Introduction: Excessive alcohol consumption has been recognized as a threat to the national security of the Russian Federation. Challenges in studying volume and pattern of alcohol consumption, registration and identification of cases of alcohol-associated deaths are among the reasons for insufficient data for prevention of alcohol-associated deaths. Decision-makers should be aware of alcohol-attributable mortality in their federal subjects to develop region-specific prevention programs. Aim: To study temporal trends in blood (urine, muscle) alcohol concentration using the data from forensic autopsy protocols from 2007-2018 in the Sakha (Yakuta) Republic, North-Eastern Russia. Methods: Data on blood (urine, muscle) alcohol concentration (BAC) were obtained for all autopsied individuals in 2007-2018 in the Sakha Republic using medical documentation from the Republican Forensic Bureau. Temporal trends in average concentrations were assessed using Jonkheer-Terpstra tests. Ordinal variables were studied with ordinal regression models. Poisson models were applied for the analysis of time trends for binomial outcomes. Results: The proportion of individuals with BAC between 3.0 and 5.0 % and more than 5.0 %) decreased 25.3 % to 18.0 % (p < 0.0001). Decreasing trends of average BAC in both men and women were observed. The proportion of deceased with BAC > 0.3 % decreased on average by 34.8 % being more pronounced among the women. Conclusions: Our finding suggest a gradual decrease in average blood alcohol concentrations as well as in the proportion of deceased with high and lethal BAC in autopsied individuals in the Sakha (Yakutia) Republic over the study period. More pronounced decrease was observed among the women. Our findings should be generalized and interpreted with due caution taking into account the limitations of the forensic autopsy study design.