If someone has passed out from drinking, the most important thing you can do right now is roll them onto their side and check their breathing. A person who is unconscious from alcohol can choke on their own vomit, stop breathing, or develop dangerously low body temperature. Your job is to keep them safe, monitor them closely, and call 911 if anything looks wrong.
Check for Signs of Alcohol Poisoning First
There’s a difference between someone who had too much and fell asleep versus someone whose body is shutting down. Alcohol poisoning is a medical emergency, and it kills people every year because bystanders assumed the person was “just sleeping it off.” Before anything else, look for these warning signs:
- Slow breathing: fewer than eight breaths per minute
- Irregular breathing: gaps of 10 seconds or more between breaths
- Skin color changes: blue, gray, or unusually pale skin, especially around the lips or fingertips
- Vomiting while unconscious
- Seizures
- Cold or clammy skin
- No response when you shout their name, shake their shoulders, or pinch their skin
If you see any of these, call 911 immediately. Don’t wait to see if they improve. Blood alcohol levels above 0.31% can cause respiratory failure, coma, and death, and the person’s BAC can still be rising even after they’ve stopped drinking because alcohol takes time to absorb.
Put Them in the Recovery Position
The single biggest physical danger to someone passed out drunk is choking on their own vomit. Alcohol suppresses the gag reflex, which means the body’s normal defense against inhaling vomit doesn’t work. If vomit enters the lungs, it can cause aspiration pneumonia, a serious infection that can lead to sepsis and respiratory failure.
To put someone in the recovery position, start with them flat on their back. Move the arm closest to you out to the side in an L-shape, with their hand roughly level with their head. Take their far hand and place it against their near cheek, holding it there. Then bend their far knee and use it as a lever to roll them toward you onto their side. Their face should tilt slightly downward so that if they vomit, gravity pulls it out of their mouth instead of back into their throat. Their head should sit slightly lower than their stomach.
Once they’re on their side, hold the back of your hand near their mouth and nose so you can feel their breath. If the back of your hand is damp, it’s easier to detect faint breathing. Stay with them.
What to Do While You Wait
Don’t leave them alone. Not even for a few minutes. Someone who seems stable can vomit without warning or quietly stop breathing. If they’re unconscious, your job is to stay close and keep checking on them.
Keep them warm. Alcohol causes body temperature to drop, and hypothermia is a real risk, especially outdoors or in a cold room. Put a blanket or jacket over them, but don’t pile on so much weight that it’s hard to see their breathing.
Try to wake them periodically. Call their name, tap their shoulder firmly, pinch the skin on the back of their hand. If they respond, even with a groan or a flinch, that’s a sign their brain is still functioning at a basic level. If you get absolutely no response at all, call 911.
If they’re awake enough to sit up and swallow, small sips of water can help. But never try to give water to someone who is unconscious or barely conscious. They can’t protect their airway and could inhale the liquid into their lungs.
Things That Don’t Help (and Can Hurt)
Cold showers are dangerous. Someone who is heavily intoxicated already has a dropping body temperature, and cold water makes that worse. They can also fall, lose consciousness in the water, or go into shock. A cold shower will not sober anyone up.
Coffee doesn’t help either. Caffeine dehydrates the body further and does nothing to lower blood alcohol levels. It can create a false sense of alertness that masks how impaired the person actually is. The same goes for trying to walk them around. If someone can’t stay conscious, forcing them to move risks falls and injuries, and it won’t speed up how fast their liver processes alcohol.
Do not try to make them throw up. Without a functioning gag reflex, induced vomiting dramatically increases the risk of choking. And never put them on their back or leave them face-down on a pillow or cushion.
When to Call 911
If you’re unsure whether it’s an emergency, call. Paramedics would rather respond to a cautious call than arrive too late. But certain signs demand an immediate call:
- You cannot wake them at all, no matter what you try
- Their breathing is slow (under eight breaths per minute), irregular, or stops
- Their skin is blue, gray, or extremely pale
- They are having a seizure
- They vomit while unconscious, especially repeatedly
Keep in mind that an unresponsive person who was drinking may also have a head injury you can’t see. Falls are common when someone is severely intoxicated, and a concussion or internal bleeding can look identical to “just being really drunk.” If they hit their head at any point, or if you don’t know what happened before you found them, that’s another reason to call for help.
How Long to Keep Watching
Blood alcohol levels can continue rising for 30 to 90 minutes after the last drink, which means someone can seem okay and then get worse. There is no safe point where you can walk away and assume everything is fine. Stay with the person until they can sit up on their own, hold a conversation, and keep water down. If they remain unconscious for an extended period or you notice their condition deteriorating rather than slowly improving, get medical help.
Once they’re awake and coherent, keep them hydrated, keep them warm, and make sure they don’t drink more alcohol. Their body is still processing what’s already in their system, and adding more can push them back into dangerous territory quickly.