The problem of alcoholism is relevant both in the 20th and 21st centuries. Alcohol dependence is one of the most difficult and dangerous diseases for humanity due to the enormous medical, social, moral, ethical, economic and spiritual losses. Alcohol damage is associated with medical expenses, decreased labor productivity, and premature death. Due to the scale of socio-demographic and economic consequences, alcoholism has been named by the President of the Russian Federation as one of the threats to national security in the field of healthcare and the health of the nation. In this regard, the issue of anti-alcohol policy of the state remains relevant. The article presents the dynamics of the prevalence of alcoholism in the Orenburg region for the period from 2009 to 2022 The purpose of the study: to analyze the dynamics of the prevalence of alcoholism among the population at the regional level (using the example of the Orenburg region). Research materials: the study used the forms of sectoral statistical reporting: form 11 "Information on diseases with narcological disorders", form 37 "Information on patients with alcoholism, drug addiction, substance abuse of the State Autonomous Healthcare Institution "Orenburg Regional Clinical Narcological Dispensary", and state reports of the Federal Service for Supervision of Consumer Rights Protection and Human Well-being across the Orenburg region. Results: According to Rosstat "Healthcare in Russia – 2023", from 2010 to 2021, the number of newly diagnosed patients with alcohol dependence decreased by 2 times from about 100 thousand to 53 thousand people, which is typical for the Orenburg region. According to the data of the State Autonomous Healthcare Institution "Orenburg Regional Clinical Narcological Dispensary (GAU OOKND), an important medical and social indicator in the region has been systematically decreasing - the number of people with alcohol dependence identified for the first time. During the study period, the incidence of alcoholism decreased by more than 1.9 times from 91.0 to 47.7 per 100 thousand. The growth rate was (-52.4%), the average annual rate of primary morbidity from alcoholism in the region was 50.2 per 100 thousand population. The prevalence of alcoholism decreased by 60.3% during the analyzed period. However, in 2020 - 2022, against the background of a number of reasons: the COVID–19 pandemic, socio-economic shocks and "increased geopolitical confrontations", an increase in the prevalence of alcoholism was noted from 598.0 per 100,000 population to 634.0 per 100,000 population by 1.1 times. In the structure of alcohol-related mortality among the population of the region, the following nosological forms should be distinguished: mortality from alcoholic psychosis, mortality from alcoholic liver disease, mortality as a result of alcoholic cardiomyopathy, mortality from degeneration of the nervous system, mortality caused by chronic pancreatitis of alcoholic etiology. The leading place is occupied by mortality as a result of alcoholic cardiomyopathy, the second place is mortality from alcoholic liver disease, the third place is mortality from degeneration of the nervous system, the fourth place is mortality from alcoholic psychoses and the fifth place is mortality caused by chronic pancreatitis of alcoholic etiology. Conclusion: The problem of alcoholism is a complex of social pathologies that affect the healthy functioning of society, and is more relevant than ever. All branches of the executive and legislative authorities, civil society, and public institutions should be involved in solving this problem, as it is not only a medical problem. Government policy plays a significant role in solving the problem of alcoholism. At the same time, the problem of child and adolescent alcoholism and female drunkenness remains unresolved. Today, one of the ways to overcome this plague is effective prevention and promotion of a healthy lifestyle. The adoption of legislative acts aimed at reducing the alcoholization of society and to introduce this indicator into the criteria for evaluating the activities of authorities. During the study period in the Orenburg region, there are trends towards a decrease in alcohol dependence, however, mortality caused by a number of causes from alcohol dependence is at a high level.