Dear Reader,

Taking care of your friends after they've had too much to drink is certainly a noble and important thing to do. It can be a challenging and unpleasant job, though, and you've brought up a number of issues to consider.

Any friends who've had a lot to drink need to be taken care of. What you do for them might depend on things like how much they've had to drink, where you are, what other factors are involved (such as other substances: illicit drugs, prescription or over-the-counter medications), and what your own level of intoxication is. One of the key risk-reduction strategies to remember is that if at least one person in your group is completely sober, s/he'll probably be someone best-suited to assess the situation accurately and call for any needed help. Even one or two drinks can impair judgment, making it more difficult to figure out how urgent a situation really is.

It might help to start by understanding some of the common signs that someone is intoxicated to the point of concern. A lot of people think that a person needs to be throwing up or passed out to need medical attention. In fact, there are many signs that can indicate a problem. Some to look for are:

• slurred speech
• stumbling or having difficulty maintaining balance and walking independently
• trouble making eye contact
• feeling excessively cold or warm (to oneself or to the touch)
• shortness of breath
• erratic, withdrawn, or aggressive behavior
• queasiness, vomiting, or dry heaving
• a tired stupor
• unconsciousness

The first thing to do when someone has had a lot to drink is to make sure that s/he doesn't drink any more alcohol. It may help for the person to sit in a quiet place where s/he can relax comfortably.

An individual's reflexes and coordination can be severely impaired when intoxicated, so walking around is not the best idea. You also need to make certain that s/he is kept warm, since high blood alcohol levels can lower body temperature, even if the person actually feels warm.

If your friends are willing to drink water on their own, you can offer it to keep them hydrated. Dehydration is one of the side effects of drinking because alcohol is a diuretic, meaning that one expels more liquid than is actually taken in. Keeping hydrated won't make someone sober, but it may help him or her to feel better the next day. But remember, drinking water, or black coffee, or eating food will not speed up the process of getting sober — only time will allow the alcohol to work its way through the system and eventually out of the body. (In fact, coffee can make things worse because it, too, causes dehydration, can be a stomach irritant, and will keep your intoxicated friend awake all night!)