Alcohol is one of the most important risk factors for disease and disability, with a strong association found between alcohol and injury. Two recent international studies have analysed the involvement of alcohol in injuries, taking into account contextual variables. Blood alcohol level (BAL) positive patients and those reporting drinking before the injury were more likely to be admitted to the emergency department (ED) with an injury compared to a non-injury problem, and detrimental patterns of drinking predicted the individual’s alcohol-related risk and the likelihood of attributing the injury to alcohol. Emergency departments are in a privileged position to identify and intervene with patients who are at risk or have developed problems because of their drinking, for these patient find themselves in a teachable moment after the critical event. Different screening instruments have been investigated for identifying alcohol use disorders in emergency department patients. The RAPS4-QF (Rapid Alcohol Problems Screen, 4 items + 2 quantity frequency items) is proposed for its optimal performance at the ED setting. A number of studies have shown good results of brief intervention among these patients. Most studies show a significant reduction in the consumption of alcohol, although not always significant compared with control patients, and a significant reduction in alcohol-related problems (e.g. new injuries and hospital admissions) compared with controls. Nevertheless, early identification and brief intervention are still a pending subject in emergency departments throughout the world.