Key Findings: Middle school years remain a significant period for experimentation with psychoactive substances, with major variations from one grade to the next, as usage levels increase significantly with grade level. Alcohol remains by far the most commonly tried substance among middle school students, but usage levels have dropped significantly between 2010 and 2014. With 28% of students reporting that they had experienced intoxication by the end of middle school, such episodes appear to be less frequent and occur later than in 2010. Daily tobacco use has declined compared to 2010, despite experimentation remaining stable in 2014. Quantified for the first time among middle school students in 2014, the prevalence of hookah smoking reveals significant popularity of this method of tobacco use. Cannabis remains the most widespread illicit substance among middle school students. It was tried in 2014, as in 2010, by one in ten middle school students. While a large proportion of middle school students recall receiving prevention information about the use of psychoactive substances, there is nevertheless a significant disparity between the later and earlier years of middle school, with 6th and 7th graders appearing significantly less affected by such interventions.