Tougher regulations limiting the sale of alcoholic beverages, as well as new taxes to pay for enforcement, are needed to combat abuse that threatens Marin County, an advocacy group asserted as it called for a crackdown.

A new report by Alcohol Justice suggests limits on new alcohol licenses “including conditional use permits, zoning restrictions … and mandatory local rules,” along with other measures including local alcohol taxes to boost enforcement of underage drinking laws.

“The most effective alcohol policies include limits on access to and availability of alcohol, including restrictions on outlet density, hours, and days of sale; increases in the price of alcohol through taxes; enhanced enforcement of underage sales laws, and restrictions on alcohol advertising and promotion,” the report concluded.

Alcohol Justice, an agency that gets about $1.2 million a year from the Beryl Buck bequest, seeks aggressive enforcement, including “retail compliance” with advertising, promotion and other regulations, and a ban on single-serve flavored malt liquor drinks dubbed “alcopops.”

Based on statewide cost figures and the county’s population, the report estimated the cost of alcohol-related problems in Marin at about $215 million a year, “including $92.2 million in direct costs to government.”

The agency’s report, titled “Marin County’s Alcohol Environment: Harm, Costs, Policies and Community Resources,” treads familiar ground in documenting problems in a region “saturated with alcohol.” It notes that with 924 licensed sales outlets including 488 restaurants and 83 bars, pubs or clubs, there is one vendor selling alcohol for every 280 Marin residents — and one location for every 67 youths.

The county has an “over-concentration of places selling alcohol, and ubiquitous access to cheap, youth-oriented products, creating an environment that surrounds youth with risk of alcohol-related harm,” according to the report.

In Marin County, the state and local governments “have allowed alcohol outlet density at rates four times more” than the state suggests is appropriate, Alcohol Justice said. “Nonetheless, additional alcohol licenses are approved every year,” according to the report, issued as controversy swirls in the Ross Valley about the Fairfax Theater’s application for a license to sell beer and wine.

The report recited a list of alcohol woes, noting that both adult and youth consumption rates in Marin are higher than the state average, generating problems including higher than average hospital admissions. It said 41 percent of high school juniors reported consuming alcohol in the past month — and 30 percent reported binge drinking. Ten percent of Marin’s auto accidents and 37 percent of fatalities are linked to alcohol.

“A notable exception to Marin County’s reputation of overall health is its high rates of risky alcohol use among adult and youth residents,” the report observed. “Between 2006-2012, the excessive drinking rate among current adult drinkers in Marin County averaged 22 percent, compared to 17 percent statewide, ranking Marin County 44th out of 51 counties.”

But by some measures, Marin is not much different from other regions in the state, the advocacy group conceded.

From 2008-2012, an average 11.26 alcohol-related deaths per 100,000 population occurred each year in Marin, slightly less than the state average. And from 2009-2013, Marin posted an average of 1,244 alcohol-related non-fatal hospitalizations each year, and 2,129 emergency department visits, with non-fatal hospitalizations slightly lower than the state average, and non-fatal emergency department visits 22 percent higher.

The average annual rate of alcohol-related crashes per 100,000 residents was 106.3 in Marin, lower than California at 113.6. And Marin County ninth-graders reported drinking at approximately the same rates as ninth-graders statewide.

The call for increased enforcement follows an unexplained dip between 2009 and 2013 in arrest rates in Marin and across the state for drunkenness and liquor law violations:

“For drunkenness and liquor law violations per 100,000 adults age 20 and older, Marin County dropped from 497 to 367, and California from 424 to 333. Among youth age 10-19, the Marin County rate decreased from 1144 to 194; statewide, from 417 to 223. For felony and misdemeanor DUI arrests per 100,000 population adults age 20 and older, Marin County decreased from 760 to 626; California from 756 to 557. For youth age 10-19, the Marin County rate dropped from 295 to 113; statewide, from 205 to 115.”

The report, complete with 29 footnotes detailing source materials, concluded with a list of ways residents can get involved in efforts to combat alcohol, including asking merchants to stop selling alcopops, reporting violations to authorities and checking in with resource and advocacy groups such as alcoholjustice.org

It was briefly outlined for county supervisors Tuesday as a parade of advocates appeared at open time to urge action.