Recognising when a friend has had too much to drink

The early signs come before the obvious ones

By the time someone is falling over, the useful moment has passed. The earlier signs are easier to act on:

• Talking louder and repeating the same story.
• Drinking faster than the rest of the table.
• Ordering another round when their glass is still half full.
• Slurring words or losing the thread of a sentence.
• Spilling drinks or bumping into furniture.

At this stage a friend can still make a sensible choice if someone offers one. That is when to step in.

Watch for the mix too. Beer after spirits, beer with certain medicines or drinking on an empty stomach all push blood alcohol up faster than the number of glasses suggests. A friend who had two pegs before arriving and is now on their third pint is further along than the table thinks. Size matters as well: the same four beers affect a small person far more than a large one.

Step in early and keep it low key

Nobody likes being told they are drunk. Make it about the next step rather than the state they are in. Order a round of water for the table. Suggest food. Offer a 330 ml alcohol free beer instead of the next 500 ml IPA. Propose leaving together.

A friend who has had three or four strong beers in quick succession can be on the way to 10 UK units or more. Their blood alcohol will also keep rising for a while after the last drink as the alcohol is absorbed. So "one more" at that point arrives later and hits harder. Our guide to how fast strong beer adds up shows the sums.

Danger signs that need emergency help

Alcohol poisoning happens when blood alcohol rises high enough to slow the parts of the brain that control breathing, heart rate and temperature. Call for emergency help if a person shows any of these:

• Confusion or being impossible to wake properly.
• Vomiting while drowsy or semi-conscious.
• Slow or irregular breathing, for example fewer than eight breaths a minute or long gaps between breaths.
• Pale, clammy or bluish skin.
• Low body temperature or shivering.
• A seizure.

You do not need all of them. One is enough. In India, dial 112 for emergency services. In many states 108 also connects to an ambulance.

What to do while help comes

Stay with them. Do not leave them alone to sleep it off, because blood alcohol can keep rising after they pass out.

• If they are awake, keep them sitting up and talking.
• If they are drowsy or unconscious but breathing, put them on their side in the recovery position so that vomit can drain from the mouth.
• Keep them warm with a jacket or blanket.
• Check their breathing every few minutes until help arrives.
• Tell the paramedics what and how much they drank, plus any medicines or other drugs you know about.

What not to do

Some old remedies make things worse:

• Coffee does not lower blood alcohol. It can make a drunk person seem more alert than they are.
• A cold shower risks a fall and drops body temperature further.
• Walking them around risks a fall and does nothing to clear alcohol.
• Making them vomit can cause choking.
• Letting them sleep on their back risks choking on vomit.

Above all, do not let them drive or ride home. Take the keys if you have to. A friend who is angry with you tomorrow is a friend who got home.

Bars and brewpubs have a part to play

Good bar staff watch for the same signs and stop serving guests who are clearly drunk. If a server refuses your friend another beer, back them up rather than arguing. If you are worried about someone at a brewpub, tell the staff. They can call a cab, find a quiet corner or call for help faster than you can.

Hosting at home puts you in the bartender's role. Our guide to hosting a beer party where nobody drives covers how to set up the evening so this moment is less likely.

Agree the plan before the night starts

Before your next night out, agree with your group that anyone can call time on anyone else without an argument. Save 112 in your phone and learn the recovery position from a first aid guide. It takes five minutes and you will hope never to use it.

Common questions

What are the signs of alcohol poisoning?

Confusion, vomiting while drowsy, slow or irregular breathing, pale or bluish skin, low body temperature, seizures or being impossible to wake. Any one of these needs emergency help.

Should I let a very drunk friend sleep it off?

Not alone. Blood alcohol can keep rising after they fall asleep. Stay with them, lay them on their side and call for help if danger signs appear.

Does coffee help someone who is very drunk?

No. Coffee does not lower blood alcohol. Only time does that.

What number do I call for help in India?

Dial 112 for emergency services. In many states 108 also connects to an ambulance.