The Department for Health and Social Care, as the lead department, does not have sufficient understanding of total cost of alcohol harm. The harms to individuals and society that alcohol misuse can cause are well-known. Alcohol is linked to over 100 illnesses, can drive mental disorder, self-harm and suicide, and is a major cause of preventable death. The Office for National Statistics reports that in 2019–20 it was linked to 42% of all violent crime, up from 40% the previous year. Moreover, alcohol does most harm in the most deprived communities. Drinking patterns are also changing with the young generally drinking less and older people drinking more. Based on analysis dating back to 2012, the Department put the annual cost of alcohol harm to the NHS at £3.5 billion, and to wider society at around £21 billion (or around £25 billion adjusted for inflation). This analysis is over a decade out of date, and we are concerned that these estimates may not reflect the full scale of harm. The Department’s understanding of the prevalence of dependency also dates back to 2018–19. As overall owner for alcohol policy, it is for the Department to coordinate a cross-government effort to understand how and where costs are rising to inform an effective response. Recommendation 2: The Department should undertake the work necessary to improve its understanding of the up-to-date costs of alcohol harm to the NHS and wider society.