How to Deal With a Drunk Person and Keep Them Safe

Keeping a drunk person safe comes down to a handful of practical steps: stay with them, keep them on their side if they’re lying down, watch for signs of alcohol poisoning, prevent them from driving, and call for emergency help the moment anything looks seriously wrong. Most of what you need to do is straightforward, but the stakes are real, because severe intoxication can suppress breathing, lower body temperature, and impair someone’s ability to protect themselves from harm. Knowing the difference between “they just need to sleep it off” and “they need medical attention right now” is the single most valuable skill in this situation.

How to Tell How Drunk Someone Actually Is

People progress through intoxication in a roughly predictable sequence. At low levels, you see loosened inhibitions, a shift in mood, and slightly impaired judgment. As blood alcohol rises, coordination, reaction time, and the ability to think through complex tasks start to decline noticeably.¹ At moderate intoxication, you’ll see slurred speech, unsteady walking, and slower reactions. The person might repeat themselves, lose track of conversations, or have trouble with basic tasks like unlocking a phone.

What matters from a safety standpoint isn’t precise blood-alcohol guessing. It’s recognizing when someone has crossed from “drunk but functional” into “incapacitated.” The practical line is this: can the person walk without support, hold a conversation that makes sense, and stay awake? If the answer to any of those is no, they need active help rather than just monitoring from across the room.

Recognizing Alcohol Poisoning

Alcohol poisoning is the scenario that can turn fatal, and it looks different from ordinary drunkenness. Severe intoxication can suppress the nervous system enough to cause breathing problems, loss of consciousness, and in the worst cases, cardiac arrest.² Call emergency services immediately if you notice any of the following:

Slow or irregular breathing: fewer than about eight breaths per minute, or gaps of ten seconds or more between breaths.
Unresponsiveness: you can’t wake the person by shaking them, speaking loudly, or pinching the skin on the back of their hand.
Vomiting while unconscious: this creates a serious choking risk, especially if they’re on their back.
Pale or bluish skin: particularly around the lips and fingertips, which signals poor oxygen circulation.
Seizures: any convulsive movement or rigidity.
Hypothermia: skin that feels unusually cold and clammy to the touch.

The instinct to “let them sleep it off” is the most dangerous myth in this situation. Blood alcohol can continue rising after someone stops drinking, because the stomach is still absorbing what’s already been consumed. A person who seems “just really drunk” when they pass out can deteriorate over the next hour. If you’re unsure, err on the side of calling for help. Emergency rooms deal with intoxicated patients routinely, and no one will judge you for being cautious.

What to Do While You’re With Them

If someone is too intoxicated to take care of themselves but doesn’t appear to need emergency medical intervention, your job is to manage the situation until they’re sober enough to be safe. Here’s what actually helps:

Keep them sitting up or, if they need to lie down, place them on their side in the recovery position. This means one leg bent forward at the knee to stop them from rolling onto their stomach, with their head tilted slightly so that if they vomit, it drains out rather than pooling in the back of the throat. Choking on vomit while unconscious is one of the leading causes of alcohol-related deaths, and it’s almost entirely preventable with this simple positioning.

Stay with them. Don’t leave them alone to sleep, especially in the first hour or two after their last drink. Check periodically that they’re still breathing normally and that their skin color hasn’t changed. If you’re at a party or a bar, recruit another sober person to help you take shifts. This is a team job when it can be.

Give them small sips of water if they’re awake and able to swallow. Alcohol does cause dehydration, but hydration isn’t the miracle cure people sometimes imagine. Research on hangover prevention found that the amount of water someone drank during or after alcohol consumption had only a modest effect on next-day hangover severity, and drinking water during the hangover itself didn’t meaningfully reduce symptoms either.³ That said, keeping someone sipping water is still worth doing. It slows the pace of alcohol intake if they’re still drinking, it prevents the discomfort of severe thirst, and it gives them something to hold that isn’t another beer.

Try to get them to eat something bland if they’re willing. Food won’t sober them up, but it can settle the stomach and reduce the likelihood of vomiting. Crackers, bread, and similar carbohydrates are the standard choices because they’re easy to keep down.

What Not to Do

Several popular “remedies” are useless at best and dangerous at worst. Cold showers don’t sober anyone up. They do, however, risk a fall in a slippery space when someone can barely stand. Coffee doesn’t help either; caffeine may make a person feel more alert while remaining just as impaired, which can give the false impression that they’re fine to drive or walk home alone.

Don’t try to make someone vomit. The gag reflex is suppressed in heavily intoxicated people, which means inducing vomiting raises the choking risk rather than reducing it. If the person vomits on their own, help them lean forward if they’re sitting or ensure they’re in the recovery position if they’re lying down, and clear any vomit from around their mouth.

Avoid physical confrontation if the person becomes aggressive. Alcohol impairs the part of the brain responsible for impulse control, and a drunk person who feels cornered can lash out unpredictably. Keep your voice calm and low, give them physical space, and don’t argue about whether they’re drunk. Trying to physically restrain an intoxicated person carries risks for both of you. In medical settings, case reviews have found that physical restraint of intoxicated individuals can lead to serious complications, particularly when the person shows signs of extreme agitation or has underlying health conditions.⁴ The safer move with an aggressive drunk person is to back away, remove yourself and others from the situation, and call for professional help if the aggression escalates.

Cold Weather and Outdoor Risks

If you’re looking after someone who’s intoxicated outdoors in cold weather, the temperature risk is more serious than most people realize. Alcohol increases heat loss from the body and, critically, delays the onset of shivering and shortens its duration.⁵ Shivering is the body’s primary emergency response to cold, so when alcohol suppresses it, the person loses the main mechanism that would otherwise keep their core temperature from dropping. At the same time, alcohol creates a subjective sensation of warmth by dilating blood vessels near the skin, which means the person may feel fine even as they’re losing dangerous amounts of body heat.

The practical takeaway is straightforward: get them inside. If that’s not immediately possible, wrap them in whatever insulation you have, get them off the ground (which conducts heat away quickly), and minimize wind exposure. People who pass out drunk outdoors in winter are at serious risk of hypothermia, frostbite, and death, even at temperatures that a sober person would manage without too much difficulty.

Preventing Drunk Driving

This is one of the most valuable things you can do as a bystander, and also one of the most socially difficult. Research into how young adults navigate these situations found that people generally value looking out for friends and recognize drunk driving as dangerous, but they often struggle with the practical challenge of actually intervening in the moment.⁶ The friction comes from not wanting to cause a scene, underestimating how impaired the person is, or assuming someone else will handle it.

What works: take the keys early, before the person is too drunk to negotiate with. Offer specific alternatives rather than just saying “you can’t drive.” “I’ll call you a ride” or “you can crash at my place” removes the logistical barrier that the drunk person is poorly equipped to solve on their own. If the person insists on driving and you can’t physically take the keys, call the police. That feels extreme in the moment, but a DUI arrest is vastly preferable to the alternative.

When Other Substances Are Involved

Alcohol alone is dangerous enough at high doses, but the risk escalates sharply when other depressants are in the mix. The combination of alcohol with opioids, benzodiazepines, or both produces a steep increase in the rate of overdose and death.⁷ These substances all suppress the central nervous system, and their combined effect on breathing is more than additive. If you know or suspect that someone has taken pills or other drugs on top of alcohol, your threshold for calling emergency services should be much lower. Don’t wait for the dramatic signs of alcohol poisoning; respiratory depression from a drug combination can develop quickly and without much warning.

One medication risk that catches people off guard involves acetaminophen (the active ingredient in Tylenol and many cold medicines). For people who drink heavily on a regular basis, the combination of chronic alcohol use and acetaminophen is an independent risk factor for liver damage.⁸ This matters most in the morning-after period, when someone with a hangover reaches for a pain reliever. If you’re caring for a person who you know drinks heavily, steer them toward ibuprofen or another non-acetaminophen option when they wake up hurting. For occasional drinkers, a standard dose of acetaminophen taken for a hangover headache isn’t likely to cause problems, but for someone whose liver is already processing large amounts of alcohol regularly, it adds genuine risk.

Protecting Someone Who Is Vulnerable

Heavily intoxicated people, and women in particular, face an elevated risk of sexual assault. Research into friend-based interventions found that women typically feel responsible for keeping their friends safe when alcohol is involved, and that this sense of responsibility is a strong driver of protective behaviors.⁹ But feeling responsible and acting effectively aren’t the same thing, especially when the bystander has also been drinking.

Alcohol narrows attention to whatever feels most immediate and obvious. A systematic review of how alcohol affects bystander behavior found that intoxicated bystanders are less likely to notice warning signs, more likely to misread ambiguous cues, and more prone to assuming someone else will step in.¹⁰ This pattern, where alcohol creates a kind of tunnel vision and reduces the sense of personal responsibility, helps explain why bystander intervention often fails in settings where everyone is drinking.

The practical counter to this is planning ahead while sober. Before going out, agree with friends on who’s keeping an eye on the group. Use a buddy system. Set a rule that no one leaves with a stranger without checking in first. These agreements are much easier to honor than decisions made in the moment after several drinks, because they’ve already been turned into simple, concrete commitments before alcohol narrowed anyone’s attention.

Why People Hesitate to Call for Help

Fear of getting in trouble is one of the biggest barriers to calling 911 for an intoxicated person, especially among college students and underage drinkers. The worry is understandable: if you’re at a party where minors are drinking, calling an ambulance feels like it could get everyone cited or arrested. But in almost every U.S. state, this concern is addressed by medical amnesty laws. As of recent review, 47 states plus the District of Columbia have some form of these protections, which generally shield the caller and the person in distress from prosecution for underage drinking or minor drug offenses when someone contacts emergency services for a medical crisis.¹¹

That said, the scope of protection varies widely from state to state. Some laws cover only the person who makes the call, while others extend to the person experiencing the emergency. Some protect against alcohol charges but not drug possession. The protections can be narrow or broad depending on where you are, so it’s worth looking up your state’s specific law before you need it. Many colleges and universities have their own medical amnesty policies on top of the state law. Research on these campus policies has found that they don’t lead to more drinking, but they do reduce barriers to seeking help during emergencies.¹²

The bottom line on this is simple: a legal headache is survivable. Alcohol poisoning sometimes isn’t. If someone looks like they need medical help, make the call.

The Morning After

Once the immediate crisis has passed and the person is sleeping safely on their side, your job shifts to making the next several hours manageable. When they wake up, they’ll likely feel terrible. Hangover and dehydration appear to be co-occurring but largely independent consequences of drinking, which means that while rehydrating helps with thirst and general discomfort, it won’t do much for the headache, nausea, and fatigue that make up the core hangover experience.³

Offer water, electrolyte drinks, and bland food. Let them rest. If they vomited during the night, they may be more dehydrated than usual and should drink fluids slowly rather than chugging a full bottle at once, which can trigger more nausea. As mentioned earlier, if you’re reaching for a pain reliever on their behalf, consider what you know about their drinking habits before defaulting to acetaminophen.

This is also the right time for an honest, non-judgmental conversation if the night raised genuine concerns. A person who consistently drinks to the point of needing someone else to keep them safe may have a pattern that goes beyond occasional overindulgence. That conversation doesn’t have to happen during the hangover, but planting the seed matters. Framing it around what you observed (“you stopped breathing normally for a few seconds” or “you couldn’t stand up”) is more effective than generalizations like “you drink too much,” which tend to provoke defensiveness rather than reflection.

When the Person Is a Stranger

Everything above assumes you know the person, but you may encounter a stranger who’s clearly in distress: someone slumped on a sidewalk, someone stumbling into traffic, someone unconscious at a party you wandered into. The instinct to walk past is strong. The psychological research on bystander behavior shows that alcohol-related situations trigger every classic barrier to intervention at once: uncertainty about whether the situation is actually dangerous, assumption that someone else will handle it, and discomfort with getting involved in a stranger’s crisis.¹⁰

You don’t need to provide extended care for a stranger. But you can do a few things that take minimal effort and may matter enormously. Check whether they’re responsive. If they’re on their back and unconscious, roll them onto their side. If they’re outdoors in cold weather, getting a coat over them or moving them to shelter could prevent hypothermia. And if they’re unresponsive or breathing abnormally, call 911. You don’t need to know their name or their story. You just need to tell the dispatcher where the person is and what you’re seeing. That call alone can be the difference between a bad night and a fatality.

1
Annals of Biological Research. The Correlation between Blood Alcohol Concentration and Cognitive Impairment
2
European Journal of Internal Medicine. Identification and management of acute alcohol intoxication
3
PubMed. Alcohol hangover versus dehydration revisited: The effect of drinking water to prevent or alleviate the alcohol hangover
4
Annals of Emergency Medicine. Electronic control device exposure: a review of morbidity and mortality
5
PubMed. Alcohol and cold
6
PubMed. Bystanding to prevent drink-driving: Young adults’ descriptions of factors that promote and restrict their behavior
7
PubMed Central. Risks, management, and monitoring of combination opioid, benzodiazepines, and/or alcohol use
8
PubMed. Acute versus chronic alcohol consumption in acetaminophen-induced hepatotoxicity
9
PubMed Central. College Women’s Perceptions of a Friend-Based Intervention to Prevent Alcohol-Involved Sexual Assault
10
PubMed Central. Alcohol’s Effects on the Bystander Decision Making Model: A Systematic Literature Review
11
PubMed. State-by-State Examination of Overdose Medical Amnesty Laws
12
PubMed. Evaluating the Effectiveness of a Medical Amnesty Policy Change on College Students’ Alcohol Consumption, Physiological Consequences, and Helping Behaviors