Little is known about the effect of acculturation on patterns of alcohol use for migrants from Islamic countries. In a field study of Afghan migrants to Germany, participants who drink alcohol were screened with respect to alcohol use problems and then interviewed concerning patterns of use, mental health, and sociodemographic variables. Snowball sampling was used until 50 Afghan migrants with alcohol use disorders could be interviewed. A significant correlation was found between acculturation stress and mental distress, as well as between mental distress and severity of alcohol use. These correlations did not differ with respect to whether alcohol had been used prior to migration. The findings support the hypothesis of the effect of acculturation on problematic alcohol use. Acculturation needs to be focused on in the treatment of alcohol use disorders.