Alcohol treatment gap among US college students

College students are heavy drinkers who experience serious alcohol-related consequences, yet little is known about their need for or use of alcohol treatment services. We use data pooled from four administrations of the Harvard School of Public Health College Alcohol Study to estimate the national prevalence of alcohol treatment need, seeking, and use, and examine individual and college-level correlates for each. We estimate that 21% of all students meet DSM-IV alcohol abuse disorder criteria, indicating potential need for treatment or help services. Of these students, 7% received treatment and 3% reported voluntarily seeking treatment. Colleges with a high proportion of students who met alcohol abuse criteria also had high drinking and binge drinking rates. Students who may need treatment were more likely to begin drinking, smoking and using marijuana before age 16. Most students who sought treatment received it (67%). Among those who met abuse criteria, students who received treatment were likely to report trouble with the police and being referred to treatment than those who were not. Students with strong peer social connections were less likely to seek or receive treatment, while those with adult social relationships were less likely to abuse alcohol and more likely to seek and receive treatment if they did. A large alcohol treatment gap exists among college youth, with potentially more than one million students annually having unmet treatment needs. Further efforts to identify students in need of help and provide resources to support treatment capacity in college are needed.