Do No Harm: The Evolution of Harm Reduction in Nightlife Culture

Consumption is a fundamental aspect of nightlife culture. Food and entertainment are two of the main lures that attract patrons into bars and clubs, but the use of alcohol and other drugs plays a role as well. The use of any intoxicant carries risk of overconsumption and responsible venue owners, city planners and public health departments work together to reduce that harm. 

However, with the case of illegal drugs, venue owners are often unable to address these harms because they are afraid to address the consumption itself.  Nightlife regulatory policies, reflective of this country’s prohibition-based War on Drugs policies, make it impossible to admit drug use occurs in nightlife venues without risk of police scrutiny, fines or closure. In this case, it is not just the over consumption of illegal drugs but the policies themselves that cause harm.   

The struggle to reduce the harms of drug use as well as ineffective drug policies is being led by the Drug Policy Alliance (DPA). Over the years, DPA has worked on the legislative and policy level to develop alternatives to destructive drug war policies. By working with high profile supporters like Russell Simmons, Arianna Huffington and Sting and creating programs that are grounded in science, compassion, health and human rights, DPA has promoted change on local, state and national levels. Thanks to the work of advocates at DPA like Stefanie Jones, nightlife is becoming the next arena for education and change with three upcoming events:

1)    Ms. Jones and Dr. Brenda Miller will be conducting a webinar with the Responsible Hospitality Institute at 4:00 pm on Tuesday, March 26^th to discuss various aspects of harm reduction in nightlife including patron education and amnesty bin programs that allow patrons to surrender illegal substances when discovered in a search instead of being arrested.  The goal of the webinar is to foster a less antagonistic relationship between patrons, police and club owners in relation to alcohol and other drug use.

2)    DPA, in cooperation with the Columbia University Students for Sensible Drug Policy will be hosting a free panel discussion at 7:00 pm on Wednesday, March 27^th entitled The Truth About Molly that aims to dispel the mythology about a drug that is becoming more popular in urban culture and entertainment.

3)    Finally, DPA is working with organizations like Dance Safe and the San Francisco Entertainment Commission to produce a three day conference called Club Health San Francisco 2013 from May 28-30. The Club Health conference will bring together experts from around the world to discuss increasing harm reduction, decreasing violence and improving the safety of nightlife culture across the board.

The relationship between alcohol and other drug consumption and nightlife culture is diverse and complicated. Each sub culture faces different challenges associated with the different substances found in each setting. It will take a substantial amount of effort and political will to alter the impact of over consumption and misguided policies, but the events that DPA is hosting and the focus of people like Ms. Jones builds a solid foundation for expanding harm reduction practices and bringing the potential for policy change to nightlife culture. 

Dealing with Drunks Part II: Your Friends

In part 1  of our guide to dealing with drunks, we gave you tips on how to handle intoxicated strangers. Now let’s get to a more delicate subject; dealing with your drunken friends.

When your friend, date, client or family member is the drunk, it’s rude to just hand them over to the bouncer and keep on drinking like we did in part 1. It is a major undertaking to save your personal drunk from himself. Shepherding a drunken companion is a sign of true friendship, but if everything turns out ok, it is also great ammunition for funny stories later. 

Once you look over at your friend and realize they need help, focus on controlling their consumption, shielding them from danger and monitoring them for more serious conditions. 

Controlling Their Consumption:

The first thing your drunken friend probably wants is another drink. This is a bad idea, but as we saw earlier, logic is not the strong suit of a drunk person. Wikihow offers some suggestions on how to give them drinks without giving them drinks: If they demand another drink, try to give them harmless drinks. Try water, a very watered down version of their drink or just a soft drink. Depending on how drunk they are, you can simply hand them a coke and claim that it contains vodka. Unless they have very sensitive drunken palettes, they might not notice, especially if you're distracting them (hint: distracting a drunk is normally easier than distracting a sober person.) Don't give them a lot of stimulating drinks such as tea or coffee since this can accelerate dehydration. Don't force a drunk person to eat, since it could create a choking situation.

Shielding Them from Danger:

Your friend needs protection when he is drunk because he can’t do it himself. First, you need to make sure he doesn’t engage in risky behavior including driving a car, fighting with other people or trying to make out with random individuals. Do your best to help your drunk avoid physical injury, especially through falling. Nicole John is the most extreme example of this hazard, but even a fall on the dance floor can be dangerous. Help them find and stay in a safe seat or even sit them the floor. It’s not the cutest look, but they can’t fall very far if they are already on the floor. 

If your drunk needs to visit the bathroom, accompany them and wait for them to make sure they don’t slip and bang their head on the toilet. Above all, don’t leave them alone to sleep it off in any venue. They could be molested, robbed or snatched from the venue by a stranger.

If it is possible, try to deal with your drunk’s personal effects after your drunk is safe. Make an effort to find their phone, make sure their tab is closed and collect whatever clothing or accessories they discarded in their travels.

While you are looking out for your drunk, don’t forget to look out for yourself. Avoid saying anything that could provoke or anger the intoxicated person, since you don’t want to fight with the person you are trying to help. Do not try to physically lift a drunken person or stop someone much larger than you falling down–you may injure your back. Instead, concentrate on protecting their head. If you need help to help your drunk, look for security. It might be embarrassing for your drunk, but it is better to ask them for help than to have them kick you out when your drunk gets out of hand. Besides, a little embarrassment is a small price to pay to avoid more long term problems. 

The final step in shielding your drunk from danger is getting them out of the venue and back to a place where they can safely wait for their hangover to arrive. That could be their place, your place or any place where they can crash. Your social relationship might prevent you from monitoring them after they leave the venue, but in extreme cases it is advisable to keep an eye on them.

Monitoring Them for Serious Conditions:

Once you make sure your drunk isn’t continuing to drink, fighting with the bouncers or sleeping in the street, you have to make sure they are resting safely. It helps to lie them down in a recovery position (on their side with the higher knee bent) to prevent choking. Put something behind their back to prevent them rolling onto their back or stomach because vomiting in either position can cause them to choke or drown. Just because Jimi Hendrix did it doesn’t make it cool. 

As they sleep, look for signs of alcohol poisoning including: 
● abnormally slow breathing 
● unresponsive to being prodded and pinched firmly
● blue lips and fingertips 
● rapid pulse 
● vomiting while asleep and not waking up even when vomiting 
● cold clammy hands/ feet

If your friend starts to exhibit these symptoms, then it is time for you to stop helping them and time for medical professionals to start. Call 911. High levels of alcohol poisoning can lead to respiratory failure, coma or death.

NCI is offering these tips with the understanding that it is not medical advice. Hopefully these tips can help you and your drunk get through the night so everyone can live to drink another day. 

Have fun.
G

Dealing with Drunks: A Practical Guide

 

Drinking is good. Getting drunk is not good, especially when you’re feeling the effects the next day. Dealing with a drunk isn’t much fun either. Unfortunately, if you go out at night there is a good chance that you might encounter a drunk. It can happen in any type of venue, no matter how high class or low key. This doesn’t mean that your night is automatically ruined. As a nightlife native, there are a few things you can do to contend with any drunk that crosses your path or stumbles into your table. 

Are You OK?

The first tip for any nightlife native is responsible indulgence. The whole point of nightlife is going out for pleasure. But if you drink so much that you pass out, you can’t successfully deal with a drunk. In fact, you become the drunk that someone else has to deal with. So the goal here is to drink, but not get drunk.

The second tip is choosing the right approach for the particular drunk that you encounter. People often identify several different types of drunks with labels that remind you of the Seven Dwarves. There are sleepy, happy, angry, flirty, loud, friendly and sad drunks. These tips don’t deal focus on those specific personality traits. Your objective is to have fun, not try to understand the drunk’s underlying emotional issues. For our purposes, there are only two types of drunks; strangers and friends.

What to Look For

No matter what type of drunk you are dealing with, you have to be able to recognize them first. 
The editors at Wikihow offer the following signs that a person has had too much to drink: 

● slurred speech 
● inability to stand or sit up straight 
● a strong desire to lie down or roll over 
● stumbling or a questionable walking technique 
● unusual, loud, or embarrassing behavior 
● violent reactions 
● bloodshot eyes

Keep in mind that a display of any single behavior does not indicate drunkenness. We all have friends who do some of these things even when they’re sober. Also, this is not an invitation to play watchdog and stick your nose in everyone’s party. Just know that a combination of these or other behaviors in your general vicinity is a clue that you might have to use your anti-drunk skills.

Do I Know You?

Dealing with Strangers: When drunken strangers rain on your parade, you’re probably not interested in taking care of them any more than you have to. While you might decide to get involved in extreme cases, your main goal is normally to remove them from your space and continue your fun. 

This is more complicated than it sounds, since it is difficult to have a logical conversation with a drunk. It is usually counterproductive to argue with or try to bully someone who thinks they are stronger, faster and smarter than they really are. 

There are two keys to distancing yourself from a strange drunk. First, isolate them. This could mean moving out of their general area, misleading them into leaving your space, or enlisting the drunk’s friends to collect their associate and move him for you. The second key is to notify someone who works in the venue that the drunk is wandering around, since isolation is only a temporary solution. Any drunk who leaves could easily come back. 

If you are the type of person who doesn’t like to get other people into trouble by calling the bouncer, keep in mind that you are helping and not hurting the drunk in this situation. Operators often have more training and experience in dealing with drunks than you do including TIPS (Training for Intervention ProcedureS)  and Nightlife Best Practices. It is actually their job, not yours, to deal with drunks in the club. Finally, if the drunk could potentially endanger themselves or someone else, then you could be preventing a problem before it happens. 

Again, this is not a suggestion that antagonize everyone in the bar with aggressive attempts at drunk control. It is a concept to help you go back to your enjoying your evening with as little hassle as possible. 

In part two of our drunken guide, we will tackle the delicate situation of dealing with one of your friends when they get drunk in public.

Have fun.
Gamal