The World Cup is finally in Seattle, but so is record-breaking summer heat. If you’re hitting up fan zones or watch parties, attending the matches, or working/volunteering at the events, be aware of the “Triple Threat” of heat, alcohol, and substance use.

Alcohol & Drugs Mask Overheating

When you’re caught up in the energy of the crowd, it’s easy to forget that alcohol and drugs can wreck your body’s ability to handle high temperatures. They don’t just dehydrate you… they disable your internal thermostat.

• Alcohol: Accelerates dehydration, messes with your body’s temperature regulation, and impairs judgment so that you forget to do basic things like hang out in a shaded area or drink water.
• Stimulant Drugs (Cocaine, Meth, etc.): Just as the name implies, stimulants put your body into overdrive. Your heart rate, blood pressure, and core body temp all increase. Combined with hot weather, you can quickly cross the line from a high energy state to bad outcomes.
• Everyday Medications: A lot of common prescriptions and over-the-counter pills make you vulnerable to the heat.
  • Anticholinergics, including lots of allergy meds like Benadryl, decrease your ability to sweat.
  • Psychiatric Meds (SSRIs, SNRIs, and ADHD meds) interfere with how your brain regulates your core temperature
  • Diuretics: increase dehydration risk and cause you to lose your “thirst sensation.”
  • Sedatives: increase your risk of fainting or falling, decrease your thirst sensation
• Mixing: Using multiple substances at once multiplies the risk of severe heat injury and death.

Red Flags

The trickiest part about the Triple Threat is that substance impairment looks very similar to severe heat exhaustion. If someone is slurring their speech or acting confused, do not just assume they “had one too many.” They could be experiencing life-threatening heat injury.

• Heat Stress: muscle cramps, heat rash. Action: Get them out of the sun and focus on hydration.
• Heat Exhaustion: Heavy sweating, muscle cramps, severe fatigue, weakness, nausea, or a pounding headache. Action: Get them out of the sun and start cooling them down immediately.
• Heat Stroke – Medical Emergency: Confusion, slurred speech, rapid heart rate, shallow breathing, vomiting, seizures, or fainting. Crucial warning sign: If they are burning hot but have stopped sweating. Action: call 911!

Substance Complications

• Severe Toxicity/Serotonin Syndrome: If someone is experiencing extreme anxiety, agitation, hallucinations, rigid/shaking muscles, or seizures, call 911 immediately.

What to Do

If notice someone struggling, you need to act fast to prevent severe injury or rhabdomyolysis (muscle breakdown that leads to kidney failure).

• Strip their layers: Get rid of heavy jerseys, hats, or extra clothing.
• Active Cooling: Move them to an air-conditioned space or shade. Pour cool water over them or place ice packs on as much of their body as you can.
• Call for Help: If someone is losing consciousness, having a seizure, or their mental state is severely altered, call 911 or find stadium medical staff immediately. Let them know if you suspect the person is overheated so they can prepare ice baths.
• Watch for Downers: If someone seems unresponsive or you can’t tell if they are breathing, they may be overdosing from an opioid (like fentanyl). Administer naloxone and call 911.

Save our number: 1-800-222-1222

We’re free, confidential, open 24/7/365, and staffed by medical professionals (live doctors, pharmacists, and nurses, not AI). If someone took something, is acting strange, and you can’t tell if it’s the heat, the alcohol, or a bad reaction, call us. We’ll tell you exactly what to do.