The problems that alcohol brings to society centre around the victims of accidents, poisonings and violence; the 'drinking casualties' of the title. This is also seen as an important area for the innovation and adoption of preventative strategies, particularly for environmental controls. Norman Giesbrecht examines systems of recording and analysing alcohol-related casualties, assesses current knowledge of the prevalence and aetiology of these cases and indicates how this information can be more effectively used to develop preventive policies and programmes.