It is important to estimate real alcohol consumption in Russia in the past 15 years because large quantities, and in recent years the bulk, of consumed alcohol evades state registration. In this study, trends in total consumption are estimated indirectly using an indicator of alcohol-related harm derived from forensic reports on accidental and violent deaths (Nemtsov, A.V., 1998. Anti-alcohol campaign, consequences, and actual alcohol consumption in Moscow, Addiction, in press). Using blood alcohol coefficients (BAC), the regression coefficients are estimated using the ratio of BAC-positive and BAC-negative accidental and violent deaths in 1983-1986 in connection with the Moscow anti-alcohol campaign; the coefficients are then used to estimate consumption as a total sum of legal sales of alcoholic beverages and illegal spirits made from sugar. Data were obtained of violent BAC-positive and BAC-negative deaths in 17-25 oblasts of Russia in 1981-1994. The derived estimates indicate that in 1984 consumption exceeded 14 l per capita, per annum (10.5 registered + 4.2 unregistered); that consumption fell to 10.8 1 in 1986 (during the anti-alcohol campaign), and that it then began to rise owing to a sharp increase in estimated unregistered alcohol consumption-climbing to 13.6 l (5.0 + 8.6) in 1993, and followed by a slight decline to 13.3 in 1994. These estimates are broadly consistent with estimates that have been made using unrelated methods, thus allowing some confidence in the overall picture obtained. Russia probably remains one of the heaviest-drinking countries in Europe. The reasons why indicators of alcohol-related harm in the mid-1990s exceed those recorded before the anti-alcohol campaign remain to be clarified.