In view of recent prevalence and other data regarding alcohol use by college students this article considers whether or not alcohol represents a problem or a changeable problem for these students and/or their colleges. On the one hand, drinking is deeply embedded in the traditions of college life; it does serve some beneficial purposes; and it is often regarded as an accepted, if not expected, part of adolescence. Furthermore, drinking behavior in college is a poor predictor of eventual alcoholism. On the other hand, both difficulty in identifying problem drinking and ambivalence over false positive diagnoses have contributed to a preoccupation with alcoholism, and a denial of subclinical or preclinical but nonetheless real problems. New ways of defining what constitutes an “alcohol” problem, as well as ways of remedying and preventing the problem are discussed. College health personnel are needed to continue their traditional diagnostic and referral functions, but must expand their roles to include involvement with other disciplines in proactive preventive and educational programming.