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Characteristics associated with intention to change drinking were examined in 254 adolescents treated in an emergency department for alcohol. Younger age, living at home, lower baseline level of drinking and drinking problems, greater depression, having penalties for breaking family drinking rules, higher injury severity, being frightened, and being admitted to the hospital predicted greater intention to change drinking at the time of the event. Baseline characteristics related to being in the action stage of change 3 months later were younger age; lower drinking; having penalties for breaking family drinking rules; injury severity; and number of anticipated consequences, including being in trouble with parents. This study has implications for brief interventions that capitalize on potential teachable moments with problem-drinking adolescents.