Understanding the role of peer involvement in UK harm reduction interventions

Aims: In recent decades British drug policy has shifted from a harm reduction approach to an abstinence-based recovery approach, changing the landscape of support available to people who continue to use drugs. People who use drugs (PWUD) are a highly stigmatised and marginalised population with high levels of mental health need, who often face barriers to accessing services. In other countries, peer work has provided opportunities for PWUD to deliver harm reduction interventions to their peers with a number of beneficial outcomes, but there is an absence of research on the experiences of peer workers in the UK. This study sought to understand the experiences of PWUD engaged as peer workers offering harm reduction interventions to fellow drug users in the UK.

Method: Semi-structured interviews were conducted with eight peer workers with living experience of drug use, recruited through a harm reduction organisation. Thematic analysis was used to interpret the data.

Results: Data analysis discovered four main themes: (1) Changing and Enhancing Perceptions of People Who Use Drugs, which referred to changes in the ways peer workers were perceived by others, allowing them to embrace a more positive perception of themselves; (2) A Unique and Valuable Role, which demonstrated the ways in which peer workers recognised their skills and, which made them feel valued and useful; (3) Positive Impact of Peer Work, which highlighted the changes that had occurred following involvement in peer work, including a reduction in drug use and improved mental health; (4) Fragility of Peer Work, which demonstrated the more challenging aspects of the work, including anxiety regarding the precariousness of the peer work role.

Conclusion: The study highlighted a variety of experiences of peer work, including positive experiences and more challenging aspects of the role. The findings have implications for both harm reduction organisations seeking to develop peer work programmes and mental health services that seek to support PWUD. Suggestions for future policy development and research that builds on this emerging approach have also been discussed.