Health secretary Jeremy Hunt said he had a “great deal of sympathy” for the idea of charging alcohol-related admissions money if they end up in A&E units.
He acknowledged that there were practical difficulties in introducing a charge, but insisted that people should be made to take responsibility for their actions.
Taxpayers should not have to foot the bill for people who had gone “over the top” on a night out, he said.
He said: “I’ve always had the same view, which is basically that people should take responsibility and if it’s through irresponsibility that they are costing all of us more as taxpayers then I don’t have sympathy.
“It’s practically very difficult”
“There’s a lot of people in the NHS we want to spend money on but we can’t because we have limited resources.”
He told LBC Radio: “I have a great deal of sympathy for the people who say we should charge people who use A&E because they go over the top on a Friday or a Saturday night.
“I don’t see why we, as taxpayers, should be funding that.
“I think the difficulty is actually distinguishing between the people who end up in an A&E department - perhaps they have been abused, they come from a troubled family - and the heartbeat of an A&E in any hospital, rightly, and I think everyone understands this, is they treat sick people who arrive in an emergency situation as quick as possible.
“So it’s practically very difficult. But if you are asking me, in terms of am I sympathetic with the sentiment, if there was a way that you could actually identify people who had been irresponsible, I would be open to it.”
Mr Hunt acknowledged that emergency departments were under a “lot of pressure” but “the real pressure is coming from vulnerable older people because of the ageing population”.