Researchers examined long-term prescription drug misuse outcomes in 3 randomized controlled trials evaluating brief universal preventive interventions conducted during middle school. In 3 studies, they tested the Iowa Strengthening Families Program (ISFP); evaluated a revised ISFP, the Strengthening Families Program: For Parents and Youth 10-14 plus the school-based Botvin LifeSkills Training (LST) (SFP 10-14 + LST); and examined the SFP 10-14 plus 1 of 3 school-based interventions. In study 2, SFP 10-14 + LST showed significant or marginally significant effects across all ages (21, 22, and 25 years); higher-risk participants showed stronger effects. Brief universal interventions have potential for public health impact by reducing prescription drug misuse among adolescents and young adults.