Enhancing Quality Standards implementation in drug demand and harm reduction: Findings from the FENIQS-EU project

The FENIQS-EU project (Further ENhancing the Implementation of Quality Standards in drug demand reduction across Europe) was implemented between April 2021 and July 2023. The project had multiple, complementary objectives: 1) to assess Quality Standards (QS) implementation in prevention, treatment and harm reduction areas in the European Union, 2) to explore barriers and factors stimulating QS implementation, 3) to identify inspiring practice examples of QS implementation, 4) and to develop Implementation Toolkit – a practical tool that might enhance QS implementation among various organisations. 

The project applied a multi-method design. Online survey (N=97) and interviews (N= 16) with key stakeholders showed that QS have mainly been implemented in the prevention domain, with the European Drug Prevention Quality Standards being implemented in 20 countries. In the treatment area, national standards and Standards and Goals in Therapeutic communities have been implemented in 14 countries, while the most commonly implemented QS in the harm reduction domain were the EU Minimum Quality Standards, reported by 12 countries. This assessment of QS implementation among key stakeholders led to the identification of various inspiring practices of QS implementation. Fourteen case studies (6 in prevention, 4 in treatment and 3 in harm reduction area) were selected for further investigation. Selection criteria included level of implementation, type of QS implemented, background of the implementation process, and a comprehensive description of the quality assurance and control system. To get deeper insight into successful implementation strategies, a Delphi study consisting of three rounds with a range of key stakeholders (N=37) was conducted, resulting in 15 statements covering following themes for successful QS implementation: collaboration, communication, support structure, education and funding. Based on the recommendations from the various work packages, an Implementation Toolkit was developed and tested among service providers. To disseminate the project findings and outputs, a dedicated website (https://feniqs-eu.net/) was created, covering information about the project, as well as short video tutorials that should enable friendly use of the Toolkit. Finally, a special Issue of the Addictology journal (1/2023) was dedicated to the project findings.

Even though this project ended in 2023, the overall feedback from key stakeholders involved in the various phases of the project implementation reflected a need to ensure the sustainability of the project findings. The theme ‘European quality standards in drug treatment’ was put high on the agenda during the Belgian EU presidency and the European Monitoring Centre for Drugs and Drug Addiction expressed its support and recognised the relevance of further discussing QS implementation across Europe. This will contribute to equal quality of drug demand and harm reduction services for persons who use drugs in the EU.