Barriers and challenges

Many years of experience, all over the globe show us that there are many hurdles and pitfalls when a peer work programme is implemented.  The most significant problems are: (source AIVL)

  • stress and burnout
  • over-ambition and over-motivation
  • problems around drug use
  • ‘professionalisation’ demands
  • high staff turnover
  • organisational issues
  • collaboration with other agencies
  • leaving the job


Each of the above will now be briefly discussed.

Stress and burnout.
Peer work can often be challenging for a drug user.  Their daily life has many issues (from supply droughts and police patrols all the way to treatment regiments and recurring health issues).  These issues come in addition to workplace issues such as demanding supervisors, annoying colleagues, ‘hard work, little pay’, and so on.  This mixture of issues are a lot to deal with and peers and the agencies they work for have to address them carefully.

Over-ambition and over-motivation
Commitment is great, over-commitment is counter-productive if not directed or channelled well.  Over-ambitious and over-motivated workers will sooner or later come up against their own or their agency’s limits.  Supervision is vital and should not only rely on advice to ‘take it easy’, don’t get so emotional’, but also positive reinforcement such as ‘Your commitment great, but it sometimes not making the impact you want. If you want we could sit a some time and talk how you could work on this.’

Problems around drug use

Relapse, increased drug use, initiating use of other drugs and switching to injecting are all issues can arise with a peer worker.  Workers and agencies need to be prepared for this.  Good supervision and support can  help to avoid, or certainly address them.

‘Professionalisation’ demands
Increasing (external) demands to professionalise agencies’ governance, operational activities, quality management and monitoring systems can lead to growing pressure on the skills of the peer worker.  He/she may be very good in making contact and building bridges to services, for instance, but his/her technical skills such as report-writing or giving presentations may not his/her cup of tea.

High staff turnover
Experience has shown us that there is a significant turnover among peer workers, which puts a burden on the shoulders of the more stable workers and the agency as a whole.  A shortage of workers due to turnover can also effect the smooth delivery of services.

Organisational issues
Having unstable or inadequate supportive management and lack of coordination will particularly negatively affect by peer workers.

Collaboration with other agencies
When working with other agencies that have different policies regarding peer work, the peer worker will expect loyalty and support from his/her own agency.  This builds respect and trust in the organisation the peer works for.

Leaving the job
At some point, peer educators will stop being involved in peer work.  After they have left, it might take a long while before people in the community they used to work in realise that they are no longer connected with the agency and are no longer a formal source of information and support.   However the ex-peer worker will always carry the knowledge, information and respect he/she has gained from being a peer worker.