School-Based Interventions for Drug Use Prevention Among Adolescents: A Scoping Review.

BACKGROUND

Drug abuse among adolescents is a global public health challenge. While schools are key environments for prevention, the impact of facilitator types and cultural contexts on program success requires clarification.

METHODS

This scoping review followed JBI and PRISMA-ScR guidelines. A systematic search of four databases (2015-2025) yielded 27 eligible studies for thematic analysis.

FINDINGS: Interventions targeting life skills led by teachers or peers consistently produced positive outcomes. Conversely, programs led by external authorities, such as police, showed mixed results. For instance, police-led initiatives effective in the US initially showed no impact or adverse effects in Brazil. Evidence indicates that rigorous cultural re-adaptation can eliminate these harms, highlighting that cultural alignment is a prerequisite for program safety.

IMPLICATIONS FOR SCHOOL HEALTH POLICY, PRACTICE, AND EQUITY: Policy should prioritize tailoring interventions to local contexts over rigid adoption of foreign models. Adaptation is a stepwise process: first ensuring safety, then aiming for effectiveness. Facilitator success relies more on trust and pedagogical skill than formal authority.

CONCLUSIONS

In school-based prevention, the messenger is as critical as the message. Success depends on contextual relevance and building genuine trust with adolescents.