How can I help my drunk friend?

Dear Reader, 

It's great that you're asking these questions and are so willing to help your friends when they are drunk. What you do for them might be different depending on where you are when it happens, what other factors are involved (such as other substances used), and your own level of intoxication. If you’re in a group and there's at least one person who's completely sober, they'll likely be the best suited to assess the situation and call for any needed help. However, it might be that it’s just you two, in which case if your friend’s still responsive you might help them by grabbing some water to drink and finding them a comfortable place to sit in an upright position. If there are any signs that your friend is having trouble breathing, is severely ill, or is already unconscious, it's best to call emergency services immediately. If you're unsure of what to do or how drunk they really are, erring on the side of caution and calling anyway may be a life-saving decision. It's key to maintain your own safety and the safety of your friend, when possible, whether this means leaving, calling for help, or both. In terms of sobering up, unfortunately only time will improve your situation. Ultimately, if you're already drunk, you may not be well-positioned to help coordinate others and may instead need to call in some sober reinforcements. Most states have Good Samaritan Laws that protect both the person who became drunk and is unconscious as well as the person who called emergency services from getting into legal trouble should they be underage or other substances be involved. 

Being aware of what signs to look out for to determine whether someone is intoxicated to the point of concern can be helpful in deciding how best to assist your friend. Some of these signs can include: 

• Slurred speech 
• Stumbling or having difficulty maintaining balance and walking independently 
• Trouble making eye contact 
• Feeling excessively cold or warm (to themselves or to the touch) 
• Shortness of breath 
• Erratic, withdrawn, or aggressive behavior 
• Queasiness, vomiting, or dry heaving 
• A tired stupor 
• Unconsciousness 

A first step in helping someone who has had a lot to drink is to encourage them to avoid consuming more alcohol. It may also be helpful to guide the person to a quiet place where they can relax comfortably as reflexes and coordination can be severely impaired when intoxicated—walking around may be dangerous and potentially lead to injury. As to your question about fresh air and warmth, both can be vital to staying safe. Since high blood alcohol levels (BAC) can lower body temperature, even if the person actually feels warm, you might consider offering them a light blanket. Depending on how your friend is feeling or behaving, you may choose to take different actions. Some situations you may encounter include your friend: 

• Wanting to drink water. Alcohol is a diuretic, meaning it causes the body to expel more liquid than it’s consuming. Although staying hydrated won't make someone sober—only time can do that—it may help them avoid dehydration and other related concerns. It’s important to note that coffee is also a diuretic and therefore more likely to cause dehydration. Coffee likely won’t be beneficial if the ultimate goal when drinking it is getting sober.  
• Being sick. The liver works to break alcohol down into acetaldehyde, however, when alcohol is consumed in large quantities over a short period of time the liver can’t keep up which causes you to become drunk. When the level of acetaldehyde becomes too high, the liver stops processing alcohol and instead, the body resorts to ridding the toxin through vomit. Should your friend reach the point of throwing up, it’s best to have another friend (or yourself) accompany them to the bathroom. Not only can that person help to keep the drunk person’s hair out of the toilet (and out of the vomit), but bathrooms can be an unsafe environment for someone who is unsteady, has poor coordination, and is ill as they can fall and injure themselves. 
• Being hungry. While eating a meal before drinking may slow the absorption of alcohol into the bloodstream, eating after becoming intoxicated unfortunately, doesn’t have the same effect. Having something to eat may make your drunk friend happy but be mindful of the foods you choose to eat as intoxication can dull the swallowing—gag—reflex which can increase their chances of choking.  
• Wanting to lie down. Keeping your friend comfortable can be a great way to support them and keep any potential alcohol related outbursts at bay. If they choose to lie down, try encouraging them to lay on their side with a support on both their back and chest to prevent them from rolling over onto either. Rolling onto these parts of their body when drunk and unconscious can increase their risk of drowning or asphyxiation if they were to vomit.  
• Falling asleep. It is not uncommon for someone to feel tired after drinking as alcohol is a depressant and therefore slows down the body's functions. While sleep can be a great pastime when drunk or hungover, it's recommended that someone stay with the sleeping person so they can continue to check on them to ensure they're breathing normally. It can be important to note that sleeping drunk people often tend to breathe slowly or shallowly, feel cold to the touch, or have blue-ish lips. This is because in large amounts, alcohol will dull the nerves that regulate breathing, heartbeat, and gag reflex.  

If you find that your friend is frequently drinking to the point where they're unable to care for themselves, are making decisions with poor judgment, or are acting aggressively, it may be time to think about how their behavior affects you. How do you feel about spending your time in this way with these friends? If you find yourself taking care of your friends while drinking, are you able to enjoy yourself, too? What would it be like for you to drink with friends who consumed alcohol in a way that allowed everyone to drink without the responsibility of having to watch out for someone else? If you were to become too drunk to take care of yourself, do you have anyone that would be able to support you?  

While it may seem helpful to be there to help your drunk friend(s), this could lead to resentment on your part or patterns of unresolved, unfavorable behavior that may be harmful to their health or your relationship with them. Having a conversation with your friend about your concerns may be a great way to set boundaries or limits around how you’re willing to help when drinking together. These conversations can also be a good starting point for encouraging them to revisit their own relationship with alcohol and to discuss whether seeking professional help might be beneficial. 

Drinking alcohol with friends can be a tricky field to navigate, but asking for information on what to look for and how to avoid uncomfortable situations is a great place to start.