When handling an intoxicated person, which of the following should you do

Alcohol dependence can be diagnosed when a person experiences any three of the following symptoms concurrently:

• The compulsion to drink;
• Loss of control while drinking;
• Alcohol tolerance;
• Alcohol takes priority over all other activities;
• Withdrawal symptoms are experienced; or
• The person keeps on drinking despite recognised harm.

If you suspect that you or someone you know has developed an alcohol dependency, it is very important that medical advice is sought. People who see a doctor for help to cut down on their alcohol consumption may benefit from the following:

• Your doctor will help you work out a drinking goal. It may take time to completely cut down, so it may be helpful to gradually cut down by setting weekly goals;
• Some people may benefit from seeing an addiction specialist;
• Some people may benefit from seeing a mutual help group; and
• For people highly dependent on alcohol, detoxification and medically-managed withdrawal may be necessary.

More information

References

1. Statistics on drug use in Australia 2006 [online]. Canberra, ACT: Australian Institute of Health and Welfare; April 2007 [cited 18 February 2011]. Available from: [URL Link]
2. Hungerford DW, Pollock DA (eds). Alcohol problems among emergency department patients: Proceedings of a Research Conference on Identification and Intervention, March 19-21, 2001, Arlington, Virginia[online]. Atlanta, GA: National Center for Injury Prevention and Control, Centers for Disease Control and Prevention; 2002 [cited 18 February 2011]. Available from: [URL Link]
3. Thygerson A, Gulli B, Krohmer JR. Chapter 18: Poisoning. In: First Aid, CPR and AED (5th edition). Sudbury Massachusetts: Jones and Bartlett Publishers; 2006. Available from: [Book]
4. Alcohol Alert 66: Brief interventions [online]. Bethesda, MD: National Institute of Alcohol Abuse and Alcoholism; July 2005 [cited 18 February 2011]. Available from: [URL Link]
5. Australian guidelines to reduce health risks from drinking alcohol [online]. Canberra, ACT: National Health and Medical Research Council; 2009 [cited 2 October 2010]. Available from: [URL Link]
6. Woolfenden S, Dossetor D, Williams K. Children and adolescents with acute alcohol intoxication/self-poisoning presenting to the emergency department. Arch Pediatr Adolesc Med. 2002;156(4):345-8. Available from: [Abstract | Full text]
7. Facts about alcohol poisoning [online]. Bethesda, MD: College Drinking Prevention; 11 July 2007 [cited 18 February 2011]. Available from: [URL Link]
8. Helping patients who drink too much: A clinician’s guide [online]. Bethesda, MD: National Institute of Alcohol Abuse and Alcoholism; 2005 [cited 15 February 2011].
9. Alcohol poisoning: How to help a drunk friend [online]. Davis, CA: University of California; February 2011 [cited 18 February 2011].
10. Conigrave KM, Proude E, Haber P, et al. Alcohol problems. Aust Doc. 27 May 2005;35-42.

All content and media on the HealthEngine Blog is created and published online for informational purposes only. It is not intended to be a substitute for professional medical advice and should not be relied on as health or personal advice. Always seek the guidance of your doctor or other qualified health professional with any questions you may have regarding your health or a medical condition. Never disregard the advice of a medical professional, or delay in seeking it because of something you have read on this Website. If you think you may have a medical emergency, call your doctor, go to the nearest hospital emergency department, or call the emergency services immediately.

To help bar staff develop skills to handle difficult situations when serving alcohol, we have developed the following training videos.

These videos simulate real-life situations commonly faced by staff at licensed venues. Shown from the perspective of a staff member, several different scenarios play out, showing the do's and don'ts of refusal of service and providing solutions to typical problems.

How to use the Behind the bar training videos

Use these videos to complement staff induction and RSA refresher training at your licensed venue or organisation. When the pause sign appears on-screen, pause the video and discuss with your group. Click on the discussion links following each of the videos for prompts to start a conversation about handling each of the situations.

You can also download Behind the Bar refusal of service signs and LCD images to display at your venue.

Think ahead

In this video the bartender is concerned with a patron's safety—she is consuming alcohol rapidly and may be alone. Although not making any trouble, she is showing clear signs of intoxication.

The bartender's thought is to slow her rate of alcohol consumption as the evening progresses and possibly prevent an unwanted situation from occurring. How would you deal with this situation?

Transcript of the 'Think ahead' video.

Download the 'Think ahead' sign to display back-of-house.

Discussion starters

(Download the 'Think ahead' discussion starters handout.)

• What signs of intoxication is the woman showing?
• Do you think she is unduly intoxicated?
• Do you have concerns with how fast she is consuming alcohol?
• A conservative approach is in the interests of all people concerned. There is no need to wait until a patron is unduly intoxicated, or close to being, before slowing down their alcohol intake.
• What is your method for slowing down a patron's consumption of alcohol?
• What is your responsibility in this situation?
• Would you have offered her water? How would you encourage her to drink it?

• Would you have a conversation with her to assess the situation further?
• Have you ever felt torn between what you think a patron's level of intoxication is and whether or not you should provide further service of alcohol? What did you do? Was it the right call at the time, or would you have done things differently in hindsight?
• Are you more inclined to continue serving alcohol to a patron who is not currently causing any issues, but who may be displaying signs of intoxication?

• What are your thoughts on the 3 possible scenarios you've just seen?
• What else could happen if the patron is served more alcohol?
• Have you or a colleague ever been in a similar situation?
• How would you deal with this situation?

• Are you clear about the approach you would take in this situation?
• Who is responsible for the patron's safety in and around the premises?
• What are you responsible for?

We all play a role

In this video, a group of patrons cannot be seen from the bar area, but the glassy observes them during his rounds. He notices the designated driver going to the bar to purchase drinks for his friends who are showing signs of intoxication.

The video highlights the importance of teamwork and communication among staff to ensure all areas of a licensed venue are monitored. How would you handle this scenario?

Transcript of the 'We all play a role' video

Download the 'We all play a role':

Discussion starters

(Download the 'We all play a role' discussion starters handout.)

• What did the glassy do well in this scenario? Would you have done anything differently?
• In relation to RSA, did you observe anything that may be cause for concern?
• Whose responsibility is it to monitor patrons throughout the venue?
• With regards to RSA within your venue, do you know your role to play?
• During staff briefings in your venue, are instructions to glassies/roaming staff different from those given to others?

• What actions would you take at this point?
• Would it have helped if the glassy had engaged directly with the patrons or made further observations subtly from nearby?
• When serving, or observing a round of drinks being served, how do you assess the intoxication levels of all patrons receiving the drinks?
• Are all staff at your venue empowered to make decisions regarding a patron's level of intoxication?

• How do you communicate information regarding patron behaviour between staff at each bar, room or area within your venue?
• Have you had a situation where you felt a patron should stop being served but you didn't know how to address the issue?
• What issues could arise if no action was taken?
• Would you have done anything different? Why?

• This environment was quite well lit with a low density of patrons. How would you deal with the challenges of working in a much darker, noisier and busier venue, with many areas out of sight from the bar area?

Just one more

In this video an unduly intoxicated patron tries several tactics to get served more liquor. How would you deal with this situation?

Transcript of the 'Just one more' video

Download the 'Just one more' signs and LCD images to display at your venue.

Discussion starters

(Download the 'Just one more' discussion starters handout.)

• What signs of undue intoxication is the young lady displaying?
• Would you have served her?
• Would you have considered cutting her off before this point?

• What are your responsibilities in this situation?
• Who is liable to be penalised if an unduly intoxicated patron is served alcohol?
• What else could result from serving liquor to an unduly intoxicated person?
• In your venue, how does communication between floor and bar staff help identify unduly intoxicated patrons?

• Would you have offered her a soda water at this point?
• Why do you think the bar attendant gave her a soda and lime instead of water?
• Was the refusal of service made clear?
• What different ways would you refuse someone service in this sort of situation?

• Was it made clear that she could remain on the premises until her transport was organised?
• What are some other excuses you have heard and how have you dealt with them?

• When ensuring the responsible service of alcohol and dealing with unduly intoxicated patrons, are your responsibilities different to the licensee's?
• If you were the licensee or manager of this venue, is there any other direction you would give bar staff around refusing service to unduly intoxicated patrons?

Tricky situation

In this video, club member Jim is trying to get his unduly intoxicated mate served more alcohol. How would you handle this scenario?

Transcript of the 'Tricky situation' video

Download the 'Tricky situation' signs and LCD images to display at your venue.

Discussion starters

(Download the 'Tricky situation' discussion starters handout.)

• Would you have refused service to any of these customers?

• What signs of undue intoxication was Jim's mate showing?
• When you serve a customer, how do you also assess the friends they are buying drinks for to ensure they aren't unduly intoxicated?
• What signs of intoxication, if any, could also be confused with disability?
• How would you have engaged with Jim to assess whether his friend did have a disability?

• How would you tell Jim that his friend needed to be put on water in this situation?
• Would you handle the situation differently if there was a larger group of friends with Jim at the bar?

• Should the fact that Jim is a club member change the refusal of service situation?
• Was the refusal of service for Jim's friend made clear?
• What are the maximum fines you and the licensee could receive for serving an unduly intoxicated person?

• Do you agree with giving Jim's friend the option to leave in a taxi?
• What are some strategies for dealing with aggressive patrons?
• If you don't feel confident dealing with an aggressive patron, what do you do?

• What else could happen if an unduly intoxicated person was served liquor?
• Overall, do you think the bar staff did a good job in identifying the signs of undue intoxication and dealing with the situation?
• Would you have done anything differently?

You should be familiar with the procedures your venue has in place to deal with situations where you need to refuse service. Talk to your licensee or approved manager if you're not sure.

Test your knowledge again by taking the unduly intoxicated patrons and the responsible service of alcohol online refresher course and quiz.

How do you respond to an intoxicated customer?

What are 3 types of assistance that can be given to an intoxicated person?

Which of the following should be done to an intoxicated guest?

Which 4 steps should staff follow to determine if a person is drunk?