Among U.S. adults, there are approximately 10 million dependent drinkers and 40 million at-risk drinkers. As many as 30% of the 100 million patient-visits to Emergency Departments (EDs) each year present with alcohol-related problems [20, 21]. The National Institute on Alcohol Abuse and Alcoholism (NIAAA) has designated April 10, 2004 as National Alcohol Screening Day (NASD), with the goal of NASD being to empower participants to reassess and change their drinking patterns to safeguard their health, and to get further evaluation and treatment. This proposal seeks to determine if the adoption of screening, brief intervention and referral to treatment for alcohol abuse (SBIRT) among ED providers will decrease at-risk drinking behavior at three and six month follow-ups. Coupled with the NASD ED Alcohol Education proposal (R25) for training ED physicians in the use of SBIRT, a before/after design will be used to determine the effectiveness of physician/nurse/physician assistant brief intervention for alcohol problems among ED patients. Using NIAAA quantity, frequency and maximum use (binge) criteria, we propose to screen at least 500 ED patients during two consecutive two-week periods. Patients screening positive (based on the NIAAA [unreadable] quantity, frequency and maximum use (binge) drinking criteria) will be asked to participate in follow-up. [unreadable] During the control period prior to NASD, ED patients screening positive will receive no intervention, only a printed handout of alcohol treatment resources. In the second or intervention period, ED patients screening positive will receive a list of alcohol treatment resources, a brief motivational intervention to reduce hazardous or dependent drinking and a referral to alcohol treatment resources. All patients will be followed and re-assessed at three and six months using a centrally managed interactive telephone interview. The main outcome measure will be self-reported alcohol using the NIAAA quantity, frequency and maximum use (binge) drinking criteria. Data analysis will be performed at the data-coordinating center. This proposal is designed to complement a proposal for NASD ED Alcohol Education, which will provide training resources for this project. This project is designed to increase provider awareness of NASD and increase the use of SBIRT within the ED. This proposal is designed to complement a proposal for NASD ED Alcohol Education, which will provide training resources for this project. This project is designed to increase provider awareness of NASD and increase the use of SBIRT. [unreadable] [unreadable]