The blood-alcohol limit for all drivers would decrease from .05 to .02 and then to zero, while the legal drinking age would rise and governments would further restrict the trading hours of licensed premises and bottle shops.

The dramatic crackdown is being proposed by the Royal Australasian College of Physicians, which has submitted a string of recommendations to a Senate inquiry on drunken violence.

RACP president Nicholas Talley said it was imperative the government adopt the recommendations in full to "bring about a shift in the Australian drinking culture" and reduce the "undeniable and substantial" harms caused by alcohol.

"Australians have a culture of alcohol – that's fine, but we also have a problem with alcohol," he told Fairfax Media.

The proposed regime recommends:

• The legal age for buying takeaway alcohol should be raised immediately, ahead of a public debate about lifting the drinking age
• State governments should ramp up last drinks and early closing laws such as those implemented in NSW, including shorter trading hours for bottle shops and bars
• Local councils should be given the power to reduce the number of licensed premises in their communities by challenging existing liquor licences and implementing caps on the number of bars
• Sports sponsorship by alcohol companies should be banned, as a precursor to a total ban on advertising alcohol to young people
• Alcohol packaging should carry warning labels, akin to cigarettes, under the Australia New Zealand Food Standards Code

The RACP also urges that all pregnant women receive screening for alcohol use, and calls for "brief intervention" for pregnant women and high-risk drinkers.

Dr Talley said this would involve making rehabilitation services more widely available, rather than involuntary rehab as advocated by Senator Jacqui Lambie.

The submission reaffirms the medical establishment's support for volumetric taxation of all alcohol, and the imposition of a minimum price per standard drink to be set by the states and territories.

Many of the recommendations are mirrored in submissions from other groups including the Victorian Alcohol & Drug Association, the Police Federation and the McCusker Centre for Action on Alcohol and Youth.

Independent Queensland senator Glenn Lazarus established the inquiry into the "need for a nationally consistent approach to alcohol-fuelled violence" after the one-punch death of 18-year-old Cole Miller in Brisbane. Senator Lazarus' son was also the victim of a glassing attack last year.

The push comes despite risky alcohol use and risky drinking being in decline in Australia. Apparent alcohol consumption last year fell to a 50-year low of 9.7 litres, according to the Australian Bureau of Statistics.

Meanwhile, the Australian Institute of Health and Welfare's authoritative survey on drug use found that from 2010 to 2013, the number of drinkers aged 14 and over who exceeded the lifetime guidelines for alcohol consumption fell to 18.2 per cent from 20 per cent. Those engaging in binge drinking at least once a month dropped to 26 per cent from 29 per cent.

The number of people who reported being a victim of an alcohol-related incident, including verbal abuse or being put in fear, also fell to 26 per cent from 29 per cent.

Dr Talley acknowledged there was "some dispute about the numbers" but said the level of harm arising from alcohol misuse in Australia was "still way too high". The RACP paper cited studies estimating the social cost of alcohol misuse in Australia was between $15 billion and $36 billion, accruing largely from healthcare costs, road accidents and lost productivity. Each year, 5000 deaths were attributable to alcohol misuse, along with 150,000 hospitalisations, Dr Talley said.

One of the more audacious ideas in the RACP's submission is to empower local governments to reduce the number of licensed premises in their area by challenging liquor licences – effectively giving councillors the ability to shut down venues.

"That's a challenging recommendation but yes, we would like to see that looked at," Dr Talley said. "We don't believe it's appropriate to do nothing. The harms from alcohol remain very significant and we're not doing enough about it."

Liberal Democrat senator David Leyonhjelm, a self-described libertarian who is conducting an inquiry into matters around personal choice, labelled the proposed regime "nanny state central".

"I think Australians are sick of people who consider themselves their superiors telling them how to live their lives," he said. "In a free society, harm is an inevitable consequence of adults making choices. You can't ever get zero harm."