It is unclear how consumer participation (CP) can be optimised to transform drug and alcohol treatment services and improve health outcomes. This paper presents the findings of a systematic review examining the types and benefits of activities, and the factors that facilitate CP in drug treatment services. Design A structured search of four databases was undertaken to identify peer reviewed primary research literature in English. Screened articles were appraised. A content analysis was applied to examine the types and outcomes of CP and the associated factors affecting the process. Sixteen articles were included for review. Findings A range of CP activities were identified, and benefits included increased consumer satisfaction, and improved health service delivery. Factors that facilitated the process of CP included positive attitudes of both consumers and providers and employment of people with a lived experience of drug use. However, the lack of consumer and organisational capacity, negative attitudes of providers and power imbalances between consumers and providers constrained CP efforts.

The Sydney Medically Supervised Injecting Centre (MSIC) is a supervised injecting facility (SIF) where people who inject drugs (PWID) can do so legally, under health professional supervision. The majority of clients have low levels of education and employment, high rates of incarceration and unstable housing and poor social networks, and 70 % do not access local health services. These factors increase the risk of poor mental health, and it has been documented that PWID have elevated rates of mood, anxiety, personality and psychotic disorders; post-traumatic stress disorder (PTSD); and higher rates of trauma exposure, suicidality and self-harm. The current study is the first to investigate the mental health among clients of a SIF. Validated instruments to examine clients’ mental health, social networks and trauma histories were administered to 50 frequently attending clients by a mental health nurse. The majority of respondents were unemployed, homeless and had a history of incarceration, and 82 % report they had been diagnosed with a mental health problem, but only 24 % report they were receiving treatment. Respondents had poor social networks, had poorer mental health symptoms compared to US inpatients and had experienced multiple traumatic events, and a high number of respondents had scores indicative of PTSD. These results highlight the need for mental health clinicians to be employed in SIFs and other drug consumption rooms (DCRs) to assist clients to address their mental health and psychosocial needs, particularly in light of the fact that these services are often the only places these PWID engage with in an ongoing way.

Nurses are frontline workers and have an important role to play in reducing the harms associated with alcohol and other drugs (AOD) dependence. AOD dependence is a major cause of preventable illness, particularly since the overprescribing of opioids has led to a worldwide overdose crisis. However, nurses receive little education in their undergraduate training about AOD or harm reduction strategies. Additionally, the 'war on drugs' and associations with criminality, often means that nurses hold negative attitudes towards people with AOD dependence. There is evidence that education can improve nurses' attitudes towards people with AOD use, especially when it includes narratives, knowledge and experiences of people with lived experience. In this paper, we outline how experts by experience (people with a lived experience of AOD dependence) and nurse educators developed a high-quality AOD undergraduate nursing subject using a co-production framework. We discuss how the co-production process allowed for the development of a unique and innovative nursing subject that provides students with a humanistic, realistic and pragmatic view of AOD dependence.

Alcohol and other drugs (AOD) use is a significant public health issue and is associated with high mortality and morbidity rates. Despite this, people who use drugs are often reluctant to seek care due to the lack of trauma‐informed treatment and harm reduction treatment options, as well as experiences of stigma and discrimination in health services. Arguably, AOD education that is co‐produced with people who use alcohol and drugs can enhance future health professionals' ability to practice in ways that support the needs of this population. This paper reports on a qualitative co‐evaluation of a co‐produced undergraduate nursing AOD subject. The AOD subject was co‐planned, co‐designed, co‐delivered, and co‐evaluated with experts by experience, who have a lived experience of substance dependence and work as advocates and peer workers. Following the delivery of the subject in 2021 and 2022, focus groups were undertaken with 12 nursing students. Focus group data indicate that the co‐produced subject supported participants to understand and appreciate how stigma impacts on nursing care and how to recognize and undertake ‘good’ nursing care that was oriented to the needs of service users. Student participants noted that being co‐taught by people who use drugs was particularly powerful for shifting their nursing perspectives on AOD use and nursing care and took learning beyond what could be understood from a book. Findings indicate that co‐produced AOD education can shift nursing students' perceptions of AOD use by providing access to tacit knowledge and embodied equitable and collaborative relationships with people who use drugs.