If someone near you shows signs of alcohol poisoning, call 911 immediately. This is a medical emergency where minutes matter. Alcohol poisoning happens when there is so much alcohol in the bloodstream that the brain areas controlling breathing, heart rate, and temperature begin to shut down. While you wait for help, there are specific steps you can take to keep the person safer.
Recognizing Alcohol Poisoning
Before you can help, you need to know what you’re looking at. Alcohol poisoning goes well beyond being “really drunk.” The key signs include:
- Unconsciousness or inability to wake up. If you can’t rouse the person by shouting or shaking their shoulders, that’s a red flag.
- Slow or irregular breathing. Fewer than eight breaths per minute, or gaps of 10 seconds or more between breaths, signals the brain is losing control of respiration.
- Vomiting while unconscious. This creates an immediate choking risk.
- Pale, bluish, or cold skin. Temperature regulation fails as blood alcohol climbs dangerously high.
- Seizures.
A critical thing to understand: alcohol in the stomach and intestine continues entering the bloodstream even after the person stops drinking. Someone who seems “just passed out” can still be getting worse. A blood alcohol level above 0.40% puts a person at risk of coma and death from respiratory arrest.
What to Do Right Now
Call 911 first. Everything else you do is while you wait for paramedics. Do not assume the person will “sleep it off.”
If the person is unconscious or semi-conscious, put them in a recovery position (sometimes called the Bacchus maneuver) so they won’t choke if they vomit. Here’s how:
- Raise the arm closest to you above their head.
- Gently roll them toward you, protecting their head from hitting the floor. Their head should rest in front of the raised arm, not on top of it.
- Tilt the head up slightly to keep the airway open. Tuck their nearest hand under their cheek to hold the head in position and keep the face off the ground.
This position lets vomit drain out instead of blocking the airway. But it is not a substitute for medical care. Stay with the person and check on them frequently. If someone has fallen and may have a spinal injury, do not try to reposition them. Call 911 and wait.
If the person is awake, talk to them. Explain what you’re doing and why. People at this level of intoxication can become confused or combative, and calmly narrating your actions helps reduce that.
What to Tell the 911 Dispatcher
Paramedics will make better decisions with good information. Try to have answers ready for these questions:
- What and how much did the person drink?
- Over what time period?
- Did they take any drugs or medications, including over-the-counter or prescription pills?
- Do they have any known medical conditions?
- When did they lose consciousness, or when did symptoms start?
The combination of alcohol with opioids or sedatives is especially dangerous because both suppress the same brain functions that control breathing. If you know or suspect the person mixed substances, tell the dispatcher immediately.
What Not to Do
Several common “remedies” for drunkenness are useless at best and dangerous at worst when someone has alcohol poisoning.
Don’t give them coffee. Caffeine does not speed up the removal of alcohol from the body. The liver processes roughly one standard drink per hour (one 12-ounce beer, one 5-ounce glass of wine, or one 1.5-ounce shot), and nothing changes that rate. Coffee can also further dehydrate someone whose body is already struggling.
Don’t put them in a cold shower. A cold shower will not lower blood alcohol level. It can, however, cause hypothermia in someone whose temperature regulation is already impaired, or cause them to fall and injure themselves.
Don’t try to make them walk it off. A person with alcohol poisoning has severely impaired coordination and consciousness. Walking increases the risk of falls and injuries, and does nothing to sober them up.
Don’t leave them alone to sleep it off. This is the most dangerous mistake. Because alcohol continues absorbing into the blood after drinking stops, the person’s condition can worsen even though they’ve stopped consuming alcohol. People die from alcohol poisoning in their sleep.
Don’t lay them on their back. A person on their back can choke on their own vomit without waking up. Always use the recovery position described above.
What Happens at the Hospital
At the emergency room, the medical team focuses on keeping the person alive and stable while their body processes the alcohol. This typically involves fluids given through an IV to prevent dehydration, along with vitamins and glucose to protect against serious complications like dangerously low blood sugar or brain damage.
In severe cases, the person may need help breathing. If someone consumed methanol (found in some industrial products) or isopropyl alcohol (rubbing alcohol) rather than regular drinking alcohol, they may need a dialysis procedure that mechanically filters the toxin from their blood.
Recovery time varies depending on how much alcohol is in the system and whether other substances are involved. Because the liver clears alcohol at a fixed rate, there is no way to speed the process. A person with a very high blood alcohol level may need monitoring for many hours.
Why Speed Matters
The window between “dangerously drunk” and “fatal overdose” is not as wide as people think. Alcohol is a central nervous system depressant that affects every organ. At extreme concentrations, it suppresses breathing to the point of respiratory arrest. Choking on vomit, severe dehydration, hypothermia, and seizures can all be fatal on their own.
Many people hesitate to call 911 because they worry about getting the person (or themselves) in trouble, especially if underage drinking or drug use is involved. Most states have medical amnesty or Good Samaritan laws that provide legal protection when you call for help during an overdose. A moment of embarrassment or legal worry is not worth a life. If you’re unsure whether the situation is serious enough to call, call anyway. Dispatchers can help you assess the situation, and it is always better to overreact than to wait too long.