Drunks should pay for the damage they cause and the resources they use, the NSW auditor-general says.
Alcohol abuse is "like a parasite drawing the lifeblood out of government services", Peter Achterstraat said in a report handed down on Tuesday.
He called on the state government to consider charging alcohol abusers for the $1 billion they cost taxpayers in state services each year.
It equates to $416 per NSW household.
"We've heard of the concept of user-pays. It might be time to consider the notion of abuser-pays," Mr Achterstraat told reporters.
"So people who are involved in drunken behaviour are asked to make a contribution to fix up the damage that they've caused."
He said if other costs such as lost productivity at work were included the total cost of alcohol abuse came to about $3.87 billion a year - $1565 per household.
NSW opposition leader John Robertson said he was concerned that the government's close relationship with the alcohol industry was preventing it from taking tougher action.
"The government has already dumped strict new measures around the sale and promotion of alcohol to young people," he said.
"Mr O'Farrell has also bowed to the pressure of Woolworths and Coles and cancelled the planned ban on shopper docket alcohol discounts."
NSW Greens MP John Kaye said the user-pay approach ignored the role that the alcohol industry played in encouraging people to drink.
Australian Medical Association NSW President Brian Owler said alcohol abuse was a massive burden on the health system.
"There are more than 1200 deaths from alcohol-related causes in NSW every year," Professor Owler said.
The Last Drinks Coalition, which aims to tackle alcohol-fuelled violence, said the report was a wake up call to the government.
"As if the human cost of alcohol-related harm wasn't enough, now the NSW Government has an economic reason to take serious action on alcohol too," it said in a statement.
