If someone near you is throwing up from drinking too much, your most important jobs are keeping them conscious, preventing them from choking on their vomit, and watching for signs that this has crossed into alcohol poisoning. Most people will recover on their own with basic care over several hours, but knowing the difference between uncomfortable vomiting and a medical emergency can save a life.
Keep Them Upright or on Their Side
The single biggest risk when someone is vomiting from alcohol is choking. Alcohol dulls the gag reflex, which means the body’s natural defense against inhaling vomit stops working properly. If the person is sitting up and alert, let them lean forward over a bucket or toilet. Stay close. Don’t leave them alone in a bathroom with the door locked.
If the person is too intoxicated to sit up, get them into the recovery position immediately:
- Step 1: Raise the arm closest to you above their head, then gently roll them toward you onto their side.
- Step 2: Guard their head as you roll them so it doesn’t hit the floor. The head should rest in front of the arm, not on top of it.
- Step 3: Tilt their head up slightly to keep the airway open. Tuck their nearest hand under their cheek to hold this position and keep their face off the floor.
- Step 4: Place a pillow behind their back so they can’t roll onto it.
This position lets vomit drain out of the mouth instead of pooling in the throat. Never put a vomiting person on their back, and never prop them up with pillows in a way that lets their head slump forward, which can block the airway just as easily.
Signs That Need Emergency Help
Vomiting alone doesn’t always mean alcohol poisoning, but it is one of the warning signs. Call 911 if you notice any of the following alongside the vomiting:
- Slow or irregular breathing: fewer than 8 breaths per minute, or gaps of 10 seconds or more between breaths
- Can’t be woken up: the person isn’t just sleeping but genuinely unresponsive to shaking or loud voices
- Seizures
- Skin changes: clammy skin, bluish or pale color, or extremely low body temperature
- Mental confusion or stupor beyond what you’d expect from someone who’s drunk
Blood alcohol levels can keep rising even after a person stops drinking, because alcohol in the stomach is still being absorbed. Someone who seems “just really drunk” can slip into something much more dangerous over the next hour. Alcohol poisoning is fatal if untreated, and there is no home remedy for it. If you’re unsure, call for help. You will never regret making that call.
What to Do While You Wait and Watch
If the person is conscious, talking, and throwing up but otherwise alert, you’re likely dealing with a rough night rather than a medical crisis. Here’s how to help them through it.
Stay with them. Don’t go to bed and assume they’ll be fine. Even after vomiting stops, keep checking on them. If they fall asleep, wake them frequently to make sure they’re actually sleeping and not unconscious. If at any point you cannot wake them up, that’s a 911 call.
Don’t try to make them eat, give them coffee, put them in a cold shower, or walk them around to “sober them up.” None of these work. Coffee adds dehydration. Cold showers risk falls and hypothermia. Walking around with someone who has poor coordination just creates injury risk. The only thing that eliminates alcohol from the body is time.
Avoid giving any pain relievers while they’re still intoxicated. Acetaminophen (Tylenol) combined with alcohol is hard on the liver, and ibuprofen or aspirin can further irritate a stomach that’s already inflamed from alcohol. Pain medication can wait until the next day, when the alcohol has cleared their system.
Rehydrating After the Vomiting Stops
Alcohol is a diuretic, and vomiting on top of that pulls a lot of fluid and electrolytes out of the body. Once the person has stopped throwing up and can keep something down, start rehydrating slowly. The key word is slowly. Gulping a full glass of water on an empty, irritated stomach often triggers another round of vomiting.
Aim for small sips, roughly an ounce (a couple of tablespoons) every few minutes. Water is fine. A sports drink diluted with equal parts water replaces some lost electrolytes without dumping too much sugar into the stomach, which can make nausea worse. Oral rehydration solutions sold at pharmacies work well too. Avoid anything carbonated, acidic, or caffeinated until the stomach has settled.
Eating After Alcohol-Induced Vomiting
Don’t push food until the person feels ready, which is usually several hours after the vomiting stops. When they are ready, the classic approach works: bland, high-carbohydrate foods that are easy to digest. Bananas, plain rice, applesauce, and dry toast (sometimes called the BRAT diet) are gentle on an irritated stomach and help bring blood sugar back up. Bananas are especially useful because they’re rich in potassium, one of the electrolytes lost during vomiting and heavy drinking.
Greasy, spicy, or heavy foods are tempting hangover cravings but tend to make nausea worse when the stomach lining is still inflamed. Stick with small, plain portions for the first 12 to 24 hours. If the person can’t keep even bland food down by the next day, or if they develop a fever, severe abdominal pain, or blood in their vomit, that warrants medical attention.
What Not to Do
A few common instincts are genuinely dangerous. Never try to induce more vomiting, thinking it will “get the alcohol out.” The body is already expelling what it can’t handle, and forcing more vomiting increases the risk of tearing the esophagus or inhaling vomit into the lungs. Never give a drunk person anything to eat or drink while they’re lying down or barely conscious, as this creates a choking hazard. And never leave them alone to “sleep it off” without someone checking in regularly. The most serious outcomes from alcohol poisoning happen when no one is watching.