encouraged.
But beyond the casinos and neon lights, Nevada faces real health consequences. High alcohol consumption is linked to above-average rates of alcohol-related deaths and emergency room visits. The state also struggles with alcohol use disorders (AUD), especially in its more remote rural areas where access to treatment is limited.
In North Dakota, the long winters and sparse population have contributed to a drinking culture that’s rooted in social tradition. Whether it’s beer at a hockey game or whiskey on a snowy evening, alcohol is often part of community gatherings.
Yet, this culture comes at a cost. North Dakota sees elevated rates of binge drinking, especially among college-age individuals. The state also experiences higher-than-average alcohol-impaired driving deaths, and its rural setting complicates access to mental health and substance abuse services.
Rounding out the top five is Montana, a state known for its natural beauty—and, increasingly, its high rates of alcohol consumption. Like North Dakota, Montana’s rural landscape and weather conditions may play a role in shaping drinking behaviors.
Montana’s per capita alcohol consumption exceeds 3 gallons annually, and the state records frequent alcohol-related fatalities, both on and off the road. Its widespread rural communities often lack the healthcare infrastructure needed to support those with alcohol use disorders, creating a silent public health burden.
It’s easy to reduce alcohol consumption statistics to curiosities or state pride, but these figures reflect broader health, social, and economic challenges. States that rank highest in alcohol consumption are also more likely to face:
Public health experts continue to call for greater awareness, better alcohol education, and increased access to treatment for alcohol use disorder, especially in high-consumption states.
The numbers don’t lie—America has a drinking problem, and where you live can influence just how serious that problem is. While some states are beginning to roll out initiatives aimed at responsible drinking, there's a long way to go in addressing the deeper health crisis at play.
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We often hear of dementia as an adult, or older people's disease, but, a father from Glasgow shares how his four-year-old daughter was diagnosed with the condition. Childhood Dementia news of Darren Scott's daughter was delivered to him like a "complete thunderbolt", he tells Sky News. She was diagnosed with the condition before she turned four. Five doctors were waiting, when Sophia Scott, who had just turned four, were summoned to a Glasgow hospital room. Then came the worst news. Scott was told that his daughter could not live beyond the age of 16. "We were told... there was nothing they could do. It was a moment that broke us, shattered our lives. We have never recovered," he says.
As per Dementia Australia, childhood dementia is a rare brain condition that affects one in every 2,900 babies globally. Childhood dementia is a group of serious brain conditions that interfere with a child’s memory, behavior, emotions and ability to communicate. It isn’t caused by lifestyle or ageing. Instead, it stems from more than 100 rare genetic disorders that children are born with. These include conditions such as Niemann-Pick type C, Batten disease and Sanfilippo syndrome.
No two children experience childhood dementia in the same way. The illness progresses differently for each child, but one thing remains constant: there is currently no cure. Like adult dementia, childhood dementia is progressive, meaning symptoms worsen over time. Heartbreakingly, around half of all affected children do not survive beyond the age of 10.
Childhood dementia is genetic. Globally, about one in every 2,900 babies is born with a condition that can lead to childhood dementia. In Australia alone, an estimated 1,394 children were living with dementia in 2021.
The conditions that cause childhood dementia fall into several categories, including inborn errors of metabolism, lysosomal disorders, mitochondrial disorders, mucopolysaccharidoses, leukodystrophy, neurodegeneration with brain iron accumulation (NBIA), and peroxisomal diseases.
Symptoms can begin in early childhood or appear much later, sometimes not showing up until the teenage years. The progression may be rapid or unfold slowly over several years, deeply affecting both the child and their family.
Much like adults with dementia, children may struggle with memory loss, confusion, changes in personality, anxiety or fear, and severe sleep disturbances. They may also find it difficult to concentrate, learn, communicate or understand things, and some experience behavioral challenges such as hyperactivity.
In addition, childhood dementia can affect the body beyond the brain. Children may develop problems with their bones or joints, experience issues with the heart, lungs or digestive system, lose their ability to move, see or hear, or have seizures.
As the condition advances, children gradually lose skills they once had — talking, walking, reading, writing and playing. Eventually, the body itself begins to shut down. Without major medical breakthroughs and more research, most children with childhood dementia will continue to face a shortened life, often not surviving beyond their teenage years.
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India is staring at a sharp rise in lung cancer cases over the next few years, with experts warning that the disease is no longer confined to smokers alone. A recent study published in the Indian Journal of Medical Research projects a significant increase in lung cancer incidence by 2030, with certain regions, particularly the North-East, expected to bear a disproportionate burden. Alarmingly, women are showing one of the fastest rises in new cases.
At a time when the country is on the brink of what researchers describe as a “tsunami” of lung cancer cases, doctors stress that public awareness, early detection, and breaking long-held myths are more important than ever.
Lung cancer has long been associated almost exclusively with smoking, but experts say that narrative is outdated. Speaking to The Times of India (TOI), Dr Arun Kumar Goel, Chairman – Surgical Oncology at Andromeda Cancer Hospital, Sonipat, explained that while smoking remains the biggest risk factor, non-smokers are increasingly being diagnosed with the disease.
“Air pollution, indoor cooking smoke, passive smoking, radon gas exposure, occupational hazards like asbestos, and even family history can contribute to lung cancer,” Dr Goel explined. He added that adenocarcinoma, a subtype of lung cancer, is particularly common among non-smokers and appears to be linked more to environmental and genetic factors than tobacco use.
One of the biggest challenges with lung cancer is that its early symptoms are often vague and easily mistaken for common respiratory problems. Dr Goel told TOI that persistent cough, changes in cough pattern, coughing up blood or mucus, unexplained chest pain, breathlessness, fatigue, and sudden weight loss are warning signs that should not be ignored.
“In India, lung cancer symptoms often overlap with illnesses like tuberculosis, which leads to delays in diagnosis,” he said. As a result, many patients only seek medical help when the disease has already progressed to an advanced stage.
A lung cancer diagnosis can be life-altering, both physically and emotionally. According to Dr Goel, patients are suddenly faced with difficult treatment decisions, ranging from surgery and chemotherapy to radiation or targeted therapy. Physical symptoms such as breathlessness and exhaustion can significantly affect daily life.
Emotionally, patients may experience shock, anxiety, fear about the future, concerns for their families, and a loss of independence. “Support from medical teams, counselling services, and loved ones plays a crucial role during this period,” he said.
The most damaging myth, experts say, is the belief that lung cancer only affects smokers. Dr Goel warned that this misconception often results in non-smokers dismissing symptoms or doctors delaying screening. “Anyone can develop lung cancer, regardless of smoking history,” he said.
If there is one message the public should remember, Dr Goel said, it is that early detection can dramatically improve outcomes. Persistent cough lasting several weeks, unexplained breathing difficulties, or ongoing chest discomfort should prompt immediate medical attention.
“Recognizing symptoms early and seeking help can change the course of treatment and significantly improve quality of life,” he said.
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Face masks are not adequate when it comes to protection against flu-like illnesses, including COVID, said the World Health Organization (WHO) guidelines. As the number of flu cases rise in the US and the UK, this WHO guideline, may be of use. The guidelines noted that the surgical masks worn by doctors and nurses, when they are face to face with a patients are no longer providing the protection, and must be replaced with respirators.
The guidelines noted in a letter to the WHO chief Dr Tedros Adhanom Ghebreyesus, noted there is “no rational justification remaining for prioritizing or using” the surgical masks that are ubiquitous in hospitals and clinics globally, given their “inadequate protection against airborne pathogens”. “There is even less justification for allowing healthcare workers to wear no face covering at all,” the letter read.
When COVID was at its peak, an estimated of 129 billion disposable face masks were being used around the world every month. These were used by the healthcare workers as well as general public. These surgical masks were most widely available and recommended by most health authorities during that time. However, respirators were then designed to filter tiny particles. Then came the masks FFP2/3 standards in the UK or the N95 in the US. Evidence also supported that many countries are switching to these masks and that they are more effective. This resulted in fewer infections in patients and health professionals, as well as reducing the rate of sickness, and burnout of the healthcare professionals.
Face masks are loose in fitting and are designed for one-way protection. It protects others from coughs and sneezes. WHO recommends a three-layer mask when people cannot socially distance. However, not all face masks have a safety rating.
The respirators on the other hand has a tight fitting, which creates a facial seal and filters both inflow and outflow of air. It tightly covers the nose and the mouth. It also removes 94% of all particles that are 0.3 microns in diameter or larger. It is also designed to protect the wear up to the safety rating of the mask.
The WHO has faced criticism for its delayed acknowledgment of Covid-19’s airborne transmission. The letter urges the agency to reassess its earlier position and clearly communicate to the public that the virus spreads through airborne respiratory particles.
Professor Trisha Greenhalgh of the University of Oxford, a signatory to the letter whose research is widely cited in it, said that infection occurs only when germs enter the body. She explained that respirators, which seal tightly against the face, force air to pass through high-grade filters that block airborne pathogens. In contrast, she noted, medical masks fit loosely and allow significant air leakage.
Supporters of the letter include members of the World Health Network, leading US epidemiologist Eric Feigl-Ding, and Guardian columnist George Monbiot.
Responding to the letter, a WHO spokesperson said it would undergo “careful review.” The spokesperson added that the organization consults experts across diverse health and economic settings when developing guidance on personal protective equipment for healthcare workers, and that its Infection Prevention and Control guidelines for epidemic- and pandemic-prone respiratory infections are currently under review in light of the latest scientific evidence.
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