There is drunk, and there is medically dangerous. The second one does not improve because everyone agrees to be chill about it.

The National Institute on Alcohol Abuse and Alcoholism warns that alcohol overdose can shut down brain areas controlling breathing, heart rate and temperature. Emergency signs include inability to wake, vomiting, seizures, confusion, slow breathing—fewer than eight breaths per minute—or gaps of 10 seconds or more between breaths, clammy or blue-tinged skin and dangerously low body temperature.

Call 911. Stay with the person. If they are vomiting or unconscious but breathing, roll them onto their side to reduce choking risk. Follow the dispatcher’s instructions. Tell responders what they drank and whether other substances may be involved.

Do not give coffee, force a shower, make them walk or leave them to “sleep it off.” Blood alcohol can keep rising after drinking stops. If opioids might be involved, give naloxone if available and call 911; naloxone will not harm someone who is not experiencing an opioid overdose.

Fear of embarrassment, parents or disciplinary trouble should not outrank breathing. Many states and campuses have some form of Good Samaritan protection, but details vary. Verify local law later. Call now.

The friendship may have an awkward morning. Let it have one.

Sources: NIAAA alcohol-overdose guidance and CDC overdose response

Related reading: When Your College Student Calls Home in Crisis

This article provides general educational information and is not a substitute for individualized legal, medical, financial or safety advice.