People may have to pay for the costs they incur to the state while drunk if an "abuser pays" system recommended by the Auditor-General is adopted by the NSW government.
According to a report by NSW Auditor-General Peter Achterstraat released yesterday, alcohol abuse costs NSW $3.87 billion every year, or the equivalent of $1565 from each household.
The report recommends the government recover some of those costs incurred by the police, hospitals, emergency services and other bodies.
"Where appropriate, alcohol abusers should pay for taking valuable resources away from more pressing work," Mr Achterstraat said.
The report commended the O'Farrell government for its efforts to reduce the harm caused by alcohol abuse, including public education campaigns and expanded police powers.
University of Wollongong academic Professor Sandra Jones, director of the Centre for Health Initiatives, welcomed the report, saying it was important to have up-to-date information to show the extent of the problem.
However, she questioned the report's focus on individuals and said the alcohol industry needed to be held to account.
"Most of the discussion has been around how can we penalise individuals," Prof Jones said.
"I'm not suggesting people shouldn't pay for the harm they cause. If you get drunk and commit an offence you should be punished and you should pay restitution.
"But there is just one throwaway sentence in there about the alcohol industry.
"Industry seems to have an awful lot of influence on the decisions that are made in this country."
Prof Jones said education campaigns and beefing up police powers were less effective than other approaches.
"If you want to reduce alcohol-related harm you do three things: make alcohol more expensive; make it less available, so fewer outlets and shorter opening hours; and you eliminate alcohol advertising, including sponsorship of sport," Prof Jones said.
"It's really easy to say those people over there have a drinking problem and we just need to fix those people and the rest of us are OK.
"It's harder to say as a culture we need to look at the way we are drinking.
"We need to look at the fact that our 15 and 16 year olds are growing up in an environment where they see drinking as absolutely essential.
"We need to be having those conversations but governments don't like that and industry doesn't like that. It's much easier to blame individuals."