This case commentary involves a hospital-based managed alcohol program that uses a standardized protocol for administration of beverage alcohol (vodka or beer) in hospitalized patients with alcohol use disorder in an urban hospital in Canada. Issues of concern include addressing alcohol use during hospitalization directly with motivational interviewing instead of permitting consumption of alcohol, dangers of beverage alcohol in hospitalized patients, and risk of worsening alcohol withdrawal syndrome. Ethical principles are also briefly addressed as they apply to managed alcohol programs.