You’re at a party. Or maybe a bar. Or just sitting on a couch on a Tuesday night. Suddenly, the vibe shifts because someone has clearly had way too much to drink. They’re stumbling, their speech is a thick slurry of vowels, and they might be getting a bit too loud or, worse, dangerously quiet. Knowing what to do when someone is intoxicated isn't just about being a "good friend." Honestly, it’s about basic harm reduction and, in some cases, literally saving a life.
Alcohol is a weird drug because we treat it like it’s no big deal, but it’s a central nervous system depressant. It slows everything down. Heart rate. Breathing. Gag reflex. When someone crosses that invisible line from "having a good time" to "dangerously drunk," the clock starts ticking. You need to know how to handle it without panicking or making the situation worse with old wives' tales.
Stop the Flow Immediately
The very first thing you have to do is make sure they don't drink another drop. This sounds obvious, right? But in a social setting, people often try to "pace" someone by giving them lower-alcohol drinks or, even worse, letting them finish what’s in their hand so it doesn't go to waste. That’s a mistake.
Take the drink away.
Don't be a jerk about it, but be firm. If they’re at a bar, tell the bartender to stop serving them. If you’re at home, hide the bottles. Alcohol takes time to hit the bloodstream; the drink they just finished ten minutes ago hasn't even fully peaked in their system yet. They are going to get more intoxicated over the next half hour regardless of what they do right now. Your goal is to cap the peak.
Coffee and Showers are Myths
Let’s get this out of the way: caffeine does not sober someone up. It just creates a "wide-awake drunk." According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), the only thing that lowers blood alcohol concentration (BAC) is time. Giving an intoxicated person a cup of black coffee might make them feel more alert, but their motor skills and judgment are still trashed. Even worse, it can give them a false sense of confidence, leading them to think they’re "fine" to drive or walk home alone.
Cold showers? Also a bad idea. Alcohol lowers your core body temperature. Throwing a severely intoxicated person into a cold shower can actually cause them to go into shock or develop hypothermia. Plus, they’re clumsy. They’ll probably slip and crack their head open. Just don't do it.
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The Danger of "Sleeping it Off"
We’ve all heard it. "Just let them sleep it off." This is probably the most dangerous advice ever given. When you're wondering what to do when someone is intoxicated, the last thing you should do is dump them in a dark bedroom and shut the door.
Why? Because of the gag reflex.
When someone is profoundly drunk, they might vomit while unconscious. If they are lying on their back, they can aspirate—basically, they breathe the vomit into their lungs. This can cause choking, lung infections, or immediate death.
Use the Bacchus Maneuver
If they are passing out, you need to put them in the Recovery Position, often called the Bacchus Maneuver. This isn't just "turning them on their side." You have to lock them into place so they don't roll back onto their spine.
- Lay them on their side.
- Tuck their bottom arm under their head to support it.
- Bend their top leg at the knee to create a sort of "kickstand" that prevents them from rolling onto their stomach or back.
- Regularly check that their airway is clear.
Stay with them. Don't leave. You need to be there to hear if their breathing changes. If you hear "snoring" that sounds weirdly gasping or irregular, that’s not a nap. That’s a sign of respiratory distress.
When Is It a Medical Emergency?
People are terrified of calling 911 because they don't want to get their friends in trouble or deal with a massive hospital bill. But listen: dead is worse than a bill. Alcohol poisoning is a genuine medical emergency.
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You need to call for help if you see the "PUBS" signs. This is a common acronym used by campus safety experts and medics:
- P - Puking while passed out.
- U - Unresponsive to pinching or shouting.
- B - Breathing is slow (less than eight breaths a minute) or irregular.
- S - Skin is blue, pale, or cold/clammy.
If they are "sleeping" and you can't wake them up by shaking them or shouting their name, they are in trouble. This is called "stupor," and it means their brain is starting to shut down essential functions. Don't wait for all the symptoms. If you see even one, call the professionals.
The Hydration Trap
Water is great, but don't force-feed it to someone who is semi-conscious. They can choke on the water just as easily as anything else. If they are awake enough to sit up and hold a glass, give them small sips of water or a drink with electrolytes.
Avoid carbonated drinks. The bubbles can actually speed up alcohol absorption in some cases and definitely make the stomach more upset. Stick to the basics.
Navigating the Social Aggression
Alcohol lowers inhibitions, which is a polite way of saying it can make people act like total idiots. If an intoxicated person is getting aggressive, your priority is safety—yours and theirs.
Avoid direct confrontation. Don't argue with "drunk logic." It’s a losing game. Their prefrontal cortex is effectively offline. Instead, use distraction. Redirect them to a different room, a different topic, or a different activity. If they want to fight, don't engage. If they want to leave and drive, that’s the one time you have to be immovable. Take the keys. Call a ride. If you have to, tell them the car is "broken" or "blocked in."
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Understanding BAC and the "Second Wave"
Blood Alcohol Concentration doesn't just drop the moment someone stops drinking. It can actually continue to rise for up to 40 minutes after the last sip. This is because the small intestine is still processing the alcohol and dumping it into the bloodstream.
This is why you can't just check on someone once and think they're "good." You need to monitor them for at least an hour after their last drink to see where their peak truly is. If they were already "borderline" when they stopped, they could easily tip into alcohol poisoning thirty minutes later while they're sitting on your couch.
Long-term Care: The Morning After
So, they survived the night. They’re awake, they’re miserable, and their head feels like it’s in a vice. Now what?
The hangover is basically a combination of dehydration, inflammation, and the toxic effects of acetaldehyde (a byproduct of alcohol metabolism).
- Food: Greasy food is a myth for "soaking up alcohol" after the fact—the alcohol is already gone or processed. Stick to bland foods like crackers or toast to settle the stomach.
- Pain Relief: Be very careful here. Never give someone Tylenol (Acetaminophen) after a night of heavy drinking. Both alcohol and Tylenol are processed by the liver, and the combination can cause severe liver damage or even failure. Use Ibuprofen instead, but keep in mind it can be hard on an already irritated stomach lining.
- Rest: Their sleep quality was likely terrible because alcohol disrupts REM cycles. They need real, sober sleep.
Actionable Steps for Safety
When you find yourself responsible for someone who’s had too much, follow this hierarchy of actions to ensure everyone stays safe:
- Clear the Area: Get them away from stairs, pools, or balconies. Gravity is a drunk person's worst enemy.
- Monitor Breathing: If you can't count at least 10 breaths a minute, call for help.
- Positioning: Get them into the Bacchus Maneuver position on the floor, not a soft sofa where they might sink and roll.
- No Home Remedies: Forget the coffee, the bread, or the "walk it off" method. None of it works.
- Check for Other Substances: If you suspect they took anything else—pills, weed, or other drugs—the risk of respiratory failure skyrockets. You must tell emergency responders exactly what was taken; they aren't there to arrest you, they're there to prevent a fatality.
Realizing what to do when someone is intoxicated is mostly about being the "designated brain." You are making the logical decisions they currently can't. Stay calm, stay present, and don't be afraid to be the "boring" friend who insists on calling a medic. It’s always better to be embarrassed by an overreaction than to live with an underreaction.