Can someone who has only ever used recreationally adequately understand a person whose use has involved a long-term struggle around their consumption and associated life impacts ?
drugs , but in many contexts they should be considered a necessary component of ‘ lived experience ’.
Drug use itself is also , obviously , far from a homogenous experience . Prohibited drugs range from depressants to stimu lants , psychedelics and more . Moreover , people who use various types of drugs do not necessarily mix much , nor necessarily share much in common .
DRUG ELITISM These differences are underlined by forms of ‘ drug elitism ’. Some who use cannabis or psilocybin mushrooms portray their ‘ natural ’ drugs as better than synthetic substances . Some who enjoy MDMA or LSD call for their ‘ non-addictive ’ drugs to be legalised , but draw the line at methamphetamine or heroin because of the potential for dependence . Some who inject steroids to increase muscle mass may resent being associated with people who inject other drugs . The list goes on .
Lived experiences of drug use often relate to very specific contexts . People who use prohibited drugs to self-medicate conditions like MS , ADHD , epilepsy or autism may have profoundly different experiences from others . People who use prohibited drugs such as coca leaves , kava or ayahuasca to engage in cultural or religious practices will have quite different motivations and experiences again .
Even among people using the same drug in the same culture , the nature of a personal relationship with that drug can vary dramatically . Can someone who has only ever used recreationally adequately understand a person whose use has involved a longterm struggle around their consumption and associated life impacts ?
LIVED AND LIVING Yet another distinction is between ‘ lived ’ and ‘ living ’ experience . To what extent , for instance , can a person who identifies as having experienced addiction , and who now selfdescribes as ‘ clean ’, meaningfully inform peer-led services for people currently using drugs ?
Some ( though by no means all ) who refer to themselves as ‘ clean ’ can be evangelical
WHAT DOES IT MEAN ?
This incomplete summary is intended to highlight the sheer diversity of what ‘ lived experience ’ can mean to a vast array of contrasting groups . And if we acknowledge that , it should prompt some important reflections .
FIRST , is it vital we operate with awareness that inclusion of one or more people with ‘ lived experience ’ is not a catch-all , when the experiences in question may differ substantially from those best-placed to lend knowledge and insight to the task at hand .
SECOND , far from undermining the value of representing lived experience , recognition of its diversity should cause us to redouble our efforts . When lived experiences are so diverse , it is only through inclusion of many different impacted people that we can hope to involve a meaningful range of experience , knowledge , values , beliefs and perspectives .
THIRD , the huge diversity of lived experiences may sometimes limit the range represented in a given project . And that raises challenging questions around the extent to which people from one group possess the knowledge , insight and empathy to adequately understand and represent the needs of another – the extent to which you ‘ have to be one to know one ’.
in their belief that the only way people can get help is if they quit drugs . As peers , they would then approach policy development and service delivery quite differently to another person with lived experience , who believes in supporting ongoing drug use through harm reduction . In all walks of life , we all run the risk of projecting our own experiences and personal solutions onto others .
These thoughts should all factor into decisions about who should be considered ‘ peers ’ in different contexts ; whom they represent , and importantly , whom they might struggle to represent . An organisation seeking to legalise and regulate drugs , for instance , should certainly seek peers with experience not only of prohibited drug use , but also of the ongoing impacts of prohibition enforcement .
All of the diverse groups of people who use drugs need and deserve to be heard and represented . But we believe that people who have suffered most under the drug war – primarily people of colour , Indigenous people , people with experiences of poverty , incarceration and chronic unmet needs – should be first to the table .
‘ Nothing about us without us ’ begins with the inclusion of those most excluded .
Dr Julian Buchanan was a pioneer of 1980s harm reduction in Merseyside . Now a retired professor in New Zealand , he helps to lead Harm Reduction Coalition Aotearoa ( HRCA )
Dr Oscar Graham is an early-career biomedical science researcher based in New Zealand . He has recently become involved with local drug policy reform organisations and serves as the secretary for HRCA .
This article was originally published by Filter , an online magazine covering drug use , drug policy and human rights through a harm reduction lens ( filtermag . org ). Follow Filter on Bluesky , X or Facebook , and sign up for its newsletter .
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