Drug and alcohol problems are increasingly important factors in emergency health services. Unless recognized and treated early, substance abuse will likely lead to repeated medical, psychiatric, and surgical emergencies. Each emergency room must develop procedures for detecting substance abuse. Emergency room personnel must also acquire clinical skills and knowledge for the early diagnosis of substance abuse. Acute medical management of emergencies associated with alcohol and drug abuse must be promulgated, since many nurses and physicians have limited knowledge regarding the management of acute intoxication, overdose, withdrawal conditions, and complications from alcohol and drug abuse.