Pharmacotherapy combined with medical management, an increasingly viable option for treating alcohol use disorders in health care settings, requires rapid and reliable diagnosis. This study explored a simple screening approach in persons with recent general hospital admission who participated in the National Epidemiologic Survey on Alcohol and Related Conditions reporting hospitalization during the past year (n = 4537). The survey included detailed assessment of alcohol consumption and full diagnostic assessment for alcohol use disorders. The sensitivity and specificity of 1 heavy drinking day question were estimated by using methods appropriate for complex survey data. Results showed that, among recently hospitalized persons consuming any alcohol in the past year, a response of at least 1 heavy drinking day during that time was 86% sensitive and 77% specific for current alcohol use disorders. The item performed better for alcohol dependence than abuse. False-negative screens were associated with older age and less alcohol consumption. Because of its brevity and compatibility with a typical admission history, the heavy drinking day item should be considered for screening current drinkers at the time of hospitalization. However, future research also should validate this screen at the point of care.