College student drinking to excess is a widespread national problem with serious consequences and it has been for a long time. Although the factors that have made the problem so intractable are complex, today based on scientific research results we have the potential to make real progress in controlling excessive drinking. In fact, a substantial body of research studies now offers direction on how to reduce excessive, underage, and high-risk college drinking. On the basis of this information, colleges and universities, communities, and other interested organizations can take steps toward positive change more confidently. Although significant information gaps remain, the science-based guidance now available means campuses and communities no longer have to "reinvent the wheel" when they try to address the problem. It also enables us to avoid inadvertently perpetuating ineffective programs and approaches. The availability of science-based guidance is a significant step forward because lack of information about what works and what does not has been a major obstacle to progress. On the research side, high-quality research has addressed only some of the issues of concern to college administrators and the practical implications of research results have not been widely disseminated. On the institutional side, most campus alcohol efforts have not been evaluated, which has hindered the effectiveness of individual campus efforts and slowed the growth of the knowledge base from which all could learn. Although the research base on college alcohol problems is limited, the panel of college presidents, students, and alcohol research specialists that contributed to this report identified a number of effective strategies that colleges and universities could confidently use today. These include strategies for changing the environment to discourage high-risk drinking, affecting the behavior of individuals and groups, creating comprehensive college-community efforts to combat the problem, and adopting effective approaches for managing program implementation. It is encouraging that many of these strategies require no new resources, are modest in costs, and can be accomplished by existing staff. From its review of the scientific literature, the Panel on Prevention and Treatment believes that adopting approaches with demonstrated effectiveness can begin to reduce high-risk college drinking and continue to advance knowledge by filling critical research gaps. The Panel recommends that the action steps and research needs described below receive priority attention from colleges and universities, researchers, the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and other potential funders, communities, and interested organizations. The Panel recommended more action steps in some areas than in others. This is primarily due to the amount of research available. Except as noted, approaches that have not been included in the recommendations are not necessarily ineffective. Often simply less is known about them. Among the "key research gaps" identified by the Panel is the need for rigorous testing of strategies now considered "promising" based on face value or common sense. As researchers rise to this challenge, the effectiveness of many of these approaches will become known.