Making it to 2018: How to Help a Person Who OD’d or Drank Way Too Much

Let’s get right to the point: you need a guide to the do’s and don’ts of how to handle it when a friend or even passerby seems to have “partied too hard.”

Nearly eight million Americans have a drug use disorder and 16 million abuse alcohol (and many use both), according to the National Center for Health Statistics. It’s easy to think that the people you see overdoing it are just taking part in Amateur’s Night Out, and, if they’re not someone you love or care about, see them as downright annoying if they’re acting like a drunken fool or taking up valuable real estate on the bathroom floor.

Additionally, it can be hard to tell if someone has overdosed on any sort of drug, and even tougher to know what to do if you are certain they’re having a dangerous physical reaction. Do you try to flood them with water or coffee instead? Do you call 911? Do you just assume they’ll sleep it off? Toss them into a cold shower somehow? We spoke to three experts to figure out how to best handle any of the above — and then some.

Helping Someone Who’s in Trouble

Firstly, if you know a friend or family member has a tendency to overdo it but the worst of it is always a hangover, it’s important to have a safety plan with your friend before going out, says John Hamilton, Chief Clinical Outreach Officer for Mountainside Treatment Center.

“This could include setting up an Uber or Lyft to ensure that nobody gets behind the wheel when intoxicated,” he says. “Other good tactics are agreeing on drinking limits for you and your friend. Often, people get in trouble when drinking is not a conscious, mindful experience.” Also, if you notice your friend is drinking too much or is out of control, try to avoid causing a confrontation by shaming, criticizing or getting emotional with them, as alcohol intoxication creates an increase in agitation, aggressiveness and irritability.

“You want to be able to engage them in a way that’s based on your relationship, but ultimately, it’s important to stay calm and firm to get your point across. Generally, I’d recommend having these conversations before the night starts,” he says. “Prior to going out, build some boundaries around your role in monitoring their usage in a respectful manner. Questions like, ‘What can I do to be helpful?’ or ‘How do I know when you’re in trouble?’ can help facilitate meaningful conversation and reduce the chances of an aggressive reaction.”

New Year’s celebrations and alcohol go hand in hand, so if you’re at a party and your friend drank too much, it’s important to know what to do. At the end of the day, alcohol is a poison, and at high enough doses, it can be fatal, says Dr. Sal Raichbach, PsyD, LCSW of Ambrosia Treatment Center.

“Look for symptoms like vomiting, confusion, or slipping in and out of consciousness. Choking or heavy, troubled breathing are also red flags. These are signs that the individual is experiencing alcohol poisoning, and you should call 9-1-1 immediately,” he says. Keep an eye, also, on skin and lip color and how dilated the person’s pupils are.

Hamilton says that when considering calling 911, you have to consider the symptoms your friend is showing. There’s a group called Aware Awake Alive that developed an acronym to help people know when to contact 911 for alcohol poisoning:

M.U.S.T. H.E.L.P.

• The ‘M’ stands for mental confusion
• The ‘U’ stands for unresponsive
• The ‘S’ stands for snoring or gasping for breath/air
• The ‘T’ stands for throwing up
• The ‘H” stands for hypothermia
• The ‘E” stands for erratic breathing
• The ‘L” stands for loss of consciousness
• The ‘P” stands for paleness or blueness of skin

“If any of those symptoms are present, you should call 911,” he says.

Make Safety Your First Priority

While it may be intimidating, especially for underage drinkers who feel like they’ll get into trouble, the primary concern is the safety of the individual who is in danger, says Dr. Raichbach.

“It’s always better to be safe than sorry. Plus, a representative will stay on the line with you while the professionals are on their way. These highly trained men and women will be able to calmly and rationally provide you with the support you need to help your friend through a scary and potentially deadly scenario.”

In the meantime, he says, it’s essential to:

• Stay with your friend to monitor their symptoms and watch if anything changes.
• Try to keep them awake and alert and give them some water to sip slowly.
• Never make them vomit, provide them with coffee or put them under a cold shower.

While these may seem like good ideas, in reality, they could actually make the individual worse by possibly causing them to choke, and suffer from severe dehydration or hypothermia.

“While the paramedics are on their way, you can try to keep the person awake by talking to them. Try to sit them up, or if that is not possible, roll them onto their side,” says Dr. Raichbach. “This will prevent asphyxiation, one of the fastest ways that alcohol poisoning can turn fatal. If they begin to respond, comfort them and try to prevent them from standing up or walking, as they could further harm themselves if they fall.”

“In situations where your friend is unconscious and you’re waiting for first responders, the positioning of their body is crucial, so they don’t asphyxiate on their vomit,” says Hamilton.

Try to use the Bacchus Maneuver:

• Put them on their side
• Raise the arm that’s closest to you above their head
• Gently roll them toward you, guarding their head
• Tilt up their head to maintain the airway and tuck their nearest hand under their cheek to maintain the head tilt. This is best way to keep their airway clear and unobstructed.

Don’t:

• Give them black coffee
• Don’t let them sleep
• Don’t have them ‘walk-it-off,’ because they could fall and hurt themselves

However, vomiting isn’t always a reason to immediately call 911, according to Paul Lavella Jr. Director of Alumni Services at Summit Behavioral Health. He says that as scary as the situation may be, if you are concerned that a friend is drinking too much, getting sick is actually a good thing.

“Alcohol is a central nervous system depressant, which means it slows down vital body systems. A person may be at risk of alcohol poisoning when their systems stop responding. If someone is vomiting from alcohol consumption, their system is fighting back. It is trying to protect it’s vital functions, like breathing and heart rate, by rejecting the alcohol.”

“You want to get Emergency Medical Services (EMS) involved when your friend is not showing signed of responsiveness or breathing,” he says. “Be sure that someone can stay with the inebriated person at all times for safety reasons, monitoring their condition, and to preventing any risk of inappropriate sexual advances. If this means calling in for help from other friends, by all means, do it.”

Be Prepared

If your friend has a drinking problem and has a slip, he says, consider gathering other friends and possibly some of the persons family to share your concerns a short while after the incident occurs. Have everyone on the same page in supporting the person to consider seeking help.

Similarly to alcohol, it’s a good idea to be prepared for the worst if you are in an environment with drug use. With the rise in opiate use, overdose is unfortunately all too common, especially when these drugs are mixed with other substances.

“If you know your friend uses drugs, try to keep an eye on them and look out for symptoms like unconsciousness, labored breathing, or a bluish tint to the skin,” Dr. Raichbach says.

If you see someone who you think might be experiencing an overdose:

• Call an ambulance immediately.
• To prevent obstruction of their airway, roll them on their side and open their mouth.
• Continue to communicate with them while the paramedics are on their way.
• Remember that you cannot simply let your friend “sleep off” an overdose or alcohol poisoning. Medical attention is absolutely necessary in these scenarios.

Also, says Dr. Lavella, most states have a “Good Samaritan Law” or some variation of it that provides legal protection to the person who is experiencing the overdose and the person calling in EMS.

“We want to make sure that fear of persecution does not interfere with potentially saving a life. That is exactly what these Good Samaritan Laws ensure,” he says.

After calling EMS, he continues, you want to make sure that someone stays with the person who may have experienced an overdose for safety and to monitor vital signs.

“If you believe the person may have overdosed on an opioid such as heroin, fentanyl, or a pain medication, check to see if anyone with you has a dose of Naloxone available. This drug helps reverse effects of opioid overdose,” he says.

If you believe the individual who is experiencing symptoms of alcohol poisoning is an alcoholic — ditto on drug use and addiction — the best approach is to get them medical help first, and approach them about their alcoholism at a later time, if necessary.

“While it might seem like a good time to bring up their dependency, their physical safety is the priority, and chances are they are not going to be able to comprehend what you are trying to tell them while they are intoxicated,” Dr. Raichbach says.

Trying to limit or otherwise intervene of someone’s substance use while he or she is using may not be the best option for anyone involved, says Lavella.

“What you can do is have the courage to be upfront and honest with your friend about your concern and then set boundaries around how you will be willing to interact with the person if the choice is to continue to use,” he says. “The key here, is that you’re not trying to control your friend’s use, you’re compassionately sharing your concerns, offering support, and controlling how you will respond if your friend declines and continues to actively use.”