During a recent twelve month period, 46 subjects injured from causes unrelated to road trauma were studied. Twenty-four control patients showed no evidence of alcohol impairment while all patients in the study group had a BAC > .10 vol% (mean 0.18). There were more serious traffic violations among the alcohol-impaired group, including reckless driving and crashes causing bodily injury and property damage. Eleven of 24 alcohol-impaired subjects had eighteen previous citations for driving under the influence of alcohol while there were none in the controls (p < .001). Alcohol related non-vehicular trauma is highly predictive of alcohol-impaired driving and suggests that the pattern of alcohol-related activity is constant across social situations. There is an urgent need for both increased recognition and improved treatment of the alcohol dependent trauma victim regardless of the etiology of injury.