INTRODUCTION: Emergency nurses could assume a unique role in the screening process and provide patient education regarding the consequences of harmful alcohol use. Screening, brief intervention, and referral to treatment is an evidence-based method used to identify drinking behaviors that may have a negative impact on people's lives and reduce abuse or dependence on alcohol. METHODS: A systematic review of the literature was conducted to evaluate both the effectiveness as well as the feasibility of nurse implementation of screening, brief intervention, and referral to treatment in the ED setting. RESULTS: The use of screening, brief intervention, and referral to treatment in the emergency department following nurse implementation resulted in a decrease in the drinking behaviors that may have negative effects. Emergency nurses were able to implement screening, brief intervention, and referral to treatment effectively, although some challenges occurred, such as nurse buy-in and limited funding support. DISCUSSION: The emergency department is an integral location for the implementation of screening, brief intervention, and referral to treatment because it can decrease injuries and readmissions due to the use of alcohol. Nurses play a key role in implementation because of their unique relationship with their patients. This review of the literature indicated that screening, brief intervention, and referral to treatment can be effective in the emergency department and successfully implemented by emergency nurses.