Alcohol use is related to numerous health and social problems. The article describes the prevalence of alcohol problems and dependence across a county and its institutions. While high rates of problem drinking were found across health, mental health, criminal justice, welfare, drug, and alcohol programs, the proportion was highest for primary health clinics, the criminal justice system, and welfare agencies. This also was the case when the county’s most serious alcohol problem cases–individuals who were alcohol dependent–were examined. Thus it may be useful to develop screening procedures, mainstream treatment interventions in non-alcohol specialty agencies, and include non-specialty agencies in services research on access.