Buzz
The night is winding down, and your friend, once the life of the party, is now unconscious on the couch. But how intoxicated are they? Do they simply need assistance getting to bed, or is their condition severe enough to need emergency help?
Back-to-school season is when alcohol-related hospital admissions spike, especially since many students, unfamiliar with heavy drinking, pick up the habit in college. Unfortunately, too many individuals in severe intoxication fail to seek emergency care when needed—either because their friends don't recognize the signs of danger or they're hesitant to involve medical services for fear of consequences.
Here’s the most vital piece of advice: If you’re unsure, it’s always safer to call 911.
To provide a fuller response, we consulted Dr. Ryan Stanton, an emergency physician and spokesperson for the American College of Emergency Physicians. According to him, excessive alcohol consumption can be fatal because it often interferes with the body's ability to maintain a clear airway. Here's what you should understand about when binge drinking becomes a serious health issue, and when it's crucial to get someone to the hospital.
The Dangers of Excessive Alcohol Consumption
Alcohol acts as a central nervous system depressant, meaning it can slow down or disrupt certain brain functions. After just a few drinks, you may notice difficulty walking straight or resisting the urge to text an ex. After consuming more, your speech and vision might start to be affected. With heavy drinking, you might lose the ability to control your breathing or trigger life-saving reflexes.
Unconsciousness occurs at the more severe end of this spectrum, which is why people often advise keeping a drunk friend awake. Since alcohol induces sleepiness, it’s common to find someone resting face-down at a party—not an issue if they’ve merely nodded off after a long night. We may call those we step over ‘passed out,’ but if someone is truly unconscious, they are in danger. How can you differentiate between someone who's asleep and someone who's unconscious? Try waking them up.
But that’s not the only symptom to watch out for. As Stanton put it:
The distinction [between someone who is safe and someone who requires help] can be quite unclear, particularly when it comes to protecting the airway. You might find someone who is ‘passed out’ from drinking and still capable of safeguarding their airway. Conversely, you could also encounter someone who was just walking around but has suddenly become apneic after choking on their own vomit. It's a tricky situation, and what we recommend to everyone is that if you're unsure about someone's safety, don't hesitate to bring them to the hospital.
Here’s the typical scenario of someone unable to protect their airway, as explained by Dr. Stanton: they can’t be woken up, and they’re vomiting without attempting to clear it from their mouth or roll over to prevent choking. In severe cases, alcohol can slow down breathing to life-threatening levels or even induce a coma. Therefore, never assume that an unconscious or unresponsive person is safe just because they’re not vomiting.
Become the hero of campus safety:
Get your hands on a Complete First Aid Pocket Guide (and perhaps take a first aid class while you’re at it).
Always keep naloxone nearby (it’s now available over-the-counter in all 50 states).
Why not be the one with a fishbowl of free condoms? After all, why should RAs have all the fun?
Another significant danger for intoxicated individuals is trauma, particularly head injuries. Alcohol can make someone unsteady on their feet, and it may dull their pain response, leading them to get up after a fall. If you notice any blood, bruising, or swelling, particularly around their head, it could indicate a serious injury.
Trauma can result from poor decisions, such as choosing to pick a fight, jump off a balcony, or fool around on a boat (70% of water-related deaths involve alcohol). Or, you know, getting behind the wheel of a car. Even those who are slightly tipsy can cause serious accidents; it’s not worth the risk.
What to Do If Your Friend Is Too Drunk
If you're on a college campus, chances are you’ve received a handbook or brochure explaining what to do in an emergency. It's a good idea to review it now, before you find yourself in a situation where you need it. Also, make sure you know the emergency number, especially if it's not just 911. (Some schools have their own “rescue squads” that can reach you faster than local authorities.)
If the person is conscious and responsive—meaning they’re not in a 'call 911' level of emergency—you should:
Stay with them. If you're also drunk, have a sober friend take over. Even if they’ve stopped drinking, their body might still be processing alcohol, which means their condition could worsen. Check on them frequently to ensure they remain responsive, and be prepared to call for help if things take a turn.
Get them to a safe location, such as their home or a friend’s place. And don’t attempt to drive them if you’ve been drinking too.
Place them in the recovery position, like this, to ensure any vomit can escape their mouth if their condition deteriorates. If you believe there’s a risk of choking, skip ahead to the section on calling for help.
Don’t try to sober them up with coffee, cold showers, or any other remedies people may suggest. Their liver just needs time to process the alcohol.
If the person isn’t responding or is showing concerning symptoms (such as unconsciousness, slow breathing, or seizures—anything that alarms you):
Call for assistance (911 or your campus rescue squad).
Stay with them until help arrives. Position them in the recovery position, and if possible, find someone who knows how to administer CPR—just in case.
Inform emergency responders about the situation—how much they drank, what type of alcohol they consumed, and any symptoms or injuries they’re experiencing.
Even if you're worried about facing consequences, calling for help is still the best option. Many states and universities have amnesty laws or policies that protect you from legal action or major disciplinary measures if you’re acting in good faith. Ultimately, emergency responders care more about saving lives than investigating legal issues. Stanton, who practices in Kentucky, explains:
If you take someone to the ER, we don’t typically see police arriving to issue tickets or make arrests. Of course, if something illegal is happening at the party, like an adult providing alcohol to minors, that’s different. But if you bring someone to the ER for help, legal troubles are rare. Often, I believe the police consider the experience of going to the ER, with all the costs involved, punishment enough. It’s probably not as severe as when your parents have to drive hours to sit by your bed at the hospital in the early morning. The most important thing is to focus on your friend’s health and safety, rather than worrying about potential consequences.
So yes, your parents will likely get a phone call. Sorry about that.
What to Expect at the Hospital
By the time someone arrives at the hospital, there's no point in trying to pump their stomach; they’ve usually already thrown up everything. According to Stanton, hospital staff focuses on three main things:
Monitor the individual—this is the high-tech equivalent of what you were doing when you were constantly checking on them. They’ll ensure the person is breathing properly, maintaining a safe body temperature, and so on.
Support their vital signs, such as administering fluids as needed and giving medications to manage pain or nausea.
If needed, protect their airway by using a breathing tube.
Once the person is sober, they will undergo a more detailed examination to check for any injuries or issues that might have surfaced. If everything looks fine, they will typically be allowed to go home in the morning.
