Systematic review on the characteristics and efficacy of school preventive programs for drug addiction in Spain.

The school environment is of great relevance in the prevention of drug use in students because it is where they spend most of their time and, since education is compulsory until upper secondary school in Spain, interventions in this area can reach the majority of children up to that stage. The objective of this systematic review is to determine the level of efficacy of the school preventive programs that have been implemented in Spain. Following the PRISMA recommendations, a systematic literature search was carried out in the Web of Science, PubMed/MEDLINE, Embase, Scopus, and Cochrane Library databases. The search yielded 274 studies, of which 29 studies were selected. It was found that 48 drug addiction prevention programs have been implemented in Spanish school context, of which only 18 (37.5%) had an evaluation of their effectiveness following the criteria and standards of effective prevention. Conversely, the programs that were not evaluated are far from these standards in their design. It is concluded that there are two models of school prevention of drug addiction in Spain: a model that meets this description; and another model classified as "pseudo-prevention", since its design does not meet the standards of effective prevention nor has its preventive efficacy been demonstrated.