When Is It Safe to Let a Drunk Person Sleep? Health and Life Considerations

JAN 18, 2023 AT 01:25 PM


We have all been there either having had too much to drink or taking care of a friend that has overindulged, sometimes both. It's the end of the party, and this time around you are the sober one.

You sternly tell your friend that if they want to be sick, they must tell you to stop as you help them into the back seat of your car for the drive home. They mumble something incoherent. You ensure they are safely strapped and head for home. There are bouts of singing and shouting from the back seat and then silence.


Thank goodness, they have nodded off you think. You will leave them to sleep it off, on the back seat if need be. What's the harm in that? Medical experts don't agree.

Health Risks

Allowing a person to sleep when very drunk can be dangerous to their health. Apart from falling and cracking their head open or breaking a bone, what can be so dangerous? Surely it is the best way for the body to rid itself of the alcohol in your friend's system?

An article on Redfrogs says that every year thousands of people die and many more are hospitalized due to alcohol consumption. Not only because of accidents while under the influence but also due to suffocation and alcohol poisoning.


Unless your friend is lying in the recovery position, there is a chance of them suffocating if they vomit, sometimes while still asleep. The contents of their stomach may not be removed through the mouth and can sit in the back of the throat, preventing breathing.

Alcohol Poisoning

If the person has still been drinking shortly before they pass out, the blood alcohol level can continue to rise even while they are sleeping. The symptoms of alcohol poisoning include confusion, vomiting, seizures, blue-tinged skin, low body temperature, unconsciousness, and slow and possibly stopping breathing altogether.

Drinking too much too quickly can affect your breathing, heart rate, and other vital organs and can lead to coma and even death says the Mayo Clinic.

Keep Watch

These and other reasons are why a responsible friend should not leave a very drunk person alone while they sleep it off. The New York Times ran an article in October 2017 about a university freshman who died of alcohol poisoning when his fraternity brothers left him to sleep while he had a blood alcohol level of 6 times the legal limit.

High alcohol levels can cause seizures that result in brain damage. The old home remedies of eating, drinking coffee, and going for a cold shower do little to rid the body of high levels of alcohol. The American Institute of Health says that serious symptoms of overindulgence such as throwing up, blacking out, and loss of consciousness can occur at .16 to.3 BAC (Blood Alcohol Concentration).

Dangerously Drunk

Short of having a breathalyzer handy to measure an absolute BAC, there are ways to tell when a person is dangerously drunk. The acronym PUBS was created by UVA to assist its students to remember the signs and symptoms.

  • Puking while passing out.
  • Unresponsive to stimulation (shaking or pinching)
  • Breathing slowly, shallowly, or not at all
  • Skin blue, clammy, or cold

If you encounter anyone that is showing these signs call an ambulance immediately.

Recovery Position (Bacchus Move)

If the drunk person is breathing normally while asleep, you can ensure their safety by placing them in the recovery position. This helps to keep their airway clear and if they do vomit, they will not choke. Roll them onto their left side, and bring their left arm under their head to use as a pillow.

Drop their right knee down in front of their body to help them remain stable in this position. Ensure they continue to breathe normally and regularly. Be aware that a gap of more than 10 seconds between breaths is a sign of alcohol poisoning.

Wake Them Up Periodically

Healthline advocates that even if a person is breathing normally and seems comfortable, it is a good idea to wake them up now and then. You can shake them, speak their name loudly, pinch or rub their sternum with your knuckles.

A person who is sleeping it off will be relatively easy to wake up. If they do not respond, seek medical assistance right away. If you have the information of how much and what they drank, and if they were using any other substances, tell first responders. It may save their life.

Falls and accidents

Even if your friend is still able to walk and talk, do not leave them alone. Many people have sustained injuries when drunk because alcohol affects judgment and muscle coordination. If possible, make them sit down on the ground where there is less chance of a fall. Wrap something warm around them.

Alcohol lowers body temperature. Try and keep them calm and still. Do not give them anything to eat or drink especially if they are showing signs of nausea. Never allow an intoxicated person to drive, swim or ride a bike (Healthengine says).

Unfortunately, the idea of diluting the alcohol in their system or soaking up the alcohol in their stomach are fallacies. Only time and the body's ability to process alcohol can help.

How Alcohol is Metabolized in the Body

Health Link BC explains the process. Alcohol molecules are extremely small and pass into the bloodstream and organs quickly. They are not broken down by the processes of digestion. Some of the alcohol may be absorbed directly through the membranes of the mouth and esophagus. The rest passes quickly through the stomach into the bloodstream through the walls of the small intestine.

It is always a good idea to eat solid food before you drink heavily not because it will absorb the alcohol, but because it slows the quick uptake of alcohol through the stomach lining. When the alcohol is in your bloodstream it is transported very quickly around your body to your brain and other organs.

Only 10% of the alcohol you consume is eliminated through urine or perspiration. A little may pass out through your breath. The remaining 90% is metabolized by the liver, which is the primary organ that transforms alcohol into a product that your body can process and eliminate. The liver cannot process large amounts of liquor quickly.

Only about one standard-size drink per hour can be fully metabolized. Other factors that contribute to how your body is affected by alcohol include your weight, age, and the food you have consumed.

Other Drugs

If your friend has been smoking or taking other recreational drugs, prescription or OTC (over-the-counter) medication in addition to drinking, the risks increase. The Alcohol Rehab Guide states categorically that "combining alcohol with other substances can be extremely dangerous and even fatal."

Drinking alcohol increases the possibility of developing dependence on other drugs. In addition, drinking and taking drugs can also cause dangerous interactions which may lead to permanent health issues.

When Is It Safe to Let Them Sleep?

If your friend is still able to walk and talk, even if a little slurred, and in a recognized language, they should be fine to go to sleep. As a check, however, ask them a few questions, before allowing them to lie down. Basic questions that they should know automatically, such as their full name and where they live.

Others such as where they are, or where they go to school or work, will help you determine if your friend is showing signs of confusion. If you are still concerned, take their pulse twice 10-15 minutes apart. If their heart rate is steadier or stronger, they are probably as drunk as they will get.

If it slows or weakens in that time, it means that there is still unmetabolized alcohol in their system, and potentially dangerous to allow them to sleep.


Nearly everyone has had one of those nights when they have had too much to drink. Instead of leaving a friend to sleep it off, ensure their safety by checking if they can walk and talk somewhat coherently.

Don't allow them to drive, swim or do any activity that may cause an accident. If they have already fallen asleep or passed out, wake them up. If in doubt or if they are breathing slowly or shallowly, their skin is clammy or blueish and you are unable to rouse them, call for medical assistance immediately.

Educate yourself on the recovery position and signs of alcohol poisoning. It may save your friend's life.