This study examines drug and psychotropic substance use in the Algerian school setting as a multidimensional health, social, and educational problem affecting adolescent students. It analyses the social determinants (family disintegration, peer pressure, and the school’s surrounding environment), educational determinants (poor academic achievement, school dropout, and weak support mechanisms), and psychological determinants (anxiety, low self-esteem, and sensation seeking), and considers their consequences for students’ health, academic performance, behaviour, and social integration. Using a descriptive-analytical method, the study critically reviews the relevant literature and the legislative and regulatory texts within an integrated socio-educational and psychological framework. It concludes that the phenomenon results from the interaction of overlapping factors and that repression alone is insufficient to address it. Effective responses require early school-based prevention; the involvement of families, civil society, and the health sector; accessible listening, psychological, and medical care services; and training for educational staff. The study ends with practical recommendations to strengthen prevention and care policies within the Algerian education system.