To assess the suitability of implementing secondary prevention approaches for alcohol abuse and dependence in the general hospital, it is worth examining how many problem drinkers are detected in this setting for the first time and whether these individuals are motivated to change their drinking behavior. In a representative general hospital sample (N = 1167), subjects were detected by a two-step diagnostic procedure including screening instruments and a diagnostic interview during a period of 6 months on all medical and surgical wards. Of alcohol-dependent patients, 38.2% had received no help in their lifetime and 70.8% did not seek help in the year prior to admission. According to the stages of change model of Prochaska and DiClemente the minority (10.9%) of subjects detected as alcohol dependent for the first time were not considering changing their drinking behavior (precontemplation stage); 84.8% were either in the contemplation or action stage. Previous help seeking showed no significant relationship with the stages of change.