Exploring paths to reduce stigma towards people who use drugs: a participatory leadership approach.

Background: Stigma is a major barrier in the lives of people who use illicit drugs; it impedes relationships and community integration, and negatively impacts on physical and mental wellbeing. Additionally, people who use OST (methadone, buprenorphine) often experience multiple stigmas –both in relation to their identities as a person who drugs and for the medication they receive. This presents barriers to treatment engagement and retention. Bristol has particularly high rates of people who inject drugs and use both crack and heroin - we therefore wanted to gather key stakeholders to explore policy, practice and research needs in this area.

Methods: I worked with a creative facilitator, experienced in The Art of Hosting methodology. This approach draws on the collective wisdom and self-organising capacity of groups to address complex challenges. We delivered a full-day participatory leadership workshop at a community music venue in Bristol. Participants included twelve people with lived/living experience of drug use and/or OST stigma, and fifteen other stakeholders from local and national organisations.

Results: Three individuals with lived experience of drug use shared their stories, which participants were asked to consider through one of three lenses: 1) policy needs; 2) practice/culture needs; and 3) research needs. Five participants then volunteered their own questions to explore in more depth with other workshop attendees. We identified several avenues for future research to inform local practice and policy.

Conclusions: This participatory leadership approach was a successful way of bringing together diverse stakeholders in a way that addressed inherent power imbalances and allowed for a creative exploration of ideas and the establishment of new networks.