Germany Country Drug Report 2018

Quality assurance

In Germany, quality assurance is embedded within the National Strategy on Drug and Addiction Policy, incorporating supranational agreements. The framework document outlines evidence-based strategies and emphasises their relevance in terms of ensuring effectiveness and favourable returns on taxpayers’ investments.

Responsibility for quality assurance and the setting of standards are shared among the federal government, the Länder and the municipalities, as is responsibility for the overall drug and addiction policy. The federal government has legislative competence for narcotic drugs law, criminal law and social welfare law. The Federal Health Ministry also promotes a number of projects in the area of drug demand reduction interventions. Following the principle of subsidiarity, the responsibility for producing guidelines and rules lies with the 16 Länder and no uniform formal requirements or criteria for quality assurance exist.

Guidelines and quality standards for drug demand reduction and addiction prevention in Germany are set by various stakeholders including governmental organisations, social insurance providers and non-governmental organisations, such as professional associations, for example the Working Group of the Scientific Medical Professional Societies, the German Society for Addiction Medicine and the German Medical Association. Insurance organisations, such as the German Pension Fund, the biggest provider of funding for drug rehabilitation programs, and the National Association of Statutory Health Insurance Funds are also responsible for quality assurance.

Some accreditation systems for intervention providers in drug demand reduction exist at the federal level and in the Länder. They are provided by government bodies, for example for outpatient services, and statutory health insurers, for example for detoxification and rehabilitation services. Examples of accreditation systems include the cooperation network Equity in Health and its database of good practice projects, the Green List Prevention and the seal of approval of the statutory health insurers (Zentrale Prüfstelle Prävention). The publication Prevention of addictive behaviours and the nationwide conference on quality assurance in addiction prevention should also be mentioned; the conference is organised by the Federal Centre for Health Education (BZgA) and brings together researchers and practitioners.

Accreditation also exists for academic degree programmes and further education in addiction therapy. Drug treatment may be provided only by adequately skilled staff with supplementary training in the specific relevant field. Germany is one of the few European countries where specific academic courses on addiction exist.

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Methodological note: Analysis of trends is based only on those countries providing sufficient data to describe changes over the period specified. The reader should also be aware that monitoring patterns and trends in a hidden and stigmatised behaviour like drug use is both practically and methodologically challenging. For this reason, multiple sources of data are used for the purposes of analysis in this report. Caution is therefore required in interpretation, in particular when countries are compared on any single measure. Detailed information on methodology and caveats and comments on the limitations in the information set available can be found in the EMCDDA Statistical Bulletin.