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.

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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.

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Why are public drunkenness laws changing in Victoria?
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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.

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What is a sobering up centre?
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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:

ACT
NT
QLD
SA
TAS
VIC
WA

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.

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So can we just do whatever we want now?
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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.

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First aid for alcohol overdose
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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.

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Consider whether you need to call 000
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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.

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What are the signs of alcohol poisoning or overdose?
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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.

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How to help someone showing signs of alcohol poisoning
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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.

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.

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How to avoid alcohol overdose
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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.

If you feel like you don’t have control over your drinking, it might be time to consider making a change. We’re here to talk about it if you need a sounding board — free, confidential, 24/7.

O brother, where art thou?

I grew up with an alcoholic father, and in years to come it would be that my three brothers would have a similar path. 

friends supporting each other

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This article first appeared in the Family Drug Help newsletter and has been republished with full permission.

Seeing a loved one battling addiction is often very difficult. I grew up with an alcoholic father, and in years to come it would be that my three brothers would have a similar path. One brother is still a somewhat functioning alcoholic, functioning considering he is on his second marriage, now separated, my other brother addicted to marijuana and my eldest brother battled a 10 year addiction to ice. Why not me, I ask, we had the same upbringing, were treated the same, had the same discipline, went through the normal highs and lows of a childhood.

I often wonder what could I have done to more to help in the initial stages of their addictions, Mum always said you don’t have to deal with adult issues. The truth is I never knew how or what could be useful. It seems that they were ashamed to tell me what was going on, until they reached their ‘rock bottoms’. It changed the relationship I had with each of them. I tried to stay in touch and have some sort of brotherly relationship with them, but time after time I was lied to, stood up, felt like I had nothing in common with them.

Although their journey is not complete, and comprises of a mixture of recovery and active alcoholism/addiction, what I do know is that I have to be vigilant, in case it’s in my genes. I do have to look after myself, I do have to support them when I can, and give my self permission to say “no” if I can’t or if it doesn’t feel right. I cannot change the past, I can’t predict the future, but it’s nice to have two of my brothers well again and on their tough journey in recovery. 

Family Drug Help work with families to have been impacted by substance misuse.

Helping others can help you stay on track

One of the involved peers at Turning Point shares his recovery story and how helping others stay on track helped him stay on track.

helping loved ones

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Getting Started
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The act of helping other people can provide you with a variety of health benefits. It’s been proven to assist those with depression, increases a sense of wellbeing and, for some, it can also help with recovery.

Anthony* is one of our involved peers at Turning Point and has been in recovery for quite a few years.

He has found that being involved and keeping busy helps him stay on track - "It keeps you focused, it keeps you occupied, it keeps you inline and it keeps you responsible!" says Anthony.

Getting started

His recovery journey began when he started going to a local community centre that provided him with support, he found them by chatting with an old friend who thought it might help. 

He had always been a very active person, in his professional life he had been a builder until his body couldn't keep up anymore. So after getting himself into a better place personally it was a very natural progression to help other people.

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Lending a hand
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Lending a hand

His chance came during a stay at residential rehab. He had been there for a while, when he was asked to welcome newcomers and give them support at the start of their stay. He found it really rewarding and once he left there he decided to continue this work. "I needed to do something" says Anthony.

Since then he has run peer support groups, presented to organisations and been on various committees that aim to improve treatment and experiences for people affected by alcohol and other drugs.

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The ups and downs of recovery
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The ups and downs of recovery

It hasn’t always been the smoothest ride for Anthony, like many others parts of his recovery journey have been a bit hit and miss. Sometimes he would slip up, but each time he learnt from it and has made progress.

Over time he has found being in recovery easier, ‘I know where my brake pedal is, I can pull myself up.’ says Anthony.

Anthony’s tips to keeping on track:

  • Preparation - mindfully preparing for your day can really help keep you on track.
  • Manage your Money - If you’re going out for the day by yourself, leave your bankcards are home, just take enough money to get where you’re going and to buy some food. Anything else can be too much temptation.
  • Surf the Urge - Learn about urges and how to surf them - if you have an urge, you can surf it until you get home. If you still have the urge when you get home have a shower, that’s always a great way of clearing your head.

If you are interested in getting involved there a number of ways to get started:

  • Be a peer supporter: We have launched our peer to peer forum and we are looking for peer leaders to help form the forum.
  • Share your own story, it can help to write your experiences down, giving clarity about where you are and where you have been. Reading recovery stories can be really helpful for other people as well, as it gives them strategies and hope of what can be achieved.

*Name changed

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