Workbook 3.3: Best practice

In France, quality assurance in Drug Demand Reduction (DDR - prevention, risk reduction, treatment and rehabilitation) builds on specific advocacy, guidelines or trainings from professional societies or organisations or public health institutions but it is not strongly institutionally structured nor imposed. As for risk reduction and treatment, different guidelines exist on (i) Opiate Substitution Treatment, (ii) Early intervention and risk/harm reduction for crack or free base users, (iii) Clinics for young drug users and (iv) Treatment of cocaine users. However their implementation is not compulsory: there is no formal prerequisite of fulfilling guidelines to get support or subsidies. The compliance to these guidelines is not as a label. The addiction treatment services (so-called CSAPA) are marginally impacted by the existing accreditation and certification processes directed to health establishments. In drug prevention, the National Institute for Prevention and Health Education (INPES) distributes information on evidence-based prevention methods. However, there is no specific drug use prevention protocol for prevention providers, public servants or associative workers to follow. In the 2010's, although many resource services in prevention engineering have collapsed at local level, there is a noticeable willing at national level to enhance quality in the programmes and services delivered, especially in prevention.
A growing though still limited number of prevention organisations get involved in implementing international evidence-based programmes in local French contexts. In the recent years, the concern about good practices and evidence-based practices has got higher. This general climate is incentivized by both a political impetus (repeated references to evidence-based approaches in governmental strategies) and professional inspiration. The Interministerial Commission for the Prevention of Addictive Behaviours (CIPCA) reflects the political will of developing evidence-based prevention knowledge. For the 2015-2017 period, the CIPCA is being funding the impact evaluation of five prevention programmes selected on the basis of a call for tenders. The endeavours started in 2014 to develop training supply on addiction and quality assurance have continued over 2015-2016, especially for professionals working in contact with young people through the training of regional trainers for the certification of competence in preventing addictive behaviours.