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This study investigated the clinical relevance of heavy drinking during the college years and beyond on concurrent and prospective alcohol-related problems in a high-risk sample (N = 377). Measures of heavy drinking and alcohol-related problems were significantly correlated cross-sectionally over the study frame, regardless of how these constructs were operationalized. However, the magnitude of the association between heavy drinking and alcohol-related problems declined substantially over time, with the most pronounced decrease following the college years. Despite this cross-sectional decrease in the association between heavy drinking and alcohol-related problems over time, heavy drinking during the college years significantly and substantially predicted alcohol-use disorders up to 10 years later. Implications for assessment of heavy drinking as well as prevention of problematic alcohol use in college students are discussed.