Drug demand reduction: global evidence for local actions
Cited from Drugs in focus, No. 23, 1st issue 2012

The development of evidence‑based demand reduction interventions is a primary drug policy objective at national, European Union (EU) and global level. A particular discourse, with its own set of concepts, is used to discuss implementation of this objective, including terms such as: best practice, quality standards, guidelines, protocols, accreditation systems and benchmarking. This paper provides readers with straightforward definitions of the terms used, whilst highlighting achievements and current challenges in transferring scientific knowledge into practice in the drug demand reduction arena. A special focus is given to ‘best practice’ because of this concept’s increasing popularity and importance in Europe.

Key issues at a glance 

1. The promotion and exchange of best practice is recognised as an important strategy both to improve the effectiveness of drug‑related interventions and ensure the efficient use of limited resources.
2. Guidelines and standards are among the most frequently used tools for the promotion of best practice. In Europe, a wealth of guidelines now exist which decision‑makers can utilise, update and adapt to suit their own national contexts, rather than starting from scratch.
3. There is a growing body of scientific evidence on the effectiveness of interventions in the drugs field, which can be used for the development and update of standards and guidelines. There is new emphasis on disinvestment, stopping ‘poor practice’ and the use of low quality interventions.
4. At European level, a recent project has aimed to promote consensus on minimum quality standards in the fields of drug prevention, treatment and harm reduction as well as the translation of quality standards into practice.
5. New disciplines have emerged focusing on methods for successfultransfer, such as implementation science, translational science, and knowledge mobilisation. Identification of barriers to change and use of multiple implementation strategies are important success factors.
6. In the best practice area, there are still many gaps in the scientific evidence base and new issues continually arise that need to be addressed. A systematic gap analysis will help to focus next steps and future developments.

The briefing concludes with a series of policy considerations:

1. Different tools are used to promote evidence‑based practices in drug demand interventions, such as guidelines and quality standards. Nationally, dissemination and adaptation of already existing evidence‑based guidelines, rather than developing new ones, is proving to be a cost effective solution that helps to ensure quality.
2. In the future, processes need to be in place to ensure that existing guidelines and standards are regularly updated as and when new evidence becomes available. In addition, the ongoing promotion and dissemination of guidelines and standards among professionals and decision‑makers is a key issue. Despite recent increases in the availability of scientific evidence on the effectiveness (and ineffectiveness) of drug‑related interventions, gaps still exist and research is required to fill these gaps. A European research agenda which gives priority to questions linked to both the effectiveness of interventions, and to improving the research‑practice interface, would be greatly welcomed.
3. The EMCDDA with its experience in monitoring and disseminating best practice will continue to promote and support quality improvement in the European drugs field. Proactive dissemination of evidence, mentoring of guidelines adaptation, support in goal setting and impact evaluation and fostering the exchange of experiences are some of the activities we will continue to provide to stakeholders.