Non-medical substance use is a risk factor for the development of non-communicable diseases. Improving the prevention of sub-stance use disorders is an important area of public health action. In Russia, an anti-drug policy is being implemented, one of the directions of which is the prevention of addiction among students. Purpose of the study. To perform a comparative analysis of the results of preventive medical examinations of students conducted in Russia and Moscow in order to early identify the illegal use of psychoactive substances. Develop proposals for the prevention of non-communicable diseases based on the results of the analysis. Material and methods. The study is based on a retrospective analysis of data obtained from federal statistical observation forms No. 37. Within the framework of this study, statistical methods were used: Comparative statistical analysis of data, increase in indicators, structure of identified psychoactive substances; legal and regulatory analysis of documentation; content analysis of literature data. The database was created and data was analyzed using Microsoft Office Excel 2016. Results. During the studied period of time in Russia and Moscow, there was a decrease in the number of students participating in preventive medical examinations, while schoolchildren prevailed in the structure of participants. The facts of the illegal use of psychoactive substances were revealed mainly in secondary vocational educational organizations. The proportion of students who illegally used psychoactive substances did not exceed 1% of the total number of those surveyed. Differences in the structure of identified psychoactive substances illegally used by students in Russia and Moscow were determined. Conclusion. Preventive medical examinations of students occupy an important place in the system of early detection of illegal use of narcotic drugs and psychotropic substances. At the same time, they act as a practical tool for preventing the development of non-communicable diseases. In the course of the study, a number of necessary measures were identified: Differentiation of students by risk groups; increasing the coverage of students of higher educational institutions with preventive medical examinations; inclusion in the procedure of preventive medical examination of the elements of formation of motivation for adherence to a healthy lifestyle. © 2022, Media Sphera Publishing Group. All rights reserved.