If someone near you has had too much to drink, the most important things you can do are keep them awake if possible, position them safely if they’re not, and watch for signs that this has crossed from uncomfortable into dangerous. Most people who drink too much will recover on their own with time and basic care, but alcohol poisoning kills, and the line between “sleeping it off” and a medical emergency isn’t always obvious.
Know When to Call 911
Before anything else, check whether this person needs emergency help. Alcohol poisoning is not just being very drunk. It happens when alcohol in the bloodstream reaches levels that start shutting down basic body functions like breathing and temperature regulation. The signs to watch for:
- Slow breathing: fewer than 8 breaths per minute
- Irregular breathing: gaps of 10 seconds or more between breaths
- Can’t wake up: you shake them, call their name, and they don’t respond
- Bluish or very pale skin, especially around the lips or fingertips
- Clammy skin or extremely low body temperature
- Mental confusion or stupor beyond normal drunkenness
- Vomiting while unconscious
If you see any of these, call 911 immediately. Don’t wait to see if they “get better.” Blood alcohol levels can keep rising for 30 to 40 minutes after a person stops drinking, which means someone who seems okay right now can deteriorate quickly. Stay with them until help arrives.
Position Them Safely
The biggest physical danger for someone who’s very drunk and losing consciousness is choking on their own vomit. If the person is passed out or can’t sit up reliably, you need to get them into a recovery position. Stanford’s health services recommends a technique sometimes called the Bacchus maneuver:
Raise the arm closest to you above their head. Gently roll them toward you onto their side, protecting their head from hitting the floor. Their head should rest in front of the raised arm, not on top of it. Then tilt their head up slightly to keep the airway open, and tuck their nearest hand under their cheek to hold that position. This keeps vomit draining out of the mouth instead of back into the throat.
One critical note: if the person fell and you suspect any kind of head, neck, or spinal injury, do not move them. Call 911 and let trained responders handle positioning.
Once they’re on their side, check on them frequently. Set a timer on your phone if you need to. You’re watching for changes in breathing, skin color, and responsiveness.
What Actually Helps (and What Doesn’t)
There is no way to speed up sobering. The liver processes alcohol at a fixed rate of roughly one standard drink per hour. One drink means one 12-ounce beer, one 5-ounce glass of wine, or one ounce of 100-proof liquor. If someone has had eight drinks, it will take approximately eight hours for their body to clear the alcohol. Nothing changes this timeline.
Coffee does not help. Caffeine can make a drunk person feel more alert, which sounds helpful but actually makes things worse. They may overestimate how sober they are and do something dangerous, like trying to drive. Their blood alcohol level is exactly the same as it was before the coffee.
Cold showers don’t work either. A cold shower on someone who’s severely intoxicated can cause a dangerous drop in body temperature, since alcohol already impairs the body’s ability to regulate heat. The shock can also cause falls.
“Walking it off” is another myth. Exercise doesn’t increase the liver’s processing speed. It just puts a physically impaired person at risk of falling and getting hurt.
Practical Care While They Recover
If the person is conscious and responsive, here’s what you can do. Keep them sitting up or at least propped on their side. Give them small sips of water. Alcohol is a powerful diuretic, meaning it causes the body to lose fluids and electrolytes rapidly. A sports drink with electrolytes can help, but water is fine. Don’t push large amounts of fluid at once, especially if they’re nauseous, because vomiting creates its own risks.
A small, bland snack can be useful if they can keep it down. Alcohol interferes with the liver’s ability to maintain blood sugar levels, which can lead to hypoglycemia (low blood sugar). The tricky part is that symptoms of low blood sugar, like slurred speech, confusion, drowsiness, and poor coordination, look almost identical to being drunk. If someone seems to be getting worse rather than better as time passes, or if they become unusually pale and sweaty, low blood sugar could be part of the picture, and that’s another reason to seek medical attention.
Keep the room at a comfortable temperature. Alcohol dilates blood vessels near the skin, which makes a person feel warm while actually losing body heat faster. A blanket helps.
What to Watch for Overnight
The phrase “let them sleep it off” is where things get dangerous. Sleep is fine and necessary, but an unconscious, unmonitored person who vomits can die from aspiration. If someone is going to sleep, make sure they’re on their side (not their back), and check on them regularly through the night.
Every time you check, look for three things. First, are they still breathing normally, with at least 8 breaths per minute? Second, is their skin a normal color and temperature? Third, can you rouse them at least partially by speaking to them or gently shaking their shoulder? If the answer to any of these is no, call for emergency help.
Blood alcohol can continue affecting the body for hours. Someone who drank heavily at midnight may not be out of danger by 2 a.m., even if they stopped drinking. The math is straightforward: count roughly one hour per drink consumed, starting from when they had their last one.
The Next Morning
Once they’re awake and coherent, the priority is rehydration. Water, broth, and electrolyte drinks all help. Eating a real meal supports blood sugar recovery. Expect headaches, nausea, fatigue, and general misery. These hangover symptoms are largely caused by dehydration, inflammation, and the toxic byproducts the liver creates while breaking down alcohol.
If the person continues vomiting well into the next day, can’t keep any fluids down, or seems confused or disoriented hours after their last drink, those are signs something more serious may be going on. Severe dehydration, lingering low blood sugar, or head injuries sustained during a fall can all hide behind what looks like a bad hangover.