This retrospective study of 2,648 emergency department visits found that self-reported readiness-to-change scores from a Brief Negotiation Interview were strongly associated with 30-day treatment enrollment among patients with alcohol use disorder, with each one-point increase in readiness linked to roughly 16% higher odds of enrollment. The authors conclude that incorporating readiness-to-change assessments into routine ED workflows could help guide referral strategies and improve linkage to alcohol treatment.