The most important thing you can do for a drunk person who’s throwing up is keep them upright or on their side, stay with them, and watch for signs that the situation is turning dangerous. Vomiting after drinking is the body’s protective response to too much alcohol, but it carries real risks, especially choking, if the person is too intoxicated to manage on their own.
Why Alcohol Causes Vomiting
Alcohol directly irritates the stomach lining, and nerve endings there send a signal to the brain that something harmful is present. At the same time, a region in the brainstem monitors the alcohol level in the blood, and when it gets too high, the brain sends a signal back down to the stomach to purge. This is a built-in safety mechanism, not something to fight against. Trying to stop someone from vomiting, or telling them to hold it in, works against the body’s attempt to protect itself.
What to Do While They’re Vomiting
If the person is conscious and able to sit up, keep them sitting forward with their head over a bucket, toilet, or trash can. Sitting upright lets gravity work in their favor and keeps vomit from entering the airway. Stay beside them. A hand on their back or shoulder helps with balance and lets you monitor how alert they are.
If they’re too drunk to sit up on their own, get them onto their side immediately. This is the single most important step. Lying flat on their back while vomiting is how people choke, because alcohol suppresses the gag reflex that would normally keep vomit out of the lungs.
How to Put Someone in the Recovery Position
With the person lying on their back, kneel beside them. Extend the arm closest to you straight out at a right angle, palm facing up. Take their other arm and fold it across their chest so the back of that hand rests against the cheek nearest to you, then hold it in place. With your free hand, bend the knee farthest from you up to a right angle. Now carefully roll them toward you by pulling on that bent knee. Their head should end up resting on the hand you placed against their cheek, and the bent leg keeps them from rolling onto their stomach.
Once they’re on their side, gently tilt their head back slightly and lift their chin to keep the airway open. Check that nothing is blocking their mouth. Stay with them and keep monitoring. Do not leave them alone, even if they seem to be sleeping it off.
After the Vomiting Stops
Once they’ve stopped throwing up and are somewhat alert, the priority is replacing lost fluids without overwhelming the stomach. Start with small sips of water or let them suck on ice chips, about every 15 minutes. Don’t hand them a full glass and tell them to drink it. The stomach is still irritated, and too much fluid at once will trigger another round of vomiting.
After they’ve kept water down for a while, you can introduce other clear fluids: broth, diluted electrolyte drinks, or ice pops. Diluted oral rehydration solutions work better than sports drinks for restoring electrolyte balance. Avoid anything with caffeine or more alcohol.
Things That Don’t Help (and Can Hurt)
Cold showers, black coffee, and walking it off are persistent myths. None of these speed up how fast the body processes alcohol. Time is the only thing that actually sobers someone up. A cold shower just gives you a cold, wet person who’s still drunk, and the shock can cause a fall or even loss of consciousness. Coffee adds caffeine to the mix but doesn’t reduce impairment.
Don’t offer pain relievers while they’re still intoxicated or actively vomiting. Acetaminophen (Tylenol) is particularly risky after heavy drinking. Alcohol changes how the liver processes the drug, increasing the production of a toxic byproduct that can cause liver damage. The FDA warns against using acetaminophen products if you’ve had three or more drinks in a day. Anti-inflammatory painkillers like ibuprofen can further irritate a stomach that’s already inflamed from alcohol. Pain management can wait until the person is sober and their stomach has settled.
Why Someone Can Still Get Worse
One thing many people don’t realize is that blood alcohol levels can keep rising after the last drink. Alcohol takes time to absorb, and peak blood alcohol concentration doesn’t arrive the moment someone puts their glass down. After beer, blood alcohol can continue climbing for about an hour. After spirits, the peak comes sooner, around 35 to 40 minutes, but the principle is the same: someone who seems okay right now may become significantly more impaired over the next half hour to hour. This is why it’s critical to keep watching them even after they’ve stopped drinking and stopped vomiting.
Signs of Alcohol Poisoning
Vomiting after drinking is common. Alcohol poisoning is not, and the difference matters. Call emergency services if you notice any of these:
- Slow breathing: fewer than 8 breaths per minute
- Irregular breathing: gaps of 10 seconds or more between breaths
- Bluish or very pale skin, especially around the lips or fingertips
- Clammy skin or extremely low body temperature
- Unresponsiveness: you can’t wake them up, or they’re conscious but completely unaware of their surroundings
- Seizures
Don’t wait for all of these signs to appear. Any one of them is enough to call for help. Alcohol poisoning can suppress breathing and heart function, and the person’s condition can deteriorate quickly. If you suspect a spinal injury from a fall, don’t move them. Keep their head still, gently lift the jaw to keep the airway open, and wait for paramedics.
Staying With Them Overnight
If the person falls asleep, make sure they’re on their side, not on their back. Check on them regularly. Look for steady, normal breathing and a skin color that isn’t turning pale or blue. Set an alarm to check every 20 to 30 minutes if you’re worried about falling asleep yourself. If at any point you can’t rouse them, their breathing changes, or their skin goes cold and clammy, that’s an emergency.
The vast majority of people who drink too much and throw up will feel terrible but recover on their own with time, fluids, and rest. Your job is to keep them safe while their body does the work, which mostly means keeping their airway clear, watching their breathing, and not leaving them alone.