This paper focuses on structural changes in alcohol consumption observed in Russia since the late 20th century. It explores the Soviet structural patterns of alcohol consumption shaping in the 1960–1980s. Governmental attempts to combat illegal production and sales of homemade distilled spirits (samogon) are overviewed. We analyze how the Soviet drinking patterns were broken down by two exogenous political and economic shocks and how the new trends in consumption of manufactured and homemade alcohol emerged in the 2000s. We also discuss an impact of the ongoing anti-alcohol campaign on changes in alcohol consumption. Three complementary data sources are used. They include the Rosstat official statistics on the level of alcohol consumption, expert statistics on illegal alcohol consumption in the Soviet period, and data on percentage of drinkers of main alcoholic beverages collected from the RLMS-HSE nationwide panel survey of individuals aged 15+ years in 1994-2015. Both statistical and survey data demonstrate similar trends. We observe recurrent cycles in consumption of licit and illicit alcohol that may move in parallel or in opposite directions in different periods of time. These changes in alcohol consumption are explained by the combined impact of economic and policy factors that may vary over time. The new trends were interrupted, and new patterns of alcohol consumption emerged in Russia in the 2010s. These patterns are not sustainable yet. However, they gradually move away from the traditional Northern style of drinking.