Various studies suggest that between 1993 and 2001, approximately 44 percent of college students were heavy drinkers, defined for men as five or more drinks in a row on at least one occasion in the past 2 weeks, and for women as four or more drinks. Although the percentage of students who have abstained from alcohol consumption increased from 16 percent in 1993 to 19 percent in 2001, the percentage of those who have engaged in frequent heavy drinking increased from 19.7 percent in 1993 to 22.8 percent in 2001. Additionally, students reported getting drunk more often in 2001 than in 1993. Drinking rates varied considerably on different campuses. Consequences of heavy drinking among college students include deaths and injuries from alcohol-related traffic accidents, unprotected sex, alcohol-related suicide attempts, alcohol-related health problems, and property damage. Students who abstain or are moderate drinkers are also frequently negatively impacted by the behavior of drunken students, including distractions that interfere with studying and sleep, arguments, property damage, and acquaintance rape. Although college students use illegal drugs at much lower rates than alcohol, illicit drug use has led to violence, sexual assault and rape, hospitalization for overdoses, and premature death. To address the problems associated with alcohol and other drug abuse, many campuses and communities have initiated comprehensive prevention approaches that go beyond traditional education programs to include strategies designed to change the physical, social, legal, and economic environment on campus and in surrounding communities. College presidents should assume the leadership in bringing together faculty, administrators, staff, students, parents, alumni, and local community residents to develop and implement effective policies and programs that prevent the abuse of alcohol and other drugs as well as the behavior related to such abuse. 21 references and descriptions of 5 organizational resources