Alcohol is putting the health of 10 million people at risk, according to a report that criticises health providers for failing to act.
The National Audit Office (NAO), the government's spending watchdog, says that 31% of men and 20% of women regularly drink above recommended levels.
It says that deaths from alcohol-related causes doubled to 8,758 between 1991 and 2006, as did hospital admissions for alcohol-related liver disease between 1995-96 and 2006-07.
It reports that primary care trusts spend an average of £600,000 a year on commissioning alcohol services, or £91m nationally, compared with the £2.7bn cost of alcohol misuse to the NHS.
A quarter of trusts had not fully assessed alcohol problems in its area, it said. Many do not have a clear picture on spending on treatments to address alcohol misuse and the knock-on effects on long-term health.
Tim Burr, head of the National Audit Office, said: "Primary Care Trusts need to understand better the scale of the problem in their local communities.
"With its increased focus on the prevention of lifestyle-related illness, the Department of Health could do more to convince trusts about the value of timely advice to help people develop safer drinking patterns."
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