The Annual Report of the North Dakota Higher Education Consortium for Substance Abuse Prevention (NDHECSAP) indicates the extent to which prevention services on North Dakota (ND) campuses assist in harm reduction and student retention. Recently a number of national studies have indicated increased attention to collegiate high-risk drinking and the related consequences. ND faces the same challenges as other campuses and the state is higher than the national rate, in high-risk drinking for youth, young adult, adult and college age individuals. The report highlights: (1) Funding; (2) Research; (3) Student Involvement; (4) Outreach Coordinator; (5) Campus Task Forces; (6) Community Coalitions; (7) State Public Policy; (8) Legislative Resolutions; (9) Prevention Model; and (10) Senior Administrators' Forum. State-specific challenges and sustainability are discussed. Twenty-seven appendixes are included.