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You're at the end of the night. The music is low, the floor is sticky, and your friend is face-down on the sofa. They aren't just sleeping; they’re "passed out." You’ve probably seen people in movies pour ice water on someone or slap them across the face to get them moving. Don't do that. Honestly, it's dangerous. Waking someone up who has had too much to drink isn't just about ending the party—it’s about making sure they actually keep breathing.
Alcohol is a central nervous system depressant. It slows down everything. Heart rate, breathing, and the gag reflex all start to lag. When you try to figure out how to wake up a drunk person, you aren't just being a "good friend." You are essentially performing a neurological check. If they don't wake up, or if they just moan and fall back into a stupor, you might be looking at a medical emergency rather than a standard hangover in the making.
The Sternum Rub and the "Wake Up" Test
Before you start shouting, try the physical approach. Not a hit. Not a shake. Doctors and EMTs use something called the "sternum rub." Take your knuckles, press them hard against the person's breastbone (the center of the chest), and rub vigorously. It hurts. It’s meant to. If a person is just sleeping deeply, that sharp shot of pain will make them pull away or open their eyes.
If they don't respond to that? That's a massive red flag.
You can also try calling their name loudly or pinching the back of their arm. But if you’re doing the sternum rub and they’re just lying there like a heavy sack of flour, their brain is too suppressed by ethanol to process the pain. According to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), this lack of response is a hallmark sign of alcohol poisoning. It means the "autonomic" stuff—the things your body does without thinking, like breathing—is at risk of shutting down entirely.
Why "Sleeping It Off" Is a Dangerous Myth
We’ve all heard it. "Just let him sleep it off." It sounds logical, right? Wrong.
Blood alcohol concentration (BAC) can actually continue to rise even after someone stops drinking. The stomach and small intestine continue to dump alcohol into the bloodstream while the person is unconscious. So, someone who seems "fine" (well, fine for a drunk person) when they first close their eyes might actually slip into a coma an hour later. This is why you never, ever leave a passed-out person alone.
If you manage to wake them up, keep them awake. Talk to them. Ask them simple questions. If they can’t stay awake for more than a few seconds, or if their speech is totally incoherent, they aren’t "sleeping." They are slipping under.
The Bacchus Maneuver: The Only Way They Should Sleep
If they are breathing okay and you’ve decided they don't need an ambulance yet, you have to position them correctly. This is called the Recovery Position or the Bacchus Maneuver.
- Roll them onto their side.
- Tuck their bottom arm under their head to support it.
- Bend their top leg at the knee to brace them so they don't roll onto their stomach or back.
Why? Because of vomit. It sounds gross, but it's the leading cause of death in these situations. If they are on their back and they throw up, their gag reflex is too weak to clear the airway. They will inhale the vomit into their lungs (aspiration), which leads to choking or a very nasty type of pneumonia. If they’re on their side, gravity does the work for you.
When to Stop Trying and Call 911
There is a point where your "help" isn't enough. You aren't a doctor. You don't have a stomach pump or an IV drip. If you notice any of the following, stop trying to wake them up and call emergency services immediately.
- Slow breathing: Less than eight breaths a minute. Count them. Watch the chest.
- Irregular breathing: A gap of more than 10 seconds between breaths.
- Skin color changes: If they look blue, pale, or feel clammy and cold. This is a sign their oxygen levels are tanking.
- Seizures: Alcohol can trigger these in high doses.
- The "No-Response" Rule: If they don't flinch at a sternum rub or a loud shout.
Don’t worry about "getting them in trouble." Most states have "Good Samaritan" laws that protect people who call for help in overdose or alcohol poisoning situations. The police aren't looking to bust a party when someone is literally dying. They want to save a life.
Common Mistakes That Make Things Worse
People do some pretty dumb stuff when they're panicked and trying to wake up a drunk friend. Let’s clear some of those up right now.
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No cold showers. You might think the shock will wake them up. In reality, alcohol lowers the body’s core temperature. Throwing a drunk person into cold water can cause them to go into shock or develop hypothermia. Plus, they might slip and crack their head open, and now you have a head injury to deal with on top of the alcohol.
No coffee. Caffeine doesn't "sober someone up." It just makes them a "wide-awake drunk." It can also dehydrate them further. The only thing that lowers BAC is time. Period.
No "walking it off." If they can barely stand, forcing them to walk is just asking for a fall. Head injuries are incredibly common in heavy drinking scenarios because the person can’t use their arms to break their fall.
Don't give them food. If they’re semi-conscious, they could easily choke on it. Their muscles aren't working right. That includes water, too—if they can't sit up and hold the glass themselves, don't pour anything down their throat.
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Understanding the "Blackout" vs. "Passed Out"
There's a big difference here. A person in a "blackout" is awake and moving. They're talking, maybe dancing, maybe arguing. But their brain—specifically the hippocampus—has stopped recording memories. When they wake up the next day, those hours are just... gone.
"Passed out" is different. That’s a loss of consciousness. It’s a stage of anesthesia. When someone passes out, they have crossed a line where their brain is basically shutting down non-essential functions to try and survive the toxin in their system.
Actionable Steps for the Next Hour
If you are currently looking at someone and wondering what to do, follow this immediate checklist:
- Perform the Sternum Rub: Knuckles to chest, rub hard. If they groan and move, they are likely okay for now.
- Check the Breathing: Sit there for a full minute. Count the breaths. If it's under 8, call 911.
- The Side-Lying Position: Get them off their back. Use pillows to prop them so they can’t roll back over.
- Stay With Them: This is the most important part. Do not leave them alone to "sleep it off." Check them every 15 minutes.
- Hydrate (When Conscious): Only when they are fully awake and can sit up on their own should you offer small sips of water or an electrolyte drink.
If at any point you feel a "gut instinct" that something is wrong, trust it. It is much better to have a frustrated friend who woke up in a hospital than to be the person who has to explain to their family why you didn't call for help. Alcohol is a literal poison in high doses, and the body treats it as such. Treat the situation with the same seriousness you would a heart attack or a car accident.