Implementation of quality standards in drug demand reduction: Insights from FENIQS-EU project and ways forward

Quality standards have been recognized as an important tool for improving the quality of drug use prevention, treatment, and harm reduction services and for bridging the gap between science and practice. The aim of this paper is to describe the state of implementation of quality standards in drug demand reduction in the European Union and to identify barriers, needs, and challenges to implementation and future pathways. Between June and November 2021, an online survey (n = 91) and follow-up interviews (n = 26) were conducted with key informants - experts in drug demand reduction and quality assurance. Data were analyzed using descriptive statistics and thematic analysis. The survey showed that most countries have implemented the European Drug Prevention Quality Standards (EDPQS) in the prevention domain and the Minimum Quality Standards (MQS) in drug demand reduction. A variety of standards are applied in the treatment area and the EQUS minimum quality standards are widely known. The application of quality standards is least reported in the harm reduction service area. Mentioned challenges and barriers to implementation included lack of funding, unrecognized importance of evaluation, professional competencies, and system fragmentation. Mentioned supportive factors included appropriate materials and training, as well as political support and professional networks. The study shows that quality standards are inconsistently implemented in all areas of drug demand reduction. According to respondents, implementation could be improved by advocating for the need to implement quality standards, ensuring sustainable funding for interventions, and providing education and training.