A six-month retrospective review of all patients arriving at a general hospital emergency room (ER) with a complaint involving alcohol use was completed to assess the level of care. Although 28% of all patients evaluated in the ER were Black, 70% of the 870 patients with a chief complaint involving alcohol were Black and Hispanic. Twenty-nine percent (254 patients) of the sample left without being evaluated by a physician. The majority of the sample met the definition of a "skid row" alcoholic. An ER-based alcohol treatment unit was proposed to better coordinate the care of alcohol abusers and alcohol dependent persons. A state statute was identified which facilitates the entry into alcohol treatment of this alcohol-dependent population.