Quality of Drug Demand Reduction Services

According to UNODC World Drug Report 2016 and WHO estimates, the extent of the global use of psychoactive substances is 2 billion alcohol users, 1.3 billion tobacco smokers and 247 million illicit drug users. Considering the resulting social and health consequences for individuals, families and communities, it is of critical importance to enhance the quality of drug demand reduction services, including treatment and social reintegration, prevention and harm reduction programmes and services. This includes the implementation of a wide variety of services, which take into account the specific needs of different target groups including women, youth, people with co-occurring mental health problems and sex workers.

Preparing and promoting minimum quality standards is an important step in the objective of reducing the demand for drugs, whether licit or illicit, because establishing standards can provide a significant foundation upon which to professionalize the workforce and strengthen existing delivery systems.  On September 2015, the Council of the European Union took this step and adopted the Council conclusions on the implementation of minimum quality standards in drug demand reduction in the EU that list 16 standards representing a minimum benchmark of quality for interventions.

These standards can be summarized as follows:

Treatment and Social reintegration

• Evidence-based treatment is tailored to the characteristics and needs of service users and is respectful of the individual’s dignity, responsibility and preparedness to change;
• Availability and accessibility of treatment (without restrictions based on social or personal characteristics);
• Setting objectives on a step-by-step basis, revising objectives and managing of relapses into use of substances;
• Based on informed consent;
• Provided by qualified specialists and trained staff who engage in continuing professional development;
• Continuity of care;
• Blood borne and infective diseases voluntary testing offered;
• Internal/external evaluation

Prevention

• Needs assessment and tailoring of interventions to the target population;
• People developing prevention strategies are trained and/or specialised professionals;
• The providers of prevention interventions work on evidence-based programmes;
• Long term planning, monitoring and evaluation of prevention interventions

Harm reduction

• Wide availability, realistic and clients-oriented goals of interventions;
• Appropriate interventions, information and referral are offered according to the characteristics and needs of the service users;
• Interventions are available to all in need;
• Evidence-based interventions, qualified and/or trained staff who engage in continuing professional development;

Although non-binding for national governments, this document represents the political will of EU countries to address demand reduction interventions through an evidence-based perspective.

It is expected that these standards help in orienting and attracting public funds and may direct new policies and programmes. It is important to keep in mind that these are just minimum standards. Whenever possible, member states should go beyond and ensure even higher quality standards.

Lastly, the minimum quality standards can stimulate exchanges among addiction professionals, thus influencing international discussions advocating evidence-based, quality drug demand reduction services.

Practical tools

• The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) is disseminating the standards via itsbest practice portal and will monitor their implementation.
• The European Drug Prevention Quality Standards Project published practical tools for people working in drug prevention. Four different toolkits are available for decision-makers, practitioners, professional trainers and educators, and for people in a coordinating role. Click here for more information.
• International standards for the treatment of drug use disorders (UNODC)