STAGE 1. Assessing needs

What steps should be completed?

STEP 2: Explore the factors associated with drug use in the population

When we design a drug demand reduction intervention it is very important to understand the population well. This could almost be considered an ethical principle. Therefore, the needs assessment should also include understanding the factors that cause and sustain drug use problems in the population. It is about exploring and analysing the determinants. Susceptibility to initiate or maintain drug use, or relapse into it, has many causes and is determined by genetic, biological, social and personal factors. Knowledge of genetic and biological factors can be especially useful for treatment interventions, while exploring environmental (or contextual) and personal determinants will be relevant for any drug demand reduction intervention. The intervention that we design will attempt to modify these factors, so it is important that we understand how they relate to the drugs problem in the area and our target population. Unlike the previous step of needs assessment, we now aim to understand the factors that facilitate drug-related problems. +

However, extensive investigation of the factors associated with drug use may not be necessary in interventions aimed at the general population. This is the case for universal prevention interventions, as considerable information on the causes of drug use in that population is usually available. In these cases, the target population can be considered to share similar characteristics with the general population so the causes of their drug use are also similar. In most cases, it would therefore seem to be sufficient to adapt the explanation of these factors to the cultural reality of the population. This would help to reduce the cost of the needs assessment.

There is a considerable and well-established body of research on the circumstances associated with the probability of starting to use drugs, which is known as the study of risk factors and protection factors. Analysis of these factors offers explanations for the possible conditions or circumstances linked with drug-use problems. It also serves as a change model (approach) for interventions to prevent use and reduce risk. These interventions aim to reverse the balance between these factors: reducing population exposure to the risk factors and strengthening or encouraging the protection factors. Therefore, the information you gather now will allow you to define you intervention’s objectives and action points in the later stages of One Step@a Time. +

This information can be located by investigating the population directly, asking reference people who understand the population and consulting the bibliography on drug use determinants. There are numerous scientific publications on the factors that cause and sustain drug use in different populations that will give you ideas to guide your needs assessment and to understand the population better. This information is often sufficient, depending on the type of intervention you wish to conduct. However, more investigation will be required into the target population’s determinants when that population is less well understood. Various tools to help you conduct a needs assessment can be found at the following links. +