The Civil Society Forum on Drugs (CSFD) is an expert group of civil society organisations (CSOs) in the European Commission that supports the commission in its drug policy formulation and implementation.1 One of its four working groups focuses on supporting and promoting the European Union’s (EU) 2015 minimum quality standards in drug demand reduction.2 In January 2020, CSFD published its guidelines and recommendations for the implementation of minimum quality standards by CSOs,3 followed in 2021 by a CFSD advocacy plan for the promotion and implementation of minimum quality standards in drug demand reduction.4

Civil Society Forum on Drugs

The CSFD comprises 45 CSOs from across Europe. Ireland is represented by the Ana Liffey Drug Project and the CityWide Drugs Crisis Campaign. The group is described as ‘representing a variety of fields of drug policy, and a variety of stances within those fields’.1 The purpose of the group is to facilitate a structured dialogue between the commission and European civil society to support drug policy formulation and implementation through practical advice. To meet this aim, CSFD is made up of four working groups, each of which focuses on a particular policy area: the EU Action Plan on Drugs; relations with international institutions; civil society involvement with national drug policies; and minimum quality standards. The focus of this article is on the work of the fourth group. 

Minimum quality standards in drug demand reduction

The Council of the EU conclusions on the implementation of the EU Action Plan on Drugs 2013–2016 regarding minimum quality standards in drug demand reduction in the EU2 were adopted by the council in 2015. It identified 16 quality standards to be met across the EU by drug demand reduction interventions in prevention; risk and harm reduction; and treatment, social integration, and rehabilitation. These standards are shown in Box 1 (overleaf). While there is no legal obligation on national governments to meet these standards, it is argued by the CSFD that they represent ‘the political will of EU countries to address demand reduction interventions through an evidence-based perspective’ (p. 4).3

Guidelines for quality standards

The CSFD working group on minimum quality standards has as its objectives to promote the implementation of the standards in EU member states (advocacy) and to improve knowledge
and skills among CSOs on how to implement
the standards at national level. Two of the activities carried out by the group to meet
these objectives were:

• To develop and apply an assessment tool through which CSOs could monitor and assess the implementation of the standards in their own countries and organisations 
• To examine the feasibility of implementing the standards among CSOs.

In January 2020, the group published a set of guidelines and recommendations for the implementation of the standards grounded in the earlier work of the group. The publication aims to support CSOs working in the drug demand reduction field to:

• Assess and implement their interventions according to the standards 
• Identify potential barriers for incorporation 
• Assess the potential need to provide training for practitioners and developers in the drug demand reduction field in line with these standards.

Source: Council of the European Union (2015)2 

The guidelines are structured around the standards. Under each standard, the key findings of the assessment tool and feasibility analysis exercises are noted. Recommendations are then made for CSOs to consider when implementing that standard. For example, under prevention standard 3 on interventions being evidence based (see Box 1), it was found that this standard was poorly implemented both at the member state and CSO levels. There were almost no registries of evidence-based interventions found at national, regional or local level across member states. However, even where registries existed at an international level (e.g. the Xchange registry of the European Monitoring Centre for Drugs and Drug Addiction5), they were not being used to inform decisions about interventions. The guidelines recommend that CSOs draw on these registries as an integral element of their work and discuss them as a routine part of staff induction and training. Funders should require the CSO to provide evidence that any proposed intervention is consistent with good practice on registries such as Xchange.

Recommendations for improving quality

The guidelines provide a valuable overview of the situation in member states and illustrate the many ways in which they and their CSOs are failing to meet the minimum standards. Its conclusion captures four cross-cutting themes that best illustrate areas in urgent need of improvement.

• Disinvestment from ineffective and harmful interventions: Interventions which are known to be ineffective or even harmful for target populations continue to be funded across the EU. This is especially a feature in the fields of prevention and risk and harm reduction. Resources should be redirected towards the implementation of evidence-based and effective interventions. 
• Education and training, and continuing professional development: A recurring theme throughout the report is a gap in quality education, training, and continuing professional development for the drug demand reduction workforce. This was found to be particularly acute in the fields of prevention and risk and harm reduction. It is recommended that governments and CSOs invest more resources in filling this gap. 
• Monitoring and evaluation: The authors conclude that ‘the evaluation culture is weak in Europe in the field of drug demand reduction’ (p. 23).3 They argue for a balance in approach, whereby evaluation and monitoring become an integrated part of delivery but which do not take away from the delivery of quality services. Monitoring and evaluation would improve the quality of interventions and would motivate professionals delivering work found to be of good quality. 
• Sustainable funding related to the implementation of standards: It was found that almost no sustainable funding was available to interventions in the field of drug demand reduction. It is recommended that this be addressed and that funding is linked to meeting the minimum quality standards. This would create a culture in which the knowledge and skills of the workforce and an evidence base of effective practice would be supported.

CSFD next steps

The CSFD’s work in this area is ongoing. Moving forward, the working group is to focus on ‘further dissemination and promotion of guidelines and recommendations across Europe, advocacy for assessment and implementation of standards in practice, and development and testing of training course for CSOs to improve the implementation of standards within civil society sector’ (p. 3).4 In February 2021, CSFD published an advocacy plan for the promotion and implementation of minimum quality standards in drug demand reduction by CSOs.4 This is a working document for the group of CSOs, which lays out specific activities that it is undertaking between 2020 and 2022 to meet their aim of advocating the implementation of the standards.

Conclusion

The work of CSFD highlights the need to improve quality in drug demand reduction interventions and to encourage stakeholders to make evidence-based decisions. In Ireland, advocacy for the implementation of the minimum quality standards needs to involve all stakeholders, such as policymakers, funders, and service providers, including CSOs. Advocacy needs to be complemented with training and support for those working in the sector. That way they can deliver services that meet these standards to ensure the most effective use of funding to deliver on the aims of interventions in this field. Training might include the European Prevention Curriculum (EUPC), which has been previously discussed in Drugnet Ireland. It is a programme of training, the primary goal of which is ‘to reduce the health, social and economic problems associated with substance use by building international prevention capacity through the expansion of the European professional prevention workforce’ (p. 10).6

2   Council of the European Union (2015) Council conclusions on the implementation of the EU Action Plan on Drugs 2013–2016 regarding minimum quality standards in drug demand reduction in the European Union. 11985/15. Brussels: Council of the European Union. https://www.drugsandalcohol.ie/24317/

3   Civil Society Forum on Drugs (2020) Guidelines and recommendations for the implementation of minimum quality standards by civil society organisations (CSOs). Amsterdam: Civil Society Forum on Drugs.
https://www.drugsandalcohol.ie/34040/   

4   Civil Society Forum on Drugs (2021) CSFD advocacy plan for the promotion & implementation of minimum quality standards in drug demand reduction. Amsterdam: Civil Society Forum on Drugs. https://www.drugsandalcohol.ie/33833/

5   For further information on Xchange, visit: http://www.emcdda.europa.eu/best-practice/xchange

6   European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) (2019) European prevention curriculum: a handbook for decision-makers, opinion-makers and policy-makers in science-based prevention of substance use. Luxembourg: Publications Office of the European Union.
https://www.drugsandalcohol.ie/31119/