What to Do If a Friend Is Drunk or Drugged: A Practical Emergency Guide

Why This Knowledge Matters

Alcohol and drug-related emergencies happen at university halls, house parties, festivals, bars, and clubs across the world every single night. Many young adults have witnessed a friend become dangerously intoxicated or suspected that someone had been given a substance without their consent. Yet despite how common these situations are, very few people receive any formal guidance on what to do when they happen.

Freezing up, assuming someone else will take charge, or simply not knowing the warning signs can have catastrophic consequences. Alcohol poisoning kills thousands of people globally each year, and drug-facilitated incidents carry serious risks that go far beyond the immediate physical effects. This guide is designed to give you the knowledge and confidence to act effectively if you ever find yourself in this situation.

Recognising the Signs of Alcohol Poisoning

There is a significant difference between someone who is drunk and someone who is in danger. Knowing where that line falls is essential.

A person who is simply drunk may be slurring their words, walking unsteadily, laughing loudly, or making poor decisions. This is concerning but not necessarily an immediate medical emergency. However, alcohol poisoning is a medical emergency and requires prompt action.

Warning signs of alcohol poisoning include confusion or complete unresponsiveness, vomiting (particularly while unconscious or semi-conscious), seizures, slow or irregular breathing (fewer than eight breaths per minute or ten seconds or more between breaths), pale or bluish-tinged skin, and a very low body temperature. If you see any combination of these signs, treat the situation as an emergency.

The myth that someone should "sleep it off" is genuinely dangerous. A person who has consumed a large amount of alcohol can continue to absorb it from the stomach even after they have stopped drinking, meaning their blood alcohol level can rise even while unconscious. Leaving someone alone in this state puts them at serious risk.

Recognising the Signs of Drug-Facilitated Incidents

Drug-facilitated harm is a serious and underreported issue in many countries. Substances such as GHB, ketamine, benzodiazepines, and others can be slipped into drinks without any visible change in colour, taste, or smell. Rohypnol, for instance, was historically colourless and odourless, though manufacturers have since added a blue dye to newer formulations in some regions.

Signs that a friend may have been given something without their knowledge include sudden and extreme intoxication that seems disproportionate to how much they have drunk, confusion, disorientation, difficulty speaking or standing, unconsciousness or semi-consciousness, nausea, and unusual behaviour that is very out of character. Pay particular attention if someone seemed fine an hour ago and is now barely able to function.

Trust your instincts. If something feels wrong, act on that feeling. You do not need to be certain before taking protective steps.

Immediate Steps to Take

Whether you suspect alcohol poisoning or a drugged drink, your first priority is the safety of your friend. Here is a clear, step-by-step approach.

Step 1: Stay With Them

Do not leave your friend alone. This is the most important rule. Even if they seem like they just need some air or a glass of water, stay close. Their condition can deteriorate quickly and without warning. If you need to get help, take them with you or send someone else to find assistance.

Step 2: Keep Them Awake If Possible

Try to keep your friend conscious and responsive. Talk to them, ask them simple questions, and encourage them to stay awake. However, do not force them to drink water or eat food if they are very confused or barely conscious, as there is a risk of choking.

Step 3: Do Not Give Them Coffee or Cold Water

There is a persistent and incorrect belief that coffee or cold showers can sober someone up. They cannot. The only thing that reduces blood alcohol concentration is time. Coffee adds stimulants to the mix and can mask symptoms. Cold water or a cold shower can cause shock in someone who is already physically compromised.

Step 4: Place Them in the Recovery Position

If your friend is unconscious or likely to vomit, place them in the recovery position immediately. This involves rolling them gently onto their side, bending their top knee forward to stabilise them, and tilting their head back slightly to keep the airway open. This position prevents them from choking on vomit, which is a leading cause of death in alcohol poisoning cases.

Remember the acronym HAINES (High Arm IN Endangered Spine) if there is any concern about a spinal injury, but in most party situations, the standard recovery position is the correct approach.

Step 5: Call Emergency Services

If your friend is unconscious, cannot be roused, is breathing irregularly, has blue-tinged lips or fingertips, or if you are simply not sure whether they are okay, call the emergency services. In the United Kingdom, that is 999. In the United States, it is 911. In Australia, it is 000. In Europe, the universal number is 112. If you are travelling, look up the local emergency number before you go out.

Do not let fear of getting into trouble stop you from calling for help. In many countries, Good Samaritan laws exist precisely to protect people who seek medical assistance for someone in distress. Your friend's life is worth far more than any concern about consequences for yourself or others.

When you call, tell the operator your location as precisely as possible, describe your friend's symptoms honestly, mention anything you know about what they have consumed, and stay on the line for instructions.

Step 6: Monitor Their Breathing

While waiting for help, keep checking that your friend is breathing. If they stop breathing and you know how to perform CPR, begin immediately. If you do not know CPR, the emergency operator can guide you through it over the phone.

If You Suspect Your Friend Has Been Drugged

If you believe your friend's drink has been spiked or that they have been given a substance without their consent, there are additional steps to consider.

Move them away from the environment where it happened. If you are at a bar or club, inform the staff or security immediately. Many venues now have trained staff for exactly these situations. Do not leave your friend with anyone you do not completely trust, regardless of how friendly that person seems.

If possible, preserve any remaining drink in a sealed container or bag. Some substances can be tested for later, which may be relevant if your friend wants to report what happened.

Once your friend is safe and has received medical attention, support them in deciding whether to report the incident to the police. This is entirely their decision, but it is worth noting that reporting can help protect others and that many police forces now have dedicated officers trained to handle drug-facilitated harm cases sensitively.

Supporting Your Friend Afterwards

Once the immediate danger has passed, your role as a friend does not end. Being involved in an alcohol or drug-related emergency can be frightening, confusing, and sometimes deeply distressing, especially if your friend suspects they were targeted deliberately.

Give your friend space to process what happened while also making it clear that you are available. Avoid making them feel judged or embarrassed about the incident. Depending on what occurred, they may need professional support from a counsellor or healthcare professional.

If your friend believes they were harmed in any way during the incident, whether physically or otherwise, encourage them to seek medical attention as soon as possible. Many types of harm can be better addressed the sooner they are identified, and healthcare professionals can provide both physical care and referrals to support services.

Looking Out for Others in the Wider Group

Emergencies rarely happen in isolation. If one person in your group has been affected, it is worth checking on others too. Have other friends had an unusually strong reaction to what they drank? Are there people you have lost track of who might be in a similar situation?

Adopting a buddy system when you go out, particularly in unfamiliar places or at large events, significantly reduces the risk of someone being left in a dangerous situation without support. Agree in advance that you will check in with each other throughout the night and that nobody leaves alone.

Practical Prevention Strategies

While this guide focuses on responding to emergencies, prevention is always preferable. Some practical habits that reduce risk include never leaving drinks unattended, covering the top of your glass or bottle when dancing or moving through a crowd, using drink-testing strips or nail polish (products that change colour when they detect certain substances), avoiding accepting drinks from people you do not know well, and keeping hydrated with water throughout the night.

Being aware of your own limits and those of your friends is also important. Eating a proper meal before drinking, alternating alcoholic drinks with water, and avoiding mixing alcohol with other substances all reduce the likelihood of an emergency occurring.

A Final Note on Bystander Responsibility

Research into bystander behaviour consistently shows that people are less likely to intervene when others are present, a phenomenon known as the bystander effect. At a crowded party or club, it can be easy to assume that someone else will help. In reality, that assumption is often wrong.

If you see someone who looks unwell, confused, or out of control, and no one else appears to be helping them, you may be the only person who takes action. Acting on that instinct, and having the knowledge to act effectively, can save a life.

The steps in this guide are not complicated. They do not require specialist training. They require only awareness, a willingness to help, and the understanding that your intervention matters.