If a friend is experiencing the overwhelming effects of intoxication, your immediate response can influence their safety and comfort. Approach the situation with a sense of calm, recognizing that their well-being is the primary concern. Your role is not to diagnose the substance involved but to manage the symptoms and ensure physical and psychological stability until the effects subside or professional help arrives. Remaining composed helps to de-escalate the situation and allows you to think clearly about necessary, symptom-based management.
Prioritizing Immediate Physical Safety
The first priority is assessing and securing the immediate physical environment to prevent accidental injury. Quickly move any hazards, such as sharp objects, unsecured furniture, or sources of heat, out of the immediate area. If the person is mobile, encourage them to sit or lie down in a safe, quiet location away from stairs or traffic.
Next, assess their level of consciousness and vital functions. If your friend is drowsy or slipping in and out of consciousness, they should be immediately placed in the recovery position. This involves gently rolling the person onto their side with their top leg bent at the hip and knee, which keeps the airway open and prevents aspiration if they vomit.
Regularly check their breathing rate and pattern, noting if it is becoming shallow, irregular, or labored. Also check for a steady pulse and observe their skin color and temperature. Bluish or grayish lips, nail beds, or skin can indicate a lack of oxygen, demanding immediate attention. Maintaining a clear airway is paramount, so ensure nothing is obstructing their mouth or throat.
Calming Psychological Distress and Anxiety
Once physical safety is established, managing the friend’s psychological state becomes the next focus, as many substances can induce significant anxiety, paranoia, or distress. Maintain a consistently calm, non-judgmental, and reassuring tone when speaking to them. Your stable demeanor acts as an anchor in their potentially chaotic experience.
Use simple, direct language to help ground them in reality, such as gently reminding them of your name and their current location. Controlling the sensory input is highly effective in managing anxiety; dimming bright lights and reducing loud or erratic noises helps to prevent overstimulation.
Offer specific, tangible reassurance, focusing on the fact that the effects are temporary and that you are there to keep them safe until the experience passes. If they express feelings of paranoia, do not argue with their perception, but gently redirect their attention to a neutral object or simple physical sensation. For example, encourage them to focus on the feeling of their feet on the floor or the texture of a blanket.
Provide simple comfort measures, like a glass of water, to offer a psychological anchor without forcing them to ingest anything. Since their perception of time and reality may be altered, repeating simple, calming phrases can help them maintain a connection to the present moment. Your sustained presence and patience are the most effective tools for de-escalation.
Recognizing the Need for Emergency Medical Intervention
While managing symptoms is important, certain objective physical signs mandate an immediate call to emergency services, as they indicate a medical crisis or overdose. You must call 911 (or the local equivalent) if your friend loses consciousness and cannot be roused, even with a firm shake or loud verbal command. This inability to wake up is a red flag that their body’s systems are dangerously overwhelmed.
Immediate professional help is also required if breathing becomes severely compromised, such as breathing that is extremely shallow, irregular, or stops altogether. The presence of cyanosis—a blue or grayish discoloration around the lips, fingertips, or nail beds—signifies dangerously low oxygen saturation in the blood. Other severe symptoms include having a seizure that lasts longer than five minutes or having multiple seizures in a row.
Severe chest pain, uncontrollable vomiting, or signs of hyperthermia, such as extremely hot, flushed skin, are equally urgent indicators of medical distress. When speaking with first responders, be as honest as possible about the substances consumed, if known, or describe the specific symptoms you are observing. This information is important for the medical team to administer the correct treatment, such as naloxone for suspected opioid involvement.
Actions to Strictly Avoid
When assisting a friend who is intoxicated, several common reactions should be strictly avoided as they can worsen the situation or compromise their safety. Never leave the person alone, even if they insist that they are fine or simply want to sleep. A person’s condition can deteriorate rapidly, requiring immediate intervention.
It is unproductive and harmful to use shame, confrontation, or anger, as this only heightens their anxiety and paranoia, making de-escalation impossible. Resist the urge to force them to walk or exercise to “sober up,” as this can increase heart rate, elevate body temperature, and lead to accidental falls.
Do not administer any unknown remedies, such as forcing them to drink large amounts of water, coffee, or energy drinks. The introduction of other substances, including caffeine or alcohol, can lead to dangerous interactions or further complicate their physiological state. Never attempt to induce vomiting, as this carries a high risk of aspiration, particularly if the person is already drowsy or semi-conscious.