Support. Don’t Punish is a global grassroots initiative in support of harm reduction and drug policies that prioritise public health and human rights. June 26 marks the global day of action where drug law reform activists around the work seek to change the narrative around drug policies and the rights of people who use drugs.

But what are enablers and barriers of a supportive drug policy system, and what role does the policy and health sector have in ensuring peer-based drug user organisations can reach their full potential?  The W3 Project considers this and other issues in a new article published in the International Journal of Drug Policy.

Peer-based drug user organisations have been part of health promotion and health service landscapes since the 1960s. However a range of factors undermine the value of peer knowledge and experience in policy reform.[1] These factors include a lack of funding for drug user organisations to evaluate and fully articulate their contributions to policy goals [2] and participation being limited to “functional tasks” in programs that peers have had no involvement in designing [3] [4].  At the same time drug user organisations are operating in the complex and coercive legislative and policy environments that the Support. Don’t Punish campaign seeks to change.

The W3 Project, with its systems thinking approach, worked with peer organisations to develop a system map that identifies the strengths and implications for the role of drug user organisations in improving drug policy and health services.

The article details the way that the influence of drug user organisations in the policy system is related to two factors: the visibility and demonstrability of engagement within their community and the quality, timeliness and usefulness of previous policy participation.

However a critical third factor emerges when considering non-peer organisations in the system: the visibility of partner organisations in valuing the policy participation of drug user organisations. 

We found the influence of peer drug user organisations in the policy system is as much about the system valuing the participation of peers as it was about the quality of their participation.

In a policy context, if public health goals, such as the elimination of hepatitis C, are to be achieved, policy and health services need to invest in strengthening peer-based drug user organisations as well as identifying, valuing and acting on the quality policy advice from peer leadership. This is critical in a drug policy system that supports rather than punishes.

The full journal article can be accessed on the International Journal of Drug Policy website here: https://doi.org/10.1016/j.drugpo.2019.05.025

If you do not have access to the journal, please contact the corresponding author, Graham Brown, at graham.brown@latrobe.edu.au

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[1] Needle, R.H , D. Burrows, D., Friedman, S.R., Dorabjee, J.,  Touzé, G., Badrieva, L.,  Latkin, C. (2005). Effectiveness of community-based outreach in preventing HIV/AIDS among injecting drug users’. International Journal of Drug Policy, 16 (Supplement 1) , pp. 45-57, 10.1016/j.drugpo.2005.02.009

[2] Hayashi, K.,  Wood, E.,  Wiebe, L., Qi, J., and Kerr, T. (2010).  ‘An external evaluation of a peer-run outreach-based syringe exchange in Vancouver, Canada’. International Journal of Drug Policy, 21 (5), pp. 418-421, 10.1016/j.drugpo.2010.03.002

[3] Bonnington, O. and Harris, M. (2017).  ‘Tensions in relation: How peer support is experienced and received in a hepatitis C treatment intervention’. International Journal of Drug Policy, 47 , pp. 221-229, 10.1016/j.drugpo.2017.05.031

[4] Marshall, Z.,  Dechman, M.K., Minichiello, A.,  Alcock, L., Harris, G.E (2015). ‘Peering into the literature: A systematic review of the roles of people who inject drugs in harm reduction initiatives’. Drug and Alcohol Dependence, 151, pp. 1-14,  10.1016/j.drugalcdep.2015.03.002

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