Experts including Professor Sir Ian Gilmore, former president of the Royal College of Physicians, predict there could be 210,000 avoidable deaths in the next two decades if current trends continue.
The figures, for England and Wales, suggest 70,000 of the deaths could be from liver disease and the rest from accidents, violence and chronic illnesses such as high blood pressure, stroke, heart disease, breast cancer and cancer of the gastrointestinal tract.
The warning comes after Prime Minister David Cameron pledged last week to crack down on excessive drinking.
He promised to look at the issue of alcohol pricing and how hospitals were treating the effects of binge drinking.
Writing in The Lancet medical journal online, the experts said it remains "entirely within the power of the UK Government" to ease the country's drink problem.
But they criticised the Government's public health responsibility deal with drinks companies, saying it represents a conflict of interest, with firms actually wanting to "maximise" consumption of alcohol.
Their latest prediction is a slight improvement on the 250,000 avoidable deaths attributable to alcohol envisaged last year.
But signs suggest alcohol-related liver deaths - which represent around a quarter of all deaths from alcohol - are increasing following a dip, the experts said.
"The actual mortality over 20 years will not be determined by our modelling but by the effectiveness or otherwise of Government alcohol policy," they added.
"Unfortunately, the recent moderate improvement might be related more to the recession than to current alcohol policy; the fact that deaths increased during 2009/10 indicates there is no room for complacency.
"It remains entirely within the power of the UK Government to prevent the worst-case scenario of avoidable deaths."
The researchers said current Government policy "relies heavily" on alcohol firms and retailers voluntarily committing to reduce consumption and harm.
"Given that the primary requirement for these industries is to deliver shareholder value by maximising consumption, there is a fundamental and unspoken conflict of interest at the heart of this initiative.
"By contrast, the Scottish Government is pressing ahead with a raft of evidence-based measures to reduce alcohol consumption, such as banning special offers based on bulk purchase and instituting a minimum price per unit of alcohol."
The experts argued the UK is at a "potential tipping point in taking on the shameful, preventable loss of life caused by alcohol that so often affects younger people."
They acknowledged the "understandable concerns over the legal status of a minimum price per unit of alcohol and whether the general public is ready for tough action" on the widespread availability of cheap alcoholic drinks.
They added: "Can the UK Government, however, afford to duck effective action on alcohol that will have such a positive impact on crime and disorder, work productivity, and health?
"The UK Government will have to withstand powerful lobbying from the drinks industry, but the potential prize of reversing this tragic toll of alcohol-related deaths is there for the taking."
Public health minister Anne Milton said: "As the Prime Minister said earlier this week, we are determined to tackle the scandal of alcohol abuse.
"It costs the NHS £2.7 billion per year and in our forthcoming alcohol strategy we will set out our plans on how to deal with the wide range of problems and harms it causes."
Alcohol Concern chief executive Eric Appleby said: "What we have to accept is that doing nothing is no longer a responsible option for alcohol policy, and that trying to 'nudge' drinking culture through information and persuasion has proved little better than doing nothing."
Henry Ashworth, chief executive of the Portman Group, which represents the industry, said: "It is really important that we put this report in context.
"The vast majority of people drink responsibly."
He said "painting doomsday scenarios won't help reduce alcohol misuse", adding: "We agree with the Prime Minister that strong partnerships are essential to tackle the minority who use alcohol recklessly and drinks producers are committed to supporting this approach."
:: Tonight's Panorama: Britain's Hidden Alcoholics looks at the rise in drinking among Britain's middle classes.
In the programme Dr Nick Sheron says half the people he treats for cirrhosis of the liver are women.
Alastair Campbell, who talks of his own drink problem, says: "I think a lot of people who have a drink problem are very good at hiding it. I was good at hiding it for a long time."
He also questions whether the Labour government's 2005 relaxation of licensing hours may have contributed to the problem.
He adds: "I never really bought the argument that Britain would suddenly become a continental-style drinking nation.
"I think we have always had this tendency to, where there is drink, drink it and drink to excess."
Panorama: Britain's Hidden Alcoholics is on BBC One tonight at 8.30pm.
PA
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