Our goal is to report relative risks of the impact of alcohol consumption six hours prior to medical emergencies presenting in the emergency department for 8,346 patients in seven countries using data from the Emergency Room Collaborative Alcohol Analysis Project. We found that alcohol increased the risk of a medical emergency by 2.17 times (Confidence Interval=1.78–2.65) and those without a regular pattern of heavy drinking and those younger showed greater risk. Acute alcohol is associated not only with injury but also with medical emergencies. More studies are needed on the acute role of alcohol in medical emergencies, preferably with data on type of medical emergencies.