Category Archives: Policy

Public Health England runs EDPQS training session

Toolkit 3 previewIn December 2015, Public Health England (PHE) used the EDPQS Training Toolkit (EDPQS Toolkit 3) to facilitate a training event with local authority commissioners and charitable funders working in drug prevention. Madeleine Rudolph, Programme Manager at the Alcohol and Drugs Team, PHE London, described the training event as follows.

Public Health England (PHE) aims to ensure the development and delivery of high quality, evidence based interventions across all of our areas of work. Where we do not directly deliver services, for example alcohol and drug prevention and treatment interventions, we aim to achieve our objective by aiding those who do so through the dissemination of evidence and championing robust quality assurance mechanisms.

In December 2015, PHE London’s alcohol and drugs team facilitated a training session on the substance misuse prevention evidence base and quality assurance of these interventions. The team liaised with Liverpool John Moores University, utilising the new European Drug Prevention Quality Standards (EDPQS) toolkits, in addition to PHE’s own summary of the United Nations Office on Drugs and Crime’s systematic assessment of evidence.

The session brought together Local Authority service commissioners and funders from a range of charitable trusts, creating an added opportunity for networking and potential future collaboration. Participants were selected by PHE to ensure the messages reached those in a position to directly influence the provision of prevention interventions.

The session was well received. Working through the “Stella” case study from EDPQS Toolkit 3 was perceived as being very useful and as bringing the standards to life. Attendees also cited a range of ways in which they would utilise the EDPQS standards such as in creating service specifications and considering funding applications.

In 2016, PHE London is planning to utilise additional EDPQS materials to deliver complementary training for service providers and grant applicants.

For further information about PHE’s work, please contact us and we can put you in touch with the relevant individuals.

Tajikistan: seminar on quality standards

EDPQS researcher Angelina Brotherhood has recently returned from Dushanbe, Tajikistan, where she facilitated a three-day seminar entitled “Prevention Strategy and Policy Makers” on behalf of the United Nations Office on Drugs and Crime (UNODC).

Angelina facilitating the discussion on prevention systems

Angelina facilitating a discussion on prevention systems

The seminar was attended by some 18 participants, representing government agencies, local non-governmental organisations, as well as international organisations. The aim of the seminar was to introduce participants to the UNODC International Standards on Drug Use Prevention (see our Related activities page), as well as the UNODC’s forthcoming guidance on evaluation. Through group-work, participants were supported in assessing the existing provision of prevention activities in Tajikistan and to identify areas for improvement based on international guidance.

Similar events have been organised by the UNODC in some 60 countries around the world, reaching over 250 policy-makers and practitioners working in the drug prevention field.

The European Drug Prevention Quality Standards (EDPQS) are also presented at these seminars, as they complement the UNODC International Standards on Drug Use Prevention well. While the UNODC International Standards describe what types of policies and interventions have been found to successfully address drug use or relevant mediators, the EDPQS describe the formal processes and structures required to implement high quality drug prevention. Put simply, the UNODC International Standards on Drug Use Prevention describe ‘what’ to do in prevention, while the EDPQS describe ‘how’ to do prevention (Burkhart 2015).

At this event, the EDPQS were presented in a half-hour session and hard copies of the EPDQS manual were also available for participants. The UNODC funded the translation of the presentation slides into Russian, meaning that for the first time, EDPQS materials are now also available in Russian.

Angelina Brotherhood reflected on the event as follows:

“It was a great experience talking to Tajik policy-makers and practitioners about drug prevention activities in their country, and I’m grateful that the UNODC invited me to hold this workshop on their behalf. Tajikistan faces unique challenges. The country is still recovering from a civil war that lasted for several years in the 1990s, whilst still being confronted with the horrors of war in its neighbouring country Afghanistan. Its proximity to Afghanistan also means proximity to the drugs trade. Seminar participants also mentioned the ‘incomplete families’ produced by emigration. Many people (especially men) leave Tajikistan in search for work, and these labour migrants’ wives were identified as a vulnerable population. I was also interested to learn that women from disadvantaged backgrounds typically cannot afford to pay to give birth in hospital, and thus home births are common among this group. Participants also spoke of the role of local traditions and superstitions which can prevent women from undergoing medical examinations. These women are consequently hard to reach and the seminar participants identified the need for greater efforts to provide medical and psychosocial services to these groups.

There are a number of different prevention activities being implemented in Tajikistan. Notably, manualised evidence-based programmes are also being adapted and piloted by the UNODC. Participants were concerned about how to sustain this work, ensuring that pilots are transformed into routine activities with high coverage of target populations. This, of course, is not a challenge faced only in this country, as we have heard similar reports from European countries throughout the EDPQS Phase I and Phase II projects.

Besides the discussion on content, participants were very interested to learn about the EDPQS. They appreciated the project cycle as a systematic way for thinking about and planning prevention. Currently, there are no national standards available in Tajikistan or any other regulatory frameworks to specify quality requirements for drug prevention. One of the outcomes of the meeting was the decision to develop national quality standards for drug prevention in Tajikistan. We discussed that such a consensus-building process, if organised carefully with involvement of all relevant stakeholders, could also help to strengthen the collaboration and coordination among prevention stakeholders in this country. Participants were interested to hear about the experiences from other countries regarding the development of quality standards, and I was glad that with EDPQS Toolkit 4, I was able to offer them a written step-by-step guide to the development of quality standards.

A model prevention system, as proposed in the UNODC International Standards on Drug Use Prevention

A model prevention system, as proposed in the UNODC International Standards on Drug Use Prevention

On the last day, there was a discussion of the national prevention system which I really enjoyed. We tried to map the Tajik prevention system against the model prevention system proposed in the UNODC International Standards on Drug Use Prevention (see above). This was a really useful process to help visualise existing organisations and structures, as well as to identify areas where things are not yet working as well as they could. One of the things to come out of this discussion was the double role of international organisations and donors. On the one hand, these organisations play a key role in planning and implementing drug prevention activities in this country. On the other hand, these activities are outside the remit of the government, and thus there may be issues with fragmentation and sustainability. It can also lead to a dependence on foreign money and expertise. Participants at the seminar all agreed that a sustainable and coherent approach to drug prevention requires strong national coordination mechanisms and delivery structures, including structures to train up a professional prevention workforce locally.

The key question of course is how to put all the good plans and intentions resulting from this meeting into practice. Over the three days, we documented all the recommendations and actions arising from the meeting. We were able to identify those individuals and organisations who are interested to take this work forward. Thankfully, the National Centre for Drugs Monitoring and Prevention volunteered to host a follow-up meeting during which the action plan could be developed further. The atmosphere upon closing the meeting was really positive, and I hope that participants will be able to continue the work and address some of the challenges which we identified together. The prevention system in Tajikistan is still in its infancy, so this is an opportune moment to set the course for a quality approach to drug prevention.”

Plenary discussion

Plenary discussion

EDPQS at the Sixth EUSPR Conference and Members’ Meeting

The Sixth Conference and Members’ Meeting of the European Society for Prevention Research (EUSPR) (www.euspr.org) was held from 22-24 October 2015 in Ljubljana, Slovenia. The conference, entitled “Changing Behaviour without Talking”, was attended by over 150 delegates, including researchers, policy-makers and practitioners, with an interest in prevention research and evidence-based prevention strategies.

There were a number of sessions relating to quality standards in general, as well as the European Drug Prevention Quality Standards (EDPQS) specifically.

Prof Harry Sumnall presenting the newly launched EDPQS Toolkits

Prof Harry Sumnall presenting the newly launched EDPQS Toolkits

Professor Harry Sumnall introduced the newly developed EDPQS Toolkits during a special lunch-time session in the afternoon of Day 2. Professor Sumnall briefly described the background to the EDPQS project, and then presented each new Toolkit in turn, highlighting potential benefits for different professional groups working in the prevention field.

Also on Day 2, Dr Gregor Burkhart presented a talk entitled “Quality Standards in Drug Demand Reduction: Prevention gave the example”. In this talk, he discussed the EU’s recently published Council conclusions on the implementation of minimum quality standards in drug demand reduction in the EU. Following the presentation, there was a heated debate regarding the feasibility of standards and optimal ways to introducing and promoting standards in EU Member States. Several members of the European Prevention Standards Partnership were present at the session and contributed to the debate with their insights gained from the EDPQS Phase I and Phase II projects.

Dr Gregor Burkhart presented the premises for developing European minimum standards for drug demand reduction

Dr Gregor Burkhart presented the premises for developing European minimum standards for drug demand reduction

On the final day of the conference, Session 13A on “Prevention policy and practice” featured a number of presentations relating to quality standards and professional qualification. The aim of the session was to present practical prevention experiences as well as the potential impact of policy in the prevention field, showing how practice and policy must go hand in hand in order to achieve effectiveness.

Dr Gregor Burkhart presented his recently published paper “International standards in prevention: How to influence prevention systems by policy interventions?” (the article can be accessed here for free); and Michal Miovsky from the Czech Republic presented work on a national qualification system for professionals in prevention (the abstract can be viewed here).

Dr Rachele Donini presented the development process behind EDPQS Toolkit 3

Dr Rachele Donini presented the development process behind EDPQS Toolkit 3

Also in this session, Dr Rachele Donini – one of the Italian EDPQS project partners – presented a talk entitled “Together we can: stakeholders involvement as a key factor in developing a training tool for prevention practitioners”. In the presentation Dr Donini explained the process that was used to develop EDPQS Toolkit 3. This Toolkit is a guide written for trainers to help them train policy makers, service managers, prevention providers, researchers, practitioners and university students regarding the European drug prevention quality standards (EDPQS). Dr Donini showed how stakeholders had been involved in the development of the toolkit, emphasising the stakeholders involvement as a key factor in the toolkit’s development. Stakeholders were representatives of the intended recipients of the training. She concluded that their knowledge and needs offered an interesting point of view in terms of the wording used, the training activities proposed and the timing of the training. The slides from her presentation are available here.

To access Rachele's slides, please click on the image above

To access the slides, please click on the image above

We were also pleased to be able to offer free hard copies of the EMCDDA’s Manual on EDPQS at one of the stands, which delegates were happy to take home. The UNODC’s International Standards on Drug Use Prevention were also available in print.

These were just some of the highlights of the conference relating to quality and quality standards in drug prevention, and we hope to be represented again at next year’s event.

For further information about the EUSPR 2015 conference:

  • The main conference web page: http://euspr.org/euspr-2015/
  • The full programme of the conference, including all abstracts, can be found here.
  • You can also see what conference delegates posted on Twitter regarding the conference: #EUSPR15.
Impressions from EUSPR15 (Plenary talk by Hugo Harper, UK)

Impressions from EUSPR15 (Plenary talk by Hugo Harper, UK)

Impressions from EUSPR15 (coffee break)

Impressions from EUSPR15 (coffee break)

Travel report by Angelina Brotherhood and Rachele Donini.

Minimum quality standards for drug demand reduction interventions in the EU

EU Council ConclusionsOn 14 September 2015, the Council of the European Union adopted Council conclusions on the implementation of minimum quality standards in drug demand reduction in the EU.

The new “minimum quality standards in drug demand reduction in the EU” build on previous initiatives to formulate and establish quality standards in prevention, treatment and harm reduction, including the European Drug Prevention Quality Standards (EDPQS) initiative (although developed through a separate activity, not directly related to the EDPQS Phase I or Phase II projects).

Recognising that implementation of standards such as the EDPQS cannot rely on engagement with practitioners alone, but requires political support at all levels, these new standards can be considered a major achievement as they have been formally endorsed by the governments of the EU Member States. It is hoped that they will provide a significant foundation upon which to implement future activities to support high quality in the drug demand reduction field (including prevention), to professionalise the workforce and strengthen existing delivery systems.

The European Monitoring Centre for Drugs and Drug Addiction (EMCDDA) commented on the publication of the minimum standards as follows:

“This innovative initiative lists 16 standards that represent a minimum benchmark of quality for interventions in: drug use prevention, risk and harm reduction, treatment, social integration and rehabilitation. 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.” (http://www.emcdda.europa.eu/news/2015/eu-minimum-quality-standards)

The political process leading up to this achievement required several years of work and the long-term support and commitment of many stakeholders. The European Prevention Standards Partnership followed the development closely and supported it at several stages. A milestone in the process, for example, was the publication of a first proposal for minimum standards in 2011: the EQUS Minimum Quality Standards in Drug Demand Reduction. These were developed in collaboration with the European Prevention Standards Partnership (responsible for the prevention strand; for further details see Example 6 in our EDPQS Toolkit 4).

The work on EU minimum standards then advanced significantly during the EU Presidencies of Italy (2014) and of Latvia (2015), with a revised proposal for minimum standards drawn up and discussed in a year-long process during the meetings of the Horizontal Working Party on Drugs (HDG) (highlighted in a previous blog post regarding the CND 2015 Side Event). Representatives of the European Prevention Standards Partnership provided input regarding the methods and sources used to develop the minimum standards, as well as their contents.

We are pleased that the endorsed minimum standards are fully compatible with, and make explicit reference to, the EDPQS. The EDPQS will continue to be helpful to achieve these minimum standards in the prevention field, and to think about quality standards and the practicalities of achieving quality at a more in-depth level.

“Minimum quality standards for drug demand reduction interventions in the EU”

CND 2015 Side event: “Developing and promoting quality standards in drug demand reduction”

This year’s meeting of the Commission on Narcotic Drugs (CND) featured a side event on quality standards. The event was a joint initiative of the European Union, the Government of Latvia, the African Union Commission, the European Monitoring Centre for Drugs and Drug Addiction, the UNODC Drug Prevention and Health Branch, and the Prevention Standards Partnership (represented by Liverpool John Moores University, UK).

Ambassadors Györgyi Martin Zanathy and Bahtijors Hasans

The event was opened by Ambassador Györgyi Martin Zanathy, Head of the Delegation of the European Union to the International Organisations in Vienna. Ambassador Zanathy emphasised that promotion of quality in the field of drug demand reduction is a priority for the European Union, with three projects funded to this effect – the “Study on the Development of an EU Framework for Minimum quality standards and benchmarks in drug demand reduction” (EQUS) (see our related activities page) and, specifically in the area of prevention, the EDPQS Phase I and Phase II projects. She further praised the efforts of the Civil Society Forum on Drugs (CSF) in this regard, referring also to the CSF’s recent submission of a Thematic Paper on EU minimum quality standards for drug demand reduction to the Horizontal Working Party on Drugs (HDG).

The event was chaired by Ambassador Bahtijors Hasans, the Permanent Representative of the Republic of Latvia to the UN, OSCE and Other International Organizations in Vienna. In his introductory statement, Ambassador Hasans stressed how projects to promote quality standards encourage different stakeholders from government and civil society to come to the negotiation table and to work together towards an evidence-based approach to addressing drug-related needs.

These opening remarks were followed by four presentations to introduce ongoing efforts in this area from different parts of the world.

Dr Gilberto Gerra referring to the treatment of Lymphoma to emphasise the importance of quality standards

Dr Gilberto Gerra, Chief of the Drug Prevention and Health Branch at the United Nations Office on Drugs and Crime (UNODC), used examples from the medical field to highlight the importance of quality standards. He argued that few people would agree to medical treatment by a doctor who refuses to follow an evidence-based protocol to treat their condition, preferring instead to follow intuition. This, however, was the reality for many activities in drug demand reduction. Dr Gerra argued that the evidence is clear on what doesn’t work to address drug-related needs, but that this knowledge does not sufficiently inform policy and practice. The UNODC has published, and is continuing to develop, standards and guidelines for prevention and treatment. Yet the challenge remains to make these documents widely known and used in different contexts.

Presentation by Ambassador Dr Olawale Maiyegun

Ambassador Dr Olawale Maiyegun, Director of Social Affairs at the African Union Commission (AUC), presented work undertaken by the African Union to raise the quality of treatment for drug dependence. Activities by the AUC include training the workforce, for example as part of the UNODC’s Treatnet projects or using the Universal Treatment Curriculum (UTC). Differences in countries’ public health care systems, along with cultural and socio-economic factors, were one of the challenges which the AUC faces in this process. However, according to Ambassador Maiyegun, the major challenge for the African continent lies in the over-reliance on supply reduction and criminal justice approaches. He commented that treatment was virtually non-existent in some countries, and where it did, treatment practices could be of such a poor standard that they led to greater harm than drug use itself. In this context, promoting quality standards offered an opportunity to redress the balance between supply and demand reduction, and to advocate for greater investment in treatment.

Presentation by Mr Jānis Bekmanis

Next up was Mr Jānis Bekmanis, President of the Horizontal Working Party on Drugs (HDG) during the Latvian Presidency at the Council of the European Union. Mr Bekmanis embedded the projects to promote quality standards within the EU’s wider activities to support high quality drug demand reduction, referring also to the EMCDDA’s Best Practice Portal. Mr Bekmanis was unable to share details with the plenum about the EU minimum quality standards in drug demand reduction, as these standards are still under discussion by the EU Member States. He did disclose that they would include standards for prevention, risk and harm reduction, as well as treatment and rehabilitation. Across these three areas, the standards would reflect common principles oriented toward human rights, monitoring and evaluation, and target population needs. Once the standards have been agreed on by Member States, Mr Bekmanis suggested that further work would be required to support and monitor implementation of the standards.

Prof Harry Sumnall

Finally, Prof Harry Sumnall, Professor in Substance Use at Centre for Public Health, Liverpool John Moores University, spoke on behalf of the Prevention Standards Partnership. Prof Sumnall highlighted that promoting quality in European prevention required collaboration with many partners. This included not only the members of the Prevention Standards Partnership but also other projects and organisations committed to high-quality drug prevention, such as the Three Cities project in Sweden or COPOLAD. A major challenge in promoting quality was how to support the prevention workforce to use and implement quality standards. Prof Sumnall argued that for a true improvement in professional practice, it is not sufficient to influence prevention providers as individuals and organisations, but that policy-makers must create the structures necessary to promote quality. He cited examples from the Czech Republic and Croatia, where the quality of preventive activities is considered when selecting projects for governmental funding. Across Europe, these examples represented the exception rather than the rule. The outputs from the EDPQS Phase II project would therefore include a guide for decision-makers to help revise funding and commissioning systems toward a greater emphasis on quality.

The side event was attended by around 50 participants, and several delegates approached Prof Sumnall over the course of the CND to discuss the role of standards in improving the quality of drug demand reduction activities, including representatives from the Australian Drug Foundation and the New Zealand Drug Foundation.

– Angelina Brotherhood

Harry Sumnall and Angelina Brotherhood with some of the colleagues who helped realise this side event (Jānis Bekmanis, Evika Siliņa and Agnese Veisberga, Government of Latvia; Artur Malczewski, National Bureau for Drug Prevention, Poland; Giovanna Campello, UNODC Drug Prevention and Health Branch) Introducing the EDPQS project Prevention Standards Partnership

Audience at the side event Audience at the side event Harry Sumnall & Angelina Brotherhood with John Rogerson, Australian Drug Foundation, and Ross Bell, NZ Drug Foundation

Silke Vitt was available at the EMCDDA stand to provide further information EDPQS Manual could be picked up during the event as well as from EMCDDA stand Project partner Artur Malczewski of the National Bureau for Drug Prevention (NBDP), Poland, was also present during the CND and referred to the EDPQS during another side event when describing the Polish prevention system

EMCDDA Drugnet Europe 88: “From guidelines to quality standards”

Drugnet Europe 88The most recent issue of EMCDDA’s Drugnet Europe contains a short article reporting on international developments regarding quality standards, referring also to the European Drug Prevention Quality Standards (EDPQS). The article was written by Marica Ferri, Danilo Ballotta and Alessandra Bo, and can be accessed here (p. 3).

The European Union Drugs Strategy 2013-2020

A meeting was held in Brussels on September 19, hosted by the Public Policy Exchange. The day provided an opportunity for reflection on the EU Drugs Strategy 2013-2020 and to hear a range of views on how things are moving forward policy wise in Europe.

Professor David Nutt (Chair of the Independent Scientific Committee on Drugs) presented his UK and European Research on drug harms, and Franz Trautmann (Head of Unit, International Affairs at the Trimbos Institute) spoke about changing drug use and availability trends. Both inputs provided a well received response for a need to reconsider current drug policy in Europe and internationally. The message was a request for focus on the reality of drug use rather than a political “emotional” response to drug related issues.

The input from the Anti-Drugs Policy Unit of DG Justice at the European Commission provided a useful overview of the new Strategy. It reflected a growing awareness for political responses that reflected the evidence base for policy and practice that would combat the problems that drugs presented both at the supply and demand reduction levels.

Fay Watson (EURAD) offered a well balanced input to suggest the need to consult with all stakeholders active in the drugs field, including civil society, in order to provide a balanced and broad response to the issues presented by drug use. The request was for responses which did not polarise people into different “camps” but acknowledged the need for a range of responses to meet the different needs of target groups.

The overall response of the audience appeared to be that whilst there were some positive moves forward, for example in respect of the need to place more emphasis on treatment and prevention and to address the issue from the perspective of health rather than law and order, the policy was still not radical enough to reflect the current need for change.

From a “Quality Standards” perspective it was interesting that increased investment in prevention still remained the recipe for the way forward. It was acknowledged that the actions that are undertaken and funded should be based on scientific evidence and with a focus on quality standards. However, no particular reference was given to the work of the Prevention Standards Partnership in developing European Drug Prevention Quality Standards or to other activities in this area, or to the ERANID agenda for identifying agreed European priorities for research in the drugs field. One was left with the feeling that the words on the need for sound research and application of quality standards still need to be translated from theory and sound bites and applied more visibly in practice.

Jeff Lee
Project Manager, European Drug Prevention Quality Standards Phase 2
Project Officer, ERANID
Centre for Public Health
Liverpool John Moores University