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1.
To consume alcoholic beverages. The term comes from twist off beer bottles. (verb, intransitive)
Sam is such an alcoholic that he has to wake up every couple of hours during the night to twist off because he starts to get too much blood in his alcohol stream.

"It's Friday evening 6:00 and all my friends are twistin' off." -Tracy Byrd, "Drinkin' Bone"
by Nick D February 04, 2004
 
2.
to punch someone.
mutha-fucka dissed me, i had to twist off on him.
by hannibal lickter April 03, 2009
 
3.
to get really angry, then explode
he finally twisted off and killed the bitch
by sayonaura April 20, 2004
 
4.
a twisting competition: roll a bunch of Ls while your homies roll a bunch of Ls as well. or should i say, try to roll them as well. some go for size, some for shear speed - all for aesthetics. twist offs either end with each person claiming they won for different reasons or simply by everyone smoking all the Ls and talking about how deece they all for said reasons. It would take a superior twister to earn mutual agreement if people were trying to judge.
nugpuffer1: 'twist off?'
nugpuffer2: 'so you think you know how to twist do ya?'

.....

nugpuffer1: 'man hurry up and finish im tryin to spark this shit'
nugpuffer2: 'man look at that weak ass shit - what is there like a g in there?'
by Persy Puffington the 1st July 19, 2010