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The article presents a study on the factors affecting fidelity to the prevention of substance use curriculum guides in middle schools. The fidelity of middle school teachers in the implementation of substance use prevention curricula is considered necessary to efficiency. The factors affecting the fidelity of teachers to curricula guides are assessed using data from national sample of 1905 lead substance use prevention teachers. The study revealed that about one-fifth of teachers did not use the curriculum guide at all while 15% reported that they followed it closely. Adherence of teachers were associated with beliefs about the efficiency of the training they received and the support they received from the principals.