Several studies are discovering differences in how boys and girls use tobacco, alcohol, and other drugs. In general, boys and girls differ in the intensity and the quality of drug use. Male adolescents report higher usage of drugs than female adolescents do (exception: medication). However, there are only few prevention programmes with integrated sex-specific strategies. The few existing girl-specific and boy-specific prevention programmes focus on strain and deficits. Drug consumption is considered a result of inadequate socialisation and development of boys and girls. New preventive strategies are therefore based on interactional and functional concepts. In this perspective health-related behaviour can be regarded in respect of its differential functionality for girls and boys. Drug use is considered to be a sex-specific attempt to express femininity or masculinity. Sex-specific drug prevention develops different strategies for same-sex and opposite-sex groups in order to meet varying needs and to take the differential functionality of drug consumption into account.