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.