This paper argues that the lack of a shared evidence base in the policy debate around alcohol control, and the failure to acknowledge this fact, creates a tendency to dismiss key bodies of evidence as irrelevant, to the detriment of public health approaches. Using examples from three policy processes, it shows that proponents of opposed positions deploy rival conceptualizations of “problem alcohol use” as the object of policy intervention. Using analytic tools from the philosophy of science, it argues that these conceptualizations correspond to distinct bodies of evidence, which are treated as incompatible. Finally, it points to institutional mechanisms through which the problem can be mitigated.