Sergio Rodrigues

“In 2009 I was living in a Drop-In Center when I went to a training course about how to run drug users associations promoted by Apdes (Portuguese NGO). I got enthusiastic about the idea of working in this field: I wanted to help people that use drugs, to give them proper information about drug use and health and involve them on the activism fight for their rights. I started to make some contacts to create a work opportunity: I talked to my therapist and with APDES and proposed to integrate one of the outreach teams of this organisation, GIRUGAIA, in a special employment program for abstinent drug users.
Now I work in APDES and here I’m a Peer Worker: I work with other professionals in this outreach team, and I also work in the Portuguese drug users association, CASO – Consumidores Associados Sobrevivem Organizados (Associated Users Survive United).”

“I see a difference in the field, talking informally with the drug users. They listen and collaborate because they know that I have the experience of drug use. On the other hand, professionals are starting to recognize peer work and call for us to represent drug users in seminars and workshops. I can give the example of this network that called for us, CASO, to assume the role of mediators for homeless drug users: they ask for our presence on the meetings!”

Sergio Rodrigues, peer worker and activist in Porto, Portugal

Jason Farrell

“Although harm reduction has become widely accepted as an approach to preventing the transmission of blood borne infections, drug users continue to be excluded from policy debates and program implementation, in contrast to consumers of traditional AIDS prevention programs. What we did in New York was when HCV treatment, prevention and care recommendations were being designed we fought for IDUs with HCV to be involved. That is how VOCAL started by organizing on behalf of HCV related issues.

"Parity, Inclusion and Representation’ - PIR was the term and guiding princable used in official documents when mandating community representation.”

“Good support systems and clinical supervision can enhance skills and build a supportive safe environment for peer workers to excel.

At my former NGO in NY we offered clinical supervision for our peer workers. It is critical and needed.  This must be included in any peer support work or peer worker service... Especially for former drug users working with current drug users.  Preventing relapse for both current and former drug users, current drug users by engaging in risky drug use practices again, and relapse for former drug users, using again is a concern and can be prevented with appropriate support systems in place.  Clinical supervision/support can enhance skills and build a supportive safe environment for peer workers to excel.”

Jason Farrell, AIDS activist and harm reduction consultant, United States/The Netherlands

Jude Byrne

“The prohibition of drugs inevitably leads to the development of a community. Drug use is illegal ipso facto drug users are criminals.  Forced to develop economic and social networks to keep one’s individual supply of drugs achievable and I must confess, to keep those not involved in as much ignorance of our activities as possible.  Outside our individual countries we are bonded by a common experience.  That goes beyond language, cultural or regional diversity.  Our common experience of discrimination, our lack of human rights speaks to every illicit drug user."

Jude Byrne, drug user activist, chair person of INPUD, Australia

Jean Paul Grund

“Nico Adriaans, best known as the founder of the first Junky Union, was also the first community field worker in the Netherlands. Our ethnographic study described routes of HIV transmission that were formerly unknown. Could not have done it without him. The legacy of Nico is that peer involvement is not just about getting knowledge into, but also out off the community and that such knowledge means power.”

“Peer education and support are effective strategies for e.g. HIV prevention among drug users. My research suggests that such efforts dovetail neatly with natural mechanisms of social support. From the streets of New York or Moscow to the pastures of rural Connecticut or Pskov, I have seen that peer action is a rewarding and empowering experience!”

Jean Paul Grund, researcher, The Netherlands

Berne Stahlenkranz

“There is no way that the government can develop a fair policy on drugs and health without consulting and involving us:  people using drugs.  We are the one and only real experts.”

Berne Stahlenkranz, drug activist, Swedish Drug Users Union, Sweden.

Katrin Schiffer

“An important social paradigm that took place over the past two decades:  from a more patronizing public health model, based on health professionals, towards a more pluralistic and democratic model with civil society participation as the main element.  As a consequence, ‘self-help’ groups and patient groups entered the policy arena and public health professionals lost their status as ‘untouchables’.”

Katrin Schiffer, Correlation , The Netherlands

Theo van Dam

“Three issues are of utter importance in peer work: good training, decent remuneration and good mutual support.But first of all practice-based training. And practical support to attent the training workshops. Technical trainings but also on dealing with various situations and issues
Help new people to become creative in solving issues. That’s the best way to address problems. Have team regular team meetings, where people feel welcome, at home.”

"Every person should have the opportunity to determine what’s best for him. When I came out of rehab in the 1980s, I wanted again to be involved in the drug scene. I got the opportunity to start a HIV pevention initiative, NO RISK. The idea was to inform and support injecting drug users who did not have contact with drug services. I noticed that they appreciated our approach and our information. Straight from the life experts. Soon we included social support and advocacy for the interests of users. On top of that I had the opportunity to support colleagues in their critisism on drug services and drug policy. I contributed to the first peer support manual in the 90s.
It became the only bible I have read several times”

Theo van Dam, drug user activist, The Netherlands

Franz Trautmann

“Peer support is in fact part of everyday life reality in the drug scene. Drug users  as everybody else – learn from each other, judge and criticise the behaviour of their peers, etc. Peer support therefore is no new approach but nothing else than intentionally  making use of this everyday influencing between peers.”

Franz Trautmann,
Trimbos Institute, co-author first manual on Peer Support in 1995

Mat Southwell

“There needs to be greater investment in the interface between drug using communities and the professional field.  Drug user organisations should be key players in this environment. ... Partnerships between academics, practitioners and drug user organisations need to be strengthened to ensure that knowledge in all three domains is considered and where appropriate translated into accessible practice or peer support interventions.”

“Many fear that drug user organising will lead to increased conflict and confrontation between services and their service users.  However, there may be benefits for both parties in a more mature engagement.  Of course, to achieve these benefits both drug users and drugs professionals need to be willing to explore, debate, and probably redefine their working relationships.  This is part of the journey towards a more open and effective engagement between drug users and their service providers.”

‘Genuine and meaningful peer involvement is absolutely key. It is an essential right s issue and will benefit to every one. Peer involvement brings back the energy in Harm Reduction’


Mat Southwell, in EMCDDA, Monograph on Harm Reduction.

Joana Marquez

“Our involvement in peer work began because we started to feel frustrated when implementing our first outreach team. We couldn’t really achieve, by ourselves, professionals, the defined goals, towards a more effective intervention: we weren’t reaching the hidden drug users groups and we couldn’t contribute more to change their risky behaviours. So, on a team meeting, we decided to do something about this and we started to explore ways to involve peers. Almost at the same time, one of our colleagues, talked to us about a drug user activist she had met at a international meeting. That was when we decided to invite him to develop workshops with professionals, decision makers and drug users. The objective was, apart from others, to motivate Portuguese drug users towards the constitution of a drug users association. After this, CASO, the Portuguese drug users union, was born.”

“Sometimes it’s difficult to separate roles (client/drug user vs. peer), because they face problems like dealing with personal issues of the drug user similar to the ones they face with the other clients. This happens because the professionals make efforts trying to look at peers as ‘normal’ workers, trying to forget that they have specific profiles and problems. The advantage of including as peers, the clients of the organization is that: they are already familiar with some of the particularities of the team, it’s rules, way of work; they know more about their peers and the consumption practices, the drug scene and so on.”

Joana Marquez, APDES, Portugal