Looking Out for Your Friends

What do you do when a friend has had too much to drink and is looking pretty sick? What about when a friend's drinking patterns have become more worrisome? At Stanford, we pride ourselves on looking out for one another, getting people help when needed, and holding each other accountable to create and maintain a safe community.

Remember, some situations require that we act to prevent problems before they start, and other times we need to jump in before a situation gets out of control.

Think about what role you usually play in your friend group...

Being an active bystander can come in many forms. Differences in our personalities and experiences can lead us to feel comfortable in some roles within groups in social settings moreso than others. Here for four examples of how you can use your strengths to play a role in creating a safe and fun environment with your peers.

• The Diplomat: The one who feels comfortable interrupting the action as it's happening. For example, you might approach a friend who is drinking too heavily at a party and say, "Hey, let's go grab some water and take a breather from the beer pong table."
• The Crisis Manager: Good on their feet and can stay calm, cool, and collected in an emergency situation. This kind of active bystander feels comfortable taking charge if things go wrong.
• The Planner: The one who thinks ahead and makes sure everything is in order BEFORE the event/gathering happens. This may include purchasing the EANABS, posting the 5-SURE number on doors, and going over the party plans with the other hosts.
• The Trend Setter: The leaders of the group. These folks may not intervene in a traditional sense, but recognize that others look up to them and they set the tone for the event/gathering. They may choose to lead by example and employ risk reducing strategies when drinking as well as encouraging others to do the same.

You might be comfortable in all of these roles, or you may even have another way to be an active bystander. Tell us your favorite way to be a positive bystander at alcohol@stanford.edu. 

Situations You May Face

1. “I’m going to get hammered (or smashed, trashed, wasted, etc.) tonight." At this point what do you do? 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 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 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 may be a danger to them, check in with them and redirect them elsewhere.
     • Tell them to savor their drink and help 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.
2. “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. 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 chugging the tasty party juice. 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're too drunk”
3. “I’m soooooo drunk [dry-heave vomit].” In this situation, your friend is pretty drunk 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 easy to recognize by the slurred speech, clumsy gestures and embarrassing jokes. 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. This may be a good time to call up 5-SURE and head home.
   • What if a drunken person vomits and/or passes out?
     • Get them away from the alcohol and the situation.
     • Eat something slowly if they are up to it.
     • Sip water; don't gulp 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.
     • Place the person on his or her side, with knees bent to keep them from turning over, so that if he or she vomits, it is less likely that he or she will stop breathing from choking on vomit.
     • Always stay with the person and watch them so if symptoms get worse you can get them more intensive help immediately.
     • If they can’t be stirred, are breathing slowly or show other signs of alcohol poisoning (see next section), call 911 (9-911 from a campus phone).
4. Alcohol Poisoning - get medical assistance and call for help immediately. You notice someone at a party is passed out and cannot be roused. This is a sign of alcohol poisoning that requires immediate medical attention.
   • What are the signs of life-threatening 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
       • Alcohol poisoning can be a life-threatening condition. You can save lives by acting quickly. Don’t worry about getting in trouble; just do the right thing!
       • Call 911 immediately (9-911 from a campus phone).
       • Contact a staff member such as a RA, CA, RF or on-call Resident Director or GLO Dean.
       • Place your friend on his or her side, with knees bent (The Bacchus Maneuver). Stay with your friend until help arrives. Never leave someone in this state alone to sober up or sleep it off!
5. Your friend seems to be drinking more often than usual and insists, "I don’t have a problem.” Alcohol problems aren't always characterized by the loudest or most belligerent person at the party; sometimes it’s the quiet but consistent drinker who is dependent. As a friend, it may be uncomfortable to intrude into someone else’s life, but in the long run, you may be helping your friend avoid poor academic and job performance, unhealthy personal relationships, inability to deal with life's stresses and possible long-term chronic health problems.
   • If you think a friend may be developing addiction or dependency, consider the 4 Cs of addiction and dependency:
     • 4Cs -- Cravings, (loss of) Control, Compulsive behaviors, and Consequences
     • Cravings: Does the person express their desire for alcohol or drugs frequently, or exhibit physiological signs of withdrawal when they do not have the substance? 
     • Control: Does the person appear to have lost control of how much or when they use substances? Do they use more of the substance than they intended or said they would use? Do they appear to be using substances at odd or atypical times (e.g. saturday morning hike with friends, at an alcohol free events, in class, etc.)
     • Compulsions: Does the person compulsively seek alcohol or drugs and appear anxious when they do not have access to them? Does the person appear to rely on alcohol or other drugs to cope with stress or negative emotions?
     • Consequences: Does the person miss class or work due to the use of alcohol or other drugs? Has the person been in dangerous situations due to their drinking and do they recognize the ways in which alcohol is impacting their life?
   • Here are some suggestions: (you’ll find additional suggestions in the next section)
     • 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.
     • Remember, you can always consult an RA, RF or RD before approaching your friend if you are not sure how to start the conversation. 

How Do I Start the Conversation?

It's easier said than done, but avoid being judgmental.

1. Open the conversation with something neutral.
   • What do you think about what happened last night?
   • How do you feel about your drinking?
   • Some event/party last night, huh?
2. Express your concern.
   • 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.
   • Assure them that you care: “If you ever want to talk about anything, let me know."
3. Help them to connect with resources.
   • Getting your friend to start thinking about problem drinking is a powerful step. Keep in mind that Stanford has a wealth of resources to help.

Resources

Residential Staff

• RA/CA: Whether for a sustained pattern of abuse or a specific incident, your staff are 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. These staff 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.
• RF:  Your resident fellow is there to support you and your RA in working with your friend.  They coordinate efforts when multiple people are involved.
• RD: The Residence Director 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.
• The Bridge: Trained peer counselors at the Bridge can begin a peer-to-peer conversation about a drinking issue.

Professional Support

• Contact Us: Alcohol and Drug Educators in the Office of Alcohol Policy and Education offer health advising and consultation for students who want information or feedback on their drinking behavior. Educational seminars and student group consultation are 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.