A high proportion of patients seen in clinical practice have an underlying alcohol problem. This is often difficult to detect, but failure to make the diagnosis may result in unnecessary investigations and inappropriate treatment. Furthermore, there is now good evidence of the effectiveness of brief intervention for problem drinking when it is still at an early stage. Several questionnaires and procedures based on clinical examination findings and laboratory tests are available to help in early diagnosis. They can be incorporated into the standard medical assessment and form the basis for screening programs for health risk factors.