How to Recognize the Signs of Intoxication

Co-authored by Tiffany Douglass, MA and Janice Tieperman

Last Updated: August 21, 2024 Fact Checked

How can you tell if someone is tipsy, drunk, intoxicated, or over-served? Can you judge by the fact that their eyes are red, their cheeks are rosy, or if their speech is slurred? There are many signs and symptoms of intoxication that can be easy enough to recognize with a little practice and research.

Part 1

Part 1 of 3:

Recognizing the Physical Signs of Intoxication

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1
Look for glassy or bloodshot eyes. A person’s eyes can tell you a lot about them and their mental state in a particular moment. If their eyes are glassy and bloodshot, it could be a sign that they've been drinking too much. Additionally, if a person has droopy eyes and is clearly having trouble keeping their eyes open, this could also be a sign of intoxication.^{[1]
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- Note: Bloodshot eyes could also be a sign of allergies or another medical condition. So make sure you ask about allergies before you interpret this symptom as a definitive sign of intoxication.^{[2]
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Notice how the person smells. While intoxication can mean being under the influence of several different substances, the smell of the user can be a big giveaway for many people. Both alcohol and marijuana have very strong odours that linger with the user long after the intoxicating substance has been consumed. Try to smell the person and see if you can notice hints of alcohol or weed on their breath or clothes.^{[3]
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- As a parent looking for signs of intoxication in their child, this is one of the most effective tell-tale signs.
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Watch for impaired motor function. Intoxicated people can’t perform normal tasks as easily as they can when they are sober. This includes things like walking a straight line, lighting a cigarette properly, spilling drinks, or fumbling with other objects.^{[4]
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- Keep in mind that impaired motor function can be a side effect of many other conditions, such as Parkinson's disease or ataxia.^{[5]
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Estimate the person’s size. Although alcohol affects everyone similarly, the speed at which it does so will be different based upon their physical characteristics. Size, sex, rate of consumption, the strength of each drink, the amount of food and the additional use of drugs all are to be considered when determining how quickly alcohol may be affecting someone.^{[6]
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- For example, a person who weighs 150 lbs. will feel the effects of the alcohol much more quickly than someone who weighs 250 lbs., even if they drink the same amount of alcohol. This is because the larger person can tolerate more alcohol since their body takes longer to process it.

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Recognizing the Behavioral Signs of Intoxication

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Watch for a person’s inhibitions to become lowered. If someone is becoming more talkative and beginning to lose some control of knowing how far he can go in a social setting, they are showing the first signs of intoxication. Louder behaviour than usual — and even mood swings — are also possible warning signs.^{[7]
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- For example, loud outbursts or inappropriate comments could be signs of intoxication.
- An intoxicated person may spend their money more freely than they usually would. With lowered inhibitions, people are more likely to focus on the good feeling that they get from drinking, rather than thinking about how they need to be responsible with their money. They might also buy drinks for strangers or acquaintances.
- Additionally, many people like to smoke cigarettes while they are drinking. Smokers usually smoke more when they are drinking, but many non-smokers will light up the occasional cigarette when they’ve been drinking.^{[8]
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  Research source} This is another sign of intoxication.
There are many signs of intoxication that you can spot just by paying attention to how someone speaks. If a person is speaking too loudly or too softly, then they are showing signs of intoxication.
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Notice if the person slurs their speech. Slurred speech is almost always a sure sign of intoxication. If you notice a person (your child, your customer, or anyone really) is slurring their words together, especially to the point where it is difficult to interpret exactly what they are saying, it is may be a sign of intoxication.
- Again, slurred speech can be a side effect of another condition or even a sign that someone is having a stroke. Don't automatically assume a person is drunk because they're slurring their words.
If a person is being combative with her words, speaking more slowly than usual, or repeating themselves a lot, these could be signs of intoxication. Watch for these verbal cues to determine if someone has been drinking too much.^{[9]
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Observe how the person interacts with others. As they become increasingly intoxicated, a person will progress through the stages of poor judgment. This is inappropriate behaviour that they normally would not engage in. Foul language, off-colour jokes, and overly flirtatious behaviour are signs of poor judgment, especially if these things are out of character for this person. Also, if their rate of consumption begins to increase or he participates in drinking games, these could also be signs of poor judgment.^{[10]
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- For example, inappropriate sexual advances, mean comments, and unusually dirty jokes can all be signs of intoxication.
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Interpret the person's mood. People who are intoxicated often have wide mood swings —being happy and laughing one second, then crying and belligerent a few minutes later.^{[11]
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Mental Health Foundation
UK charity working towards good mental health for all.

Go to source} If their mood seems more exaggerated than normal (on either end of the spectrum), they might be intoxicated.
- For example, if someone is drinking and they seem to be in a good mood but suddenly starts crying, this could be a sign of intoxication.
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Look for clues in other modes of communication. Sometimes it’s important to be able to determine if someone is intoxicated even if you are not in the same room with them.
- Phone calls. An intoxicated person might call an old lover or call someone repeatedly (also known as ‘‘drunk dialing’’). Their inhibitions are lowered, so calling over and over might not seem disruptive or rude to them and so they may feel less accountable for their actions.^{[12]
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- Text messages. Signs of intoxication to look for in text messages include drastic misspellings, overly emotional pronouncements, or receiving a text (or a series of texts) at an unusually late hour.^{[13]
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Consider alcohol tolerance. Remember that people can develop a tolerance for alcohol, but that doesn't mean that they are not legally intoxicated. It just means that visual recognition is more difficult.^{[14]
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Research source} For some people with exceptional tolerance, drink counting may be the only way to assess intoxication but this is not without problems.
- If you are a bartender trying to determine whether you should keep serving someone alcohol or not, try to count the number of drinks the person has had. You can even ask one of their friends how much she has had to drink or how drunk the friend thinks the person is.

Part 3

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Helping Someone Who is Intoxicated

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Try to get the person to stop drinking. Once people drinking alcohol begin to show signs of physical impairment, first get them to stop drinking any more alcohol.^{[15]
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Research source} Some beginning signs of physical impairment are slurred speech, slow or clumsy movements, swaying, dropping objects (e.g., goods, money, keys) or forgetting thoughts in mid-sentence.^{[16]
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- To get someone to stop drinking, try talking to them calmly as a friend. Tell them that you think they may have had too much to drink and that you are worried, so it would make you feel better if they would quit drinking for the night. Appeal to their sense of friendship if you have to — that they are doing you a favour by not drinking anymore.
- If they refuse to quit drinking, consider taking more drastic measures. If you are in a bar, tell the bartender that you think the intoxicated person has been drinking too much and ask the bartender to quit serving them alcohol. If you are in a private space like a house, try to hide all the remaining alcohol. The drunk person will not be as observant as usual because of their dulled senses, so it should be relatively easy for you to hide the alcohol without them noticing.
If a person shows a loss of motor control, function, or poor coordination, they must not be left alone as they could become a danger to themselves or others. Stumbling or swaying, having difficulty with depth perception, and dropping things repeatedly or having difficulty picking them up are signs that the person has progressed to this level.^{[17]
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If you notice someone is very intoxicated and they are in a public place like a bar or restaurant, try to help them get home so he can go to bed and sleep it off. You can offer the person a ride yourself, call a cab for them, offer to call a friend, or call a drunk ride service if one is available in your area.^{[18]
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Drinking and driving is extremely dangerous — to the drunk driver themselves and to everyone who crosses paths with them. Sometimes people make poor decisions when they have had too much to drink, or aren’t able to correctly gauge their own level of drunkenness, so they choose to drive when they shouldn’t. To prevent someone from driving drunk you can try helping them get home another way, by notifying the bartender or the police, or even by stealing their car keys.^{[19]
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Make sure the person is safe. People can be a danger to themselves when they are intoxicated. This is especially true if the intoxicated person is well past the point of minor drunkenness. There are many dangers to be considered — for example, people have been known to die from choking on their own vomit while they were intoxicated. If the person is unable to sit up, make sure they are lying on their side so they won’t be able to choke if they vomit.^{[20]
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- If you see a person who is heavily intoxicated but this seems to be out of character for them, or notice they only had a single drink, it is possible that they have been roofied. This means that someone has slipped a drug in their drink (usually the sedative Rohypnol) that will cause them to lose some muscle control and, in effect, be unable to resist if he is assaulted.
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Seek medical attention if you think the person has alcohol poisoning. Alcohol poisoning is a very serious condition that results from drinking more alcohol than your body can handle. In a worst-case scenario, this can result in death. If you think someone you know has alcohol poisoning, seek emergency medical attention immediately. These are some symptoms of alcohol poisoning:
- Vomiting
- Poor coordination
- Confusion
- Slowed breathing
- Passing out
- Blue-tinted skin^{[21]
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Keep other causes in mind. There are a number of different medical conditions which may cause a person to appear drunk. For instance, someone suffering a stroke may have a drooping face, slurred speech, confusion, dizziness, difficulty walking, and so on.^{[22]
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Centers for Disease Control and Prevention
Main public health institute for the US, run by the Dept. of Health and Human Services

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- If the person displays symptoms of being drunk but has not been drinking, these signs appear out of nowhere, or you are simply unsure, you can perform a few simple tests to see if the person is having a stroke. Ask them to smile, to raise both arms over their head, and to speak a simple sentence. If part of the person's face droops or their smile is asymmetrical, if one arm seems to drift downward, and/or if they cannot repeat the sentence or seems to be searching for words, they may be having a stroke and needs emergency medical assistance.^{[23]
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  Centers for Disease Control and Prevention
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- A person with diabetes may display what could be interpreted as "drunk behaviour" when they are, in fact, experiencing ketoacidosis, which occurs when the body doesn't have enough insulin and there is a build-up of acids called ketones in the bloodstream. If you also notice the person has fruity-smelling breath and they have not been drinking fruit-flavoured drinks, they may be experiencing ketoacidosis and needs immediate medical help.^{[24]
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  Mayo Clinic
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- Disorders like Parkinson’s disease and ataxia affect movement and may cause a person to appear drunk or have difficulty maintaining their balance. Don't assume that someone who has difficulty keeping their balance is intoxicated.^{[25]
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How can you tell if someone is high on painkillers?

Tiffany Douglass, MA
Alcohol Treatment Specialist
Tiffany Douglass is the Founder of Wellness Retreat Recovery Center, a JCAHO (Joint Commission on Accreditation of Healthcare Organizations) accredited drug and alcohol treatment program based in San Jose, California. She is also the Executive Director for Midland Tennessee at JourneyPure. She has over ten years of experience in substance abuse treatment and was appointed a Global Goodwill Ambassador in 2019 for her efforts in residential addiction treatment. Tiffany earned a BA in Psychology from Emory University in 2004 and an MA in Psychology with an emphasis on Organization Behavior and Program Evaluation from Claremont Graduate University in 2006.

Tiffany Douglass, MA

Alcohol Treatment Specialist

Expert Answer

Signs that someone may be on painkillers include slurring their speech, difficulty keeping their eyes open, and falling asleep during regular activities. You might also notice that their work is suffering and they're leaving the house less often.

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Is cold turkey the best way to quit?

Tiffany Douglass, MA
Alcohol Treatment Specialist
Tiffany Douglass is the Founder of Wellness Retreat Recovery Center, a JCAHO (Joint Commission on Accreditation of Healthcare Organizations) accredited drug and alcohol treatment program based in San Jose, California. She is also the Executive Director for Midland Tennessee at JourneyPure. She has over ten years of experience in substance abuse treatment and was appointed a Global Goodwill Ambassador in 2019 for her efforts in residential addiction treatment. Tiffany earned a BA in Psychology from Emory University in 2004 and an MA in Psychology with an emphasis on Organization Behavior and Program Evaluation from Claremont Graduate University in 2006.

Tiffany Douglass, MA

Alcohol Treatment Specialist

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Not always. Talk to your doctor before you stop using substances to make sure you withdraw safely.

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When determining a person’s level of intoxication, the type of alcohol does not make a difference if it has been served in a measured dose. Alcohol is classified as a drug. The amount of alcohol in 12 oz. of a typical domestic beer, 5 oz. of wine, or a 1 oz. shot of 100-proof spirits or 1.5 ounces of 80-proof liquor is the same.^{[26]
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Research source} What is typically different with these drinks is the rate at which a person consumes them.

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If you're worried that someone has a drinking problem, avoid confronting them head-on and telling them they need to stop. Instead, tell the person how their drinking makes you feel so they're less likely to get defensive.^{[27]
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Try to be supportive if someone you know is struggling with a drinking problem. Recommend that they talk to a therapist and join a social support group, like Alcoholics Anonymous.^{[28]
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Warnings

In some states obvious intoxication means that if someone has consumed a large number of drinks, it should be obvious that they are intoxicated and not capable of driving. Other state laws define visible intoxication as specific types of behaviour such as trouble walking, slurred speech, and other common signs of alcohol intoxication.

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In most people, reliable signs of intoxication are present by casual observation at a blood alcohol concentration (BAC) of 150 mg/dl or more, even in most tolerant individuals.

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At a low BAC, signs of visible intoxication are not as obvious in most drinkers.^{[29]
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Research source} So, the likelihood of identifying signs of impairment is less likely.<

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John Brick, executive director of In toxin International, said that one of the deadliest consequence of alcohol over-consumption is impaired driving and it is still difficult for trained observers to fully identify "intoxication," given that so many factors contribute to it. "It is important to understand and recognize intoxication because of the risk for injury that results from it."^{[30]
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Anyone with an addiction who is trying to withdraw themselves from a substance, like alcohol, should talk to their doctor first to make sure they do it safely.^{[31]
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