If you or someone nearby is drunk and throwing up, the most important thing right now is to stay upright or lie on your side, never on your back. Vomiting while intoxicated is your body’s attempt to get rid of excess alcohol, but the real danger is choking on vomit, especially if you’re too impaired to react. Everything else, the headache, the nausea, the misery, comes second to keeping the airway clear.
Stay on Your Side, Not Your Back
If you’re the one vomiting, sit up or lean forward over a bucket or toilet. Gravity helps keep your airway open. If you feel too dizzy to sit, lie on your side with your mouth angled toward the ground so anything you throw up can drain out rather than back into your throat.
If you’re helping someone else who is too drunk to sit up on their own, roll them into the recovery position: lay them on their back first, then bend the knee farthest from you to a right angle, fold their far arm so the back of their hand rests against their near cheek, and roll them toward you by pulling the bent knee. Their head should rest on their bent arm, tilted slightly back with the chin lifted so air flows freely. Stay with them. Do not leave a heavily intoxicated person alone.
Know When to Call 911
Throwing up after drinking too much is common. Alcohol poisoning is not common, and it kills. The line between “really drunk” and “dangerously poisoned” can blur fast, so watch for these signs:
- Slow breathing: fewer than eight breaths per minute.
- Irregular breathing: gaps of more than 10 seconds between breaths.
- Skin that looks blue, gray, or unusually pale.
- Low body temperature: skin feels cold and clammy to the touch.
- Unresponsiveness: you cannot wake the person up by shouting or shaking their shoulder.
- Seizures.
Any one of these means call emergency services immediately. Don’t worry about getting someone “in trouble.” Paramedics and emergency rooms deal with alcohol poisoning routinely, and waiting too long is how people die from it. Alcohol levels in the blood can keep rising even after a person stops drinking, so someone who seems “just really drunk” at midnight can slide into a medical emergency an hour later.
Sip Water, Skip the Coffee
Vomiting drains your body of fluid fast. Once the heaving slows down, take small sips of water or an electrolyte drink. Don’t gulp. A full stomach of water on top of alcohol will likely come right back up. A few sips every few minutes is the goal.
Coffee will not sober you up. It just makes you a jittery, wide-awake version of drunk. Cold showers don’t speed up alcohol processing either. Your liver breaks down alcohol at a fixed rate, roughly one standard drink per hour, and nothing changes that. The only thing that actually sobers you up is time.
Be Careful With Pain Relievers
You’ll probably want something for the headache. Be cautious. Acetaminophen (Tylenol) is processed by your liver, which is already working hard to clear alcohol. The FDA specifically warns people who drink three or more alcoholic beverages a day to talk to a doctor before taking it, because the combination raises the risk of liver damage. If you’ve been drinking heavily, acetaminophen is not a safe choice that night.
Ibuprofen and aspirin are easier on the liver but can irritate an already inflamed stomach lining, which is the last thing you need after vomiting. If you can tolerate it, ibuprofen with a small amount of food the next morning is generally a better option than reaching for anything while still intoxicated.
Watching Someone Sleep It Off
If the person who was vomiting has stopped and wants to sleep, don’t just let them pass out unsupervised. Position them on their side with a pillow behind their back to keep them from rolling flat. Then check on them regularly. Wake them up every 20 to 30 minutes for the first couple of hours. You’re confirming they’re actually sleeping and not unconscious. If at any point you cannot wake them, call 911.
Even after someone stops drinking, alcohol continues to absorb from the stomach into the bloodstream. A person can seem stable, fall asleep, and become more impaired over the next hour. This is why “just letting them sleep” without monitoring is risky. Set alarms on your phone if you need to. It’s one night of interrupted sleep that could prevent something irreversible.
What to Eat the Next Day
Your stomach lining is inflamed after a night of heavy drinking and vomiting, so don’t force food until you actually feel ready. When you do start eating, go bland: bananas, plain toast or crackers made with white flour, applesauce, broth-based soup, plain rice, or eggs. Popsicles and gelatin are also gentle options if solid food still feels like too much. Eat small amounts and chew slowly rather than sitting down to a big meal.
Avoid anything greasy, spicy, acidic (like orange juice or tomato-based foods), or high in fiber for the first 12 to 24 hours. Drink fluids slowly and steadily throughout the day. Weak tea is fine. Your stomach needs a reset, and pushing it too hard will just restart the nausea cycle.
Watch for Signs of Aspiration
The biggest medical risk of throwing up while heavily intoxicated, beyond the immediate choking hazard, is aspirating vomit into the lungs. This can cause a type of pneumonia that develops in the hours or days after the episode. If you or the person you were caring for develops any of the following in the 24 to 72 hours after the incident, get medical attention:
- Chest pain
- Shortness of breath or wheezing
- Fever or chills
- Coughing up discolored, foul-smelling, or bloody phlegm
- Bluish discoloration of the lips or tongue
Aspiration pneumonia is treatable, but it needs to be caught. A cough that appears the day after a bad night of drinking, especially with fever, is not something to brush off as a hangover symptom.