How can we help people experiencing alcohol poisoning?
As public intoxication laws change, we examine the signs of alcohol overdose and how we can give first aid to protect each other.
Public drunkenness will soon no longer be a criminal offense in Victoria, but that doesn’t mean it’s always safe. We encourage everyone to look after each other and learn how to help out with first aid in the event that someone experiences medical risk.
From 7 November, public intoxication will no longer be a criminal offense in Victoria. The Victorian government says this means that means that “no person will be placed in a police cell or arrested solely on the basis of intoxication”. There will now be a health-led response to people who are drunk or visibly affected by drugs in public.
Why are public drunkenness laws changing in Victoria?
The reform brings Victoria into line with most other Australian states, where public intoxication was decriminalised decades ago. Public intoxication remains a criminal offense in Queensland, where there are also calls for change.
The Victorian changes were made in response to a 2020 report of the Expert Reference Group on Public Drunkenness, which found the government should act on a recommendation made by the 1991 Royal Commission into Aboriginal Deaths in Custody. Investigations found that the law had disproportionately impacted First Nations people and was tied to several deaths in custody.
Criminalising public intoxication can be dangerous because many medical emergencies can be mistaken for or masked by intoxication. For example, an incoherent person with the smell of alcohol on their breath may appear to be drunk, when really they’ve had a stroke. A health-led approach to public intoxication aims to promote the safety of community members by prioritising access to medical care. To this end, the Victorian government are implementing sobering up shelters similar to those already found in other states, along with an outreach, intake, referral and dispatch services aimed at identifying and assisting people who need support for intoxication.
What is a sobering up centre?
A sobering up centre is a harm reduction facility that provides a safe environment where somebody can go or be taken to sober up. The facilities are staffed by health workers or people trained in first aid. Facilities around Australia offer slightly different services, but most provide a bed for the night, close observation and monitoring for signs of danger, and referral to further care if required.
Many sobering up facilities aim to intercept people who need support before they come into conflict with police.
Different states have different rules about whether attendance at a sobering up service is voluntary or mandatory. People can usually voluntarily walk-in to a centre, but they may also be brought in by police, outreach or patrol services, health or welfare agencies, or other community members.
Find out about the sobering up centres in your state:
NSW does not currently operate sobering up centres. Police have powers to take intoxicated people into custody until they deem it safe to release them.
So can we just do whatever we want now?
We definitely can’t take this as a sign that we can now get away with anything we want. It’s important to remember that there are still a lot of ways to get in legal trouble if you drink or use drugs in public, even if public intoxication is now decriminalised. For example,
- Illicit drug possession is still a criminal offense in most jurisdictions. If police find illicit substances on you, you may still be charged.
- You are still not permitted to drink or use drugs in certain public places, such as many parks or on public transport.
- Public nuisance laws still apply if you are being threatening, violent or abusive in a public place.
Public intoxication can still be legally risky, even if it’s no longer criminalised.
First aid for alcohol overdose
Alcohol is basically everywhere in Australia, so it’s a good idea for us to all make sure we know how to help somebody who has had too much to drink.
Consider whether you need to call 000
Firstly, keep in mind that many medical emergencies can look like alcohol poisoning or intoxication, so if you come across somebody who is disoriented and incoherent and you don’t know for sure they’ve had a lot to drink, it’s not safe to assume that’s what is happening.
Also, although it’s common for people to become unwell after drinking too much, that doesn’t mean it can’t be serious. According to St John’s Ambulance Service, 400 people are hospitalised every day due to excessive alcohol consumption. Alcohol poisoning can be life-threatening. If somebody is showing symptoms of alcohol poisoning, they may need emergency medical assistance.
You might need to call 000.
If you’re hesitant to call 000 but want some medical advice, call a health advice line and talk it through with them:
- ACT, NSW, NT, SA, TAS, WA: HealthDirect — 1300 022 222
- QLD: 13 Health — 13 43 25 84
- VIC: Nurse-on-call — 1300 60 60 24
These services can talk through the symptoms with you and help you figure out what to do.
What are the signs of alcohol poisoning or overdose?
The Mayo Clinic lists the following signs of alcohol poisoning:
- Disorientation or incoherence: When somebody is confused, unable to speak or communicate clearly, or generally seems to not understand what is happening.
- Vomiting: Frequent or severe vomiting is both a symptom of alcohol poisoning and can pose a deadly risk of choking if the person continues to vomit while unconscious.
- Slow or irregular breathing: Alcohol is a sedative, so it’s common for it to interfere with the natural rhythm of breathing. Fewer than 8 breaths per minute is considered slow breath, while irregular breathing may include a gap of more than 10 seconds between breaths.
- Hypothermia or low body temperature: Hypothermia is when the body drops below 35°C. They might be shivering or feel cool to the touch. Learn more about identifying hypothermia from NSW Health.
- Blue, grey or pale skin
- Seizures: A seizure is when brain cells send signals incorrectly and uncontrollably due to a malfunction. This can look a little different in different people or circumstances, but common symptoms of seizures are involuntary twitching, suddenly passing out, or convulsions, which are when the limbs suddenly stiffen and shake while the person loses consciousness. Seizures can be very serious and may cause permanent brain damage if they last too long.
- Unconsciousness or inability to stay awake: Unconsciousness can be a very dangerous symptom of alcohol poisoning and is an indication that the person probably needs medical attention.
Somebody doesn’t need to have all of these symptoms before it becomes a medical emergency. Even one or two of these symptoms can be a sign of significant danger. If you’re at all unsure, take action.
How to help someone showing signs of alcohol poisoning
There are some simple steps you can take to help lower the risk for someone who is experiencing alcohol overdose.
- Call for emergency help.
- While you wait for help, take them somewhere quiet and warm or cover them with a coat or blanket if you can.
- If they’re unresponsive or unconscious but are breathing normally, put them in the recovery position — lying on their side with their knee bent and head tilted back slightly. This will help to keep their airway clear and minimise the risk of choking on vomit. Don’t try to make them sick.Check out this St John’s Ambulance UK Guide to putting somebody in the recovery position.
- Get as much information as you can about what and how much they’ve had to drink — if they’re responsive, you can ask them, but otherwise ask anyone else that might have been around, take note of the bottles or cans you can see around them. If they vomit, St John’s Victoria suggests taking a sample to provide for medical testing.
- Monitor them until help arrives. Check their breathing regularly. If you don’t know CPR, find out if anybody present does, and be prepared to intervene if they stop breathing.
- Try to shock them out of it by putting them in a cold shower or bath — they’re already at risk of hypothermia and may go into shock.
- Give them coffee or food to ‘help them sober up’. Coffee can cause further dehydration, and food increases the choking risk if they vomit.
- Try to make them vomit.
- Assume they can just sleep it off — their blood alcohol is still rising even while they sleep.
Read more of St John’s Ambulance Victoria’s suggestions to Know Your Alcohol Overdose First Aid or the International Overdose Awareness Day Alcohol Fact Sheet.
How to avoid alcohol overdose
To reduce your risk of alcohol overdose, St John’s Vic says:
“The golden rule to avoid alcohol overdose is to drink responsibly. Be aware of how many drinks you are consuming and do not exceed the recommended maximum limit of one standard alcoholic drink per hour.”
You can also make sure you eat before and while you drink, drink plenty of water between alcoholic drinks, and ask someone to help you keep track of how much you’re drinking.