Peer-led drug prevention programs for middle school youth are reviewed as to whether or not they are a vital resource in an overall effort to minimize the use of alcohol, tobacco, and other drugs (ATOD). The paper focuses on the following: a) results of a 120-study meta-analysis of school-based drug prevention programs and positive program features; b) considerations for falsely concluding that peer programs are ineffective; c) features of two model or stellar programs that compared interactive (peer leadership) to teacher/researcher-led (non-interactive) programs that followed National Peer Helpers Association (NPHA) Programmatic Standards; and d) suggestions for designing and implementing high-quality, peer-led programs. The authors conclude that interactive peer interventions for middle school students are statistically superior to non-interactive didactic, lecture programs led by teachers/researchers. Programs implemented according to NPHA Programmatic Standards may eliminate Type II (false negative) and III ("implementation failure" or ineffectively designed and implemented program) errors. Opportunities for prudent application of well-designed peer programs appropriately implemented and evaluated must remain a salient priority.