This study presents an innovative analysis of the impact of harmful alcohol consumption on the Romanian health care system, being the first research of its kind identified by the authors. The results show that the health system annually manages about 70,000 alcohol-attributable discharges, generating more than 570,000 days of hospitalization. The profile of discharged patients shows a male predominance (80%), a high prevalence in people over 45 years of age (75%) and a balanced distribution between the residence backgrounds. A problematic aspect is that approximately 15% of discharged cases represent uninsured persons, creating difficulties in validating and reimbursing these cases. The research highlights alcohol as a major risk factor for the health of the Romanian population and emphasizes the need for functional changes in the health system to respond more effectively to the problems associated with harmful consumption. Many essential services to control alcohol consumption at the population level, including secondary prevention services for early identification of problematic consumption, are lacking. The added value of the study consists in: summarizing international policies relevant to Romania, comparative analysis of alcohol consumption at national and international level, highlighting the social, economic and medical impact of the phenomenon, quantifying the burden on the hospital system, estimating the costs of the health insurance system and identifying services that are either non-existent or not properly reported. The research paves the way for comprehensive studies needed to inform policies and services in the field.