Peer work raises recurring issues.  In this section, we will address some of the hurdles facing peer work and provide suggestions on how to deal with them.

We can identify a number of critical factors that have to be addressed when initiating or conducting peer work:

  1. Expectations
  2. Stigma
  3. Lack of agency commitment
  4. Legal barriers
  5. Neglect by decision-makers
  6. Limited involvement
  7. Need for clear objectives
  8. The debate on evidence

“ never hurts to consider new opportunities; sometimes people find they really do like doing something they’d never thought of before.  Peer work isn’t for everyone, and agencies that run these programs must be aware of that.  If peers change their mind after accepting a job, or if it just doesn’t work out, no harm done.  But peers and agencies might be in for a pleasant surprise!”

Toronto Harm Reduction Task Force in Peer Manual, A guide for peer workers and agencies



Peer work is no silver bullet, a tool that easily solves every problem, but might be a very valuable additional method to support people by involving them.

Defining clear goals and setting realistic expectations is an important prerequisite of peer work.  A programme should have realistic perspectives and avoid too high expectations, which can lead to tensions and disillusionment.  There is a detailed section on programme initiation. See:  HOW TO DEVELOP PEER INVOLVEMENT/Initiate

It is important to realise that not every individual is interested in getting involved.  Some people have other, more pressing priorities;  some might feel they lack organisational knowledge, skills and capacities;  while others simply have different ambitions.



Existing stigma and lack of community acceptance put a serious burden upon many who want to be involved in peer work.  Peers walk the finest line between their community and the mainstream world of policy development and service delivery.

Peer programmes should acknowledge that peers are facing the same stigma as the community they come from. Stepping out in the open and expressing yourself as a peer isn’t an easy thing to do.  Many peer participants feel that the stigma associated with drugs and drug users is still powerful.

“Peer work is an imperfect science operating in a context where personal, societal, and legal agendas collide.  As current or former drug users, peer educators will be exposed to pressure and situations that affect their personal and professional lives.  To protect employees and employer, drug-user organisations have a responsibility to recognise these pressures, anticipate these situations, and establish a clear framework to guide the peer educators' decisions from both practical and ethical perspectives.”

Annie Madden in AIVL brochure ‘A framework for peer education by drug-user organisations’


Lack of agency commitment

Peer work requires a special attitude from supportive agencies.  Agencies have to give up the concept of the traditional helper-client model as the only way to operate and need to open up to alternative approaches and agencies. Services need to be seriously committed to support peers in their work and other workers as well.

Agencies need to provide continued investment in the recruitment, training and supervision of peer workers. Other colleagues may have difficulties in working with a new approach and new colleagues who have a different expertise.  Involving new types of colleagues and different types of collaborations may be new and counter-intuitive to some organisational cultures. 

The section on implementation gives many examples of how agencies can support peer work in daily practice.

Legal barriers

There are many environmental factors that influence a person’s behaviour. For marginalised groups, who live often live at the fringes of society and are subject to stigma and discrimination, the significance of an enabling environment is great.  In some settings, disclosing that you are a community member - a drug user - may be risky.  Activities such drug use and sex work are (sometimes) illegal and individuals might face legal problems when exposing this personal information.

Peer work is likely to be more successful if you are able to embed the activities in supportive (organisational) environment.

An interesting research on peer work (among sex workers in India and South Africa) shows the importance and necessity of a stable and supportive political and social environment in which peer work can operate effectively (Cambell, 2009).


Neglect by decision-makers

An issue influencing the involvement of drug users is the role of decision-makers.  Decision-makers are likely to be the ones initiating the participation process to involve drug users in services and in decision-making:  they most often create the climate and the conditions in which consultation and participation takes place.  However, the participation and involvement of peers or community members is often neglected by service providers, policymakers and other decision-makers, because it is considered a time-consuming and disrupting process.


Limited involvement

Peer involvement is a delicate issue.  If not done well, it may frustrate peers and can possibly damage more than it benefits.  As such, even well-intended but poorly delivered participation approaches can be counterproductive if the dynamics of ownership and power-sharing are not properly managed.


This is especially the case if peers feel that that they are not adequately supported or that they are promoting someone else’s agenda.  The result may be that they lose interest in involvement and leave the programme.

So again:   a plea for meaningful involvement see: BACKGROUND/Meaningful involvement



Need for clear objectives

Another challenge is that peer work is criticised for often lacking clear objectives and is more a matter of ‘just doing what seems right’.  Practitioners work on the ground, have first class information, knowledge and intuition and many operational decisions are often made on ‘gut feeling’.   Consequently, they may not always see the benefits of  what might be felt to be ‘academic processes’.

Unfortunately, this is a mistake. It is no use working just hoping for the best. Sound planning, preparing and monitoring if you are on track are absolutely necessary. The argument for the necessity to have clear objectives and to monitor progress makes absolute sense.  Sections dealing with these issues on this website are: