Looking Out for Your Friends

“ One of the coolest things about Stanford is that we look out for each other. When I was a frosh, Josh, my housemate noticed that I was way beyond my limit. Somehow, he tricked me into drinking something very diluted, and got me back to the dorm safely. Next day, I heard about how drunk I was - I thought he was pretty awesome for taking care of me - now I do the same .”

SM, Junior

It’s a situation you may already have encountered: a friend has had too much to drink and is looking pretty sick. At Stanford, we pride ourselves on looking out for one another and getting people help when needed. It's sometimes tough to spot the telltale signs that someone’s had one-too-many, or perhaps has a serious drinking problem. But it’s even tougher to figure out what to do about it. Some situations we act to prevent problems before they start and other times we need to jump in before a sketchy situation gets out of control.

In this section, we’ll look at six basic situations, requiring different types of response.

Short-term:

A friend who is DETERMINED to get drunk one night.
A friend who is on his or her way to drinking way too much alcohol.
A friend already had too many drinks one night, and needs someone’s help to keep them safe from harm.
A friend had way too many drinks one night, and may show signs of alcohol poisoning.

Longer-term:

A friend may be developing a drinking problem, or perhaps showing signs of a recurrent alcohol problem.
A friend may be an alcoholic

Situation 1: “I’m going to get smashed … trashed … wasted …hammered ____________ (fill in the blank) tonight.”

You may overhear a friend saying something similar to what is stated above. You suspect that this evening may not turn out so well because your buddy is determined to get reeeaaalllllly drunk. At this point what do you do? Many students aren’t sure if they should even approach the topic with their friend. Who wants to be the one who preaches to them about drinking? Well, there are ways to not preach, but still make sure your friend is safe and has a good time. The key here is to prevent a problem before it begins.

The “I’m getting trashed” comment is a signal for you to be a good friend. Take some action to avoid a bad night for both of you:

Check-in with them before they start drinking to ask how they are doing. “How’s your week been?” You might discover that they are really stressed or may want to just chill for the night instead of getting wasted. Going out for dinner or catching a movie might be a much better solution than getting wasted.
Encourage your friend to eat dinner (have some protein) and go into the evening with a full stomach
Don’t let them drive to the party or be in a situation where they might need to drive
Look out for them during the night. If you see him or her going into a situation that he or she may later regret, check-in with them and redirect them elsewhere.
Tell them to savor his or her drink and have them avoid drinking games and taking repeated shots of hard liquor.
Encourage your friend to drink water in between every alcoholic drink.
Go to the party in a group and leave in a group.

Situation 2A: “I’ve gotta down all of this before I can get back into the game/party”

In this situation, your friend may be on the path to a not- so -pleasant outcome to your evening/day. You can clearly see that he or she is drinking way too much alcohol in a short amount of time. Maybe it ’s a drinking game or perhaps they are downing the tasty party juice in great gulps. The key in this situation is heading off an inevitably disastrous ending.

Before your friend reaches for the next drink, get his or her attention and use some of these strategies:

Ask them to take a break with you and go outside for some good, oxygen-saturated air.
Take them out to the dance floor (without the drink in hand).
Take them aside and ask them not to embarrass themselves or you.
Encourage them to leave and grab something to eat with you.
Tell them that you will get his or her next drink for them – and make it weak.
Tell them straight up:

“I’m not cleaning up your puke tonight.”
“I don’t want to have to leave early because you ’r e too drunk”

Situation 2B: “I’m soooooo drunk [dry-heave]”

In this situation, your friend is pretty toasted, but able to function and is aware of his or her surroundings (can tell you who they are and where they are). A heavily intoxicated person is often easy to recognize. The slurred speech, clumsy gestures and embarrassing jokes are dead giveaways. The best thing you can do is to stop them from pouring more alcohol into their already overtaxed system. Lead them away from the booze by drawing their attention elsewhere.

“JJ was so hammered that I couldn’t get him outside. He kept asking for more to drink, so I gave him a Sprite and told him it was a G&T. He was so wasted that he didn’t know the difference. After two more sprites, he announced that he’d probably had enough.”

JL, Senior

What if a drunken person vomits and/or “passes out” before the hours pass and they've sobered up?

Remember that alcohol is a depressant, so here's what to get them to do.

Get them away from the alcohol and the situation.
Eat something slowly if they are up to it.
Sip water, not down tons, but sip it.
If they need to vomit, let them (preferably in the bathroom toilet). Don’t make them vomit. If he or she needs to vomit, their body will do it naturally.
Stay with them and keep an eye on them (watch a movie or TV with him or her next to you).
If they fall asleep, check on them frequently and make sure they are breathing regularly and can be stirred.
If they can’t be stirred, are breathing slowly or show other signs of alcohol poisoning (see next section), call 9-911

BIGTIME THING TO KNOW:

“Passing out” is basically an alcohol-induced sleep from which people can be roused, and during which they have normal sleep breathing. If this happens, place the person on his or her side, with knees bent to keep the person from turning over. This position keeps your friend turned so that if he or she vomits, it is less likely that he or she will stop breathing from choking on vomit. As long as someone responsible stays with the person, it is generally okay to let him or her sober up at home. It’s important to stay with the person and watch them so if symptoms get worse you can get them more intensive help immediately.

“I really didn’t party much in high school. When I got to Stanford I figured that I could handle my liquor. The third time I drank alcohol I got into a drinking game with shots of Vodka. I probably had about 8 shots, well that’s all I can remember taking. The next thing I remember is waking up in the emergency room with an IV in my arm. They said someone found me lying outside and I was unresponsive, so they call 911. The doctor told me that my blood alcohol concentration was 0.32 . They had to put me on life support- a respirator was breathing for me. Now that I know how serious this could’ve been, I’m grateful that someone found me and got me help.

My parents were really distraught. Now I tell other students to look out for each other and don’t let an inexperienced or an experienced drinker for that matter, take repeated shots of hard alcohol.”

MJ, Sophomore

Situation 3: “I’m sooooo drunk – again & again & again….”

Whether your friend is loud and annoying, or quiet and introverted, in this situation your friend may be developing a drinking pattern that is unsafe, unhealthy, and very concerning. They may not always need medical assistance, but they almost always go way past their limit.

Some friends in this state are obvious because they're irritating and obnoxious.

Others who also need support go unnoticed because they aren’t the one’s making a mess. They somehow manage to function well, and kinda fade into the background when drinking. This is a difficult situation to navigate. The main thing to remember is to offer support and show your concern in a nonjudgmental and open manner.

Here are some suggestions : (you’ll find additional suggestions in the next section).

Use “I” statements when talking to your friend

I’m concerned about you
I care about you
I’m a little (a lot) concerned about your drinking

Ask them what they think about their drinking
Offer support and listen
Help them connect with resources on campus (go with them to check them out). Remember that Counseling and Psychological Services (CAPS) and the clergy at Memorial Church are completely confidential services.

“I felt weird talking to my roommate about her quiet, but persistent drinking. At first, I didn’t know what to do. I didn’t know if 100 other people already told her that they were concerned. I didn’t know if I was number 1, or number 99. But regardless, I knew I had to talk to her. Sometimes we have to know that someone is concerned about us before we figure it out ourselves ”.

FJ, Senior

Situation 4: Alcohol poisoning—get medical assistance

Alcohol poisoning is a very serious and critical condition. If a friend “passes out” but can’t be roused or has very slow breathing (see below), he or she may have developed alcohol poisoning. This is very serious and you can save lives by acting quickly. If a friend exhibits the signs call 911 immediately (9-911 from a campus phone

. Also contact a staff member like an RA , RF or PHE. Be sure to place your friend on his or her side, with knees bent. Stay with your friend until help arrives. Never leave someone in this state alone to sober up or sleep it off.

“I respect Stanford students because they take care of each other. They not only prevent their buddies from facing ugly consequences, but they actually protect each other’s lives. That single call to 911 has saved more lives than I dare to think about”.

Stanford Police Officer

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What are the signs of Alcohol Poisoning?

Passing out and can’t be roused
Vomiting more than once
Fewer than eight breaths per minute or breaths spaced by 10 or more seconds
Blue lips
Cold and clammy extremities

__________________________________________________

As a depressant, alcohol slows down central nervous system (CNS) functioning. Alcohol poisoning occurs when a large amount of alcohol depresses CNS functioning to an abnormal level, which may lead to coma and death. Every year, some students at Stanford drink too much alcohol and get taken to the emergency room for alcohol poisoning. Even though these situations are rare, we should recognize them and know how to react.

Drinking to the point of alcohol poisoning is seriously dangerous. An inexperienced drinker may do so simply because he or she doesn’t know how the body handles alcohol. Keep in mind that the number of drinks isn’t necessarily a final determinant for alcohol poisoning. As in many things, moderation is the key to drinking responsibly.

YOU CAN MAKE A DIFFERENCE

Act if you notice someone needing assistance. Be part of the solution, not a bystander.

CALLING FOR HELP

Calling 911 – sometimes it may seem drastic, but it is better to err on the side of safety than jeopardize your friend’s health. If you feel concerned about a friend’s immediate condition, trust your instincts. If your friend goes to the hospital, he or she has the best chance of making a healthy and quick recovery.

Don’t worry about getting in trouble—just do the right thing!!

”I was hanging out with some friends one night and we started taking shots of Rum. We were playing a game that I never played before. Well after about 8 shots I started to feel dizzy, especially after I stood up. I figured I was drunk. I really wasn’t a seasoned drinker. This was probably the 3 rd or 4 th time I really ever drank alcohol. My friends told me that I did take a few more shot s and wandered down to the bathroom. When I didn’t come back, they came looking for me and I guess I didn’t even make it to the bathroom. They found me outside lying on the concrete and I had puked all over myself. I couldn’t be roused so they called 911 and I was taken to the ER. When I awoke, I had an IV in my arm , an oxygen mask over my nose and been hooked up to a respirator. I still felt somewhat drunk. The next morning, I was told that my blood alcohol concentration was 0.33 - that, I was told, is really, really high. The ER staff told me that if I had been left outside all night, I probably would have stopped breathing. I never thought that I could come that close to death from drinking alcohol. I definitely learned a lot from that experience and now I look out for myself and others around me.”

SB, frosh

You may worry that alerting your house staff, or directly calling 911, will have negative outcomes for you or your friends. Your RAs, RFs and other staff are firmly committed to keeping students safe, first and foremost. Their approach will always emphasize education and healthy behavior. No one wants you to face any consequences for doing the right thing. Police typically respond to the 911 call, and their primary concern is also with safety and health. They may take other action, especially if a serious crime like assault is involved. But rest assured, any risk is far outweighed by the risk to your friend's life. By alerting staff, and/or calling 911, you may very well be saving a life.

AN OUNCE OF PREVENTION IS WORTH A POUND OF CURE:

Here’s the main thing. Stop trouble before it starts. Don’t’ stand by while your friends go overboard. Watch out for each other and it won’t come to alcohol poisoning, a 911 call, or other problems.

There are plenty of ways to go about stopping trouble before it starts. Here are some tips:

It’s safest to not drink alcohol and stick to EANABS

For tasty EANAB recipes:

http://www.floras-hideout.com/drrecipes/non-alco-ALL.html
http://www.maddorangecounty.org/drinks.htm
http://www.wpi.edu/Admin/HAO/drinks.html

If you drink booze, do so moderately. That usually means 1-2 measured drinks per hour and no more than 4 drinks overall.
Set limits before you drink (get your friends onboard to not let you get trashed)
Avoid drinking games (go somewhere to dance or mingle without competition)
Have non-alcoholic beverages (EANABs) at events- fruit smoothies, non-alcoholic blended drinks and teas are favorites.
Set the intention to stay sober, or get pleasantly buzzed- not drunk and sick
If you’re going out in groups, take turns being a non-drinker
Always set up a designated driver
Understand and heed the dangers of hard liquor and shots
Never abandon an intoxicated friend or let them wander away- make sure they get home safely.

“My parents were pretty cool about alcohol and drinking when I was growing up. I would have wine with dinner and learned how to be responsible. I don’t get why students drink so much that they vomit or pass out. That is the last thing I want to happen when if I’m drinking alcohol. I like to be in control. I am glad my parents taught me how to be a responsible drinker. It helps me overcome the trap of needing to get drunk, or thinking I need to get drunk, every time I drink.”

TH, Senior

Situation 5: “I don’t have a problem. I can stop whenever I want. Now, give me my bottle back and get out.”

Maybe he/she isn't slurring their words or getting pulled up off the floor, but the statement “I’m totally fine – you don’t have to take care of me” is just as problematic when your friend is a habitual drinker. Even when alcohol isn’t involved, we know that sometimes friends push away help when they need it most. It’s the Stanford way to use our good judgment, take in the big picture, and help each other when needed.

Alcohol is an addictive drug, both physically and psychologically. Yet, it’s widely accepted in this country and is seen as part of the college experience. In this context, alcohol problems like binge drinking and alcoholism can be trivialized, or even seen as "normal". But they’re not.

"My junior roommate got seriously buzzed at least five times a week. Maybe 10-12 drinks a night. We all looked up to him as "the man". It wasn't until he faced a serious problem that I finally got it- he was an alcoholic. "The man" really needed good professional help, not a bunch of kids telling him how cool he was”.

CS, senior

Alcohol problems don’t necessarily start with the loudest or most belligerent person at the party – sometimes it’s the quiet but consistent drinker who is dependent. If you think a friend may have a drinking problem, consider these questions:

Are the person's closest friends heavy drinkers?
Is the person socially isolated from non-drinking friends?
Does the person frequently drink alone?
Does the person rely on alcohol or other drugs to cope with stress or negative emotions?
Does the person miss class or work due to the use of alcohol or other drugs?
Is the person in denial about his or her level of drinking?
Does the person keep alcohol hidden for quick drinks?
Has the person repeatedly placed himself/herself in dangerous situations due to his or her drinking?

“I never really though too much about my drinking or thought it was an issue until a speaker from Vaden came to my dorm and had us answer the question why do we drink? I figured out that I drink for the wrong reasons – because I’m shy, because I felt like I was suppose to drink, and because I’m an alcoholic. That was a big step for me to say that I am an alcoholic, but after years of kidding myself, I finally came to terms with it and got help.”

JB, Junior

Bottom line:

It's hard to think about Stanford students having serious alcohol problems. However, alcohol abuse and alcoholism are generally defined by the serious negative effects on the drinker’s life. Although your friend says that he/she is choosing to drink often and heavily, remember that it may be a disorder that’s driving the drinking. Unfortunately, they are not really in control of their drinking, nor have freedom of choice.

As a friend, it may be uncomfortable to intrude into someone else’s life, especially if you are pushed away and your concern seems to endanger your friendship. In the long run, however, you may be helping your friend to deal with their dependency or abuse. Consider the consequences to someone whose life is consumed by alcoholism: poor academic and job performance, unhealthy personal relationships, inability to deal with life's stresses and possible long term chronic health problems.

Jess, a PHE, was concerned about one of her frosh. She asked the guy if anyone ever told him that he had a drinking problem. "Nope", the frosh said with a hint of annoyance in his voice. "Great", replied Jess. "Next time someone asks you that question, you'll have to say yes. And then I hope you'll get some help."

EDUCATE YOURSELF

Do you wish you had more info about it to help?

LAUNCHING THE CONVERSATION: Easier said than done

So after you’ve identified your friend as a problem drinker, and decided to take action, what do you do? And how do you do it?

The first tip is to open the conversation either by a general question to invite more dialogue, or depending on the situation, perhaps begin talking about yourself and your concerns. Always avoid the judg emental “You... “, as in “You really have a problem”, or “You acted like a jerk”. This is decidedly unhelpful because it will almost always lead to a nonproductive, defensive response.

Here are some CONVERSATION OPENERS:

What do you think about what happened last night?
How do you feel about your drinking?
Some event/party last night, huh?

Good “I” statements when talking to your friend

I’m concerned about you
I care about you and am worried
I’m a little (a lot) concerned about your drinking

Other tips:

Offer support and listen
Assure them that you care: “If you ever want to talk about anything, let me know”.
Help them connect with resources on campus (go with them to check them out). Remember that Counseling and Psychological Services (CAPS) and the clergy at Memorial Church are completely confidential services.

Resources to help

Gett ing your friend to start thinking about problem drinking is a powerful step. Keep in mind that Stanford has a wealth of resources to help.

RA/CA: Whether for a sustained pattern of abuse or a specific incident, your RA/CA is a great resource. At Stanford, their primary role regarding alcohol is to provide support and education. Their first response will likely be to help your friend discuss their particular situation and offer educational resources. They can also help you prepare to approach your friend.

RAs/CAs are also trained to recognize signs of immediate distress. If you are concerned that your friend presents a short-term danger of harm to self or others, your staff can consult with professionals who have greater expertise. The RAs’ concern is the students’ best interest.

PHE: Your peer health educator has access to specific information about the long term and short-term physical and psychological effects of drinking. They can coach you and help you figure out how to best approach your friend. If appropriate, they are also trained to help the person get help, depending on the nature of their issue.

RF : Your resident fellow is there to support you and your RA/CA/PHE in working with your friend. They coordinate efforts when multiple people are involved.

RD : The Residence Dean has specialized training, information, and a variety of approaches to help your friend regain control. Although you or you friend can go directly to the RD for assistance, RD's are usually consulted by your residence staff.

Vaden Substance Abuse Prevention Program: Alcohol and Drug Educator Ralph Castro offers health advising and consultation for students who want information or feedback on their drinking behavior. Educational seminars and student group consultation is also available.

CAPS : Vaden Health Center’s Counseling and Psychological Services offer a great and confidential place to talk through questions and concerns about drinking. If you feel comfortable, you can suggest to your friend that he/she consider counseling options.

The Bridge: Trained peer counselors at the Bridge can begin a peer-to-peer conversation about a drinking issue.

For an expanded list of resources available at the University, see RESOURCES at the end of this guide .

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