Public consultation was carried out as part of the development of Ireland’s current national drug strategy, Reducing harm, supporting recovery.1 In a bid to ensure that the voice of those most affected by the new strategy would be heard, the Union for Improved Services, Communication and Education (UISCE) carried out a consultation with people who use drugs (PWUD). While central to any drug policy, the stigmatisation and criminalisation of drug use are just two of the reasons why the voices of PWUD tend not to be heard in the policy-making process. A paper has been published on the ‘peer-led street outreach approach’ undertaken by UISCE to fill this gap. The paper provides valuable insights on how to engage with PWUD to inform policy development.2
UISCE focused its efforts on what might be considered the most hard to reach of the cohort of PWUD in Ireland – those who are ‘injecting on the street’. The authors describe this as presenting a number of challenges: how to access these PWUD, ethical issues of safety and consent, and the logistical demands of carrying out the consultation in the time available. UISCE decided to build on its experience of taking a peer-led approach to its work, whereby PWUD use their knowledge and contacts to engage with other PWUD. Through this work, the views and experiences of 51 PWUD were included in the consultation.
Key issues in using this method of consultation:
- Prior to carrying out the consultation, UISCE had to address the ethical concerns of informed consent, confidentiality and safety. It did this by complying with various ethical frameworks that guide its work more broadly.
- The research tool (a questionnaire designed by the Department of Health for the public consultation more broadly) needed to be adapted to be appropriate for PWUD. The wording was made more accessible through consultation with PWUD.
- Success depended on how well-known the peer carrying out the recruitment was to the potential participants. Furthermore, reassurances were needed where PWUD were suspicious of others because of concerns, for example, about the police or drug debt.
- The weather also presented a barrier to recruitment – people were less willing to complete the survey when it was cold and wet.
Given the nature of the questionnaire as a broader public consultation document, the findings were limited in terms of depth. Findings included that 72% of PWUD identified heroin as the most harmful drug; 60% agreed that it was difficult to access treatment; and 68% were not aware of the existence of the 2009–2016 national drugs strategy. A full report of the findings is available from UISCE.3
This consultation ensured that the voices of PWUD were heard in the development of the strategy; however, this paper highlights how time consuming a process it can be and the challenges faced. UISCE is represented on the National Oversight Committee and as such it might be expected that further consultation exercises of this kind will be undertaken to ensure the voices of PWUD are heard to inform the ongoing implementation of the strategy.
1 Department of Health (2017) Reducing harm, supporting recovery: a health-led response to drug and alcohol use in Ireland 2017–2025. Dublin: Department of Health. https://www.drugsandalcohol.ie/27603/
2 Melaugh B and Rodrigues H (2018) ‘The voice of the street’: using peer led outreach with people who use drugs to inform the development of Ireland’s National Drug Strategy. Social Work and Social Sciences Review, 19(3): 7–16. https://www.drugsandalcohol.ie/29784/
3 UISCE (2016) Your voice: 2017 national drug strategy. Brass Munkie, 30, Winter 2016