Colombia is one of the first countries in the world to have a national plan for the prevention of drug use (1983); however, as in other Latin American countries, the development of state policies in this field has been challenging to achieve, so successive governments can abruptly change the direction to follow or ignore the problem. This chapter presents the evolution of drug policies in the country until 2024, when the focus is more on harm reduction, and more than two decades of trying to find effective preventive programs are left aside, but without having managed to give continuity to the actions over time. Even though there has been some progress in the sense of decriminalizing consumption since 1994, thirty years later, the offer of prevention strategies by the state for the population of children and adolescents is conspicuous by its absence; another advance, at a theoretical level, is to consider the problem of drug use a matter of public health, but it is inconsistent not to give any importance to prevention. Even though this consideration allowed free treatment to be offered to problematic consumers, the coverage is very low compared to the needs. An overview of the developments in the research field is presented, which are largely associated with universities or private non-profit entities.