Centring lived and living experience in the alcohol (and other drug) sector
Key takeaways
> People with lived and living experience (LLE) bring unique expertise that strengthens alcohol and other drug (AOD) policy, service delivery, advocacy, and system reform. LLE expertise reduces stigma, supports recovery and harm reduction, improves service relevance, and helps ensure systems reflect the needs of people directly affected by AOD use.
> The LLE workforce is still emerging and in need of greater support to overcome the challenges inherent in embedding these essential professional roles within the service system.
> Greater investment in peer work, consumer and family and supporter participation in services and systems, LLE workforce development and leadership opportunities is critical to embed LLE perspectives across the AOD sector.
LLE is integral to responding to alcohol harms
Forty-one percent of people seeking support for AOD harms report alcohol as their principal drug of concern,¹ and alcohol is also often involved in polydrug use.² People with LLE have direct experience of alcohol and other drug use, recovery, treatment, harm reduction, or supporting a family member affected by AOD-related harms. Across Australia, people with lived experience contribute through formal peer support roles, mutual aid, service system navigation support,³ advocacy, research, consumer and family and supporter participation, service design, governance and policy development. Their expertise provides insight into issues, barriers and opportunities that are often unavailable to the broader workforce and supports more responsive, person-centered services and systems.⁴
Peer workers help people engage with services, build trust, reduce self-stigma and model hope and recovery. LLE expertise also strengthens program design and delivery by ensuring services reflect the realities of people directly affected by AOD use.
An emerging LLE workforce in need of more support
Despite growing recognition of the importance of LLE and its vital role in the service system, challenges remain, including:
Ongoing stigma associated with identifying as a person with lived experience.
Limited secure and ongoing employment opportunities for designated LLE positions.
Inconsistent role clarity and understanding of LLE as a distinct discipline.
Barriers to career progression, professional development and supervision.⁵
Underinvestment in consumer, family and supporter participation and representative structures.⁶
No nationally recognised vocational education training dedicated to AOD peer work.
Embedding LLE experience perspectives in policy and practice
Tackling alcohol harms requires meaningful LLE participation and structured, adequately resourced mechanisms that enable people with LLE to contribute to planning, governance, service delivery, and evaluation. Evidence highlights the importance of involving people directly affected by AOD use in decisions that impact them, both for service quality and human rights and ethical standards. Embedding LLE leadership helps reduce stigma, strengthens accountability, and improves the effectiveness of policies and programs.⁷
Recommendations
Increase investment in secure, clearly defined LLE roles with appropriate remuneration, supervision and career pathways.
Expand peer worker and peer navigation roles across the AOD system to improve engagement, access and continuity of care.
Strengthen consumer participation mechanisms and resourcing and ensure LLE expertise is embedded in policy, planning, research, commissioning, governance and advisory structures.
Invest in representative and peer-led organisations to support safe, meaningful and supported participation in system reform and service design.
Develop workforce guidance that clearly distinguishes designated LLE roles and supports role integrity, integration and shared understanding.
Support nationally recognised training and professional development pathways for the AOD lived experience workforce, including a nationally recognised AOD peer worker qualification.
References
1 ‘Alcohol and Other Drug Treatment Services in Australia Annual Report 2024–25’, Australian Institute of Health and Welfare (Web Report, 25 June 2026) <https://www.aihw.gov.au/reports/alcohol-other-drug-treatment-services/alcohol-other-drug-treatment-services-australia/contents/drugs-of-concern>
2 ‘Experiences of Alcohol and Other Drugs Among People Who Inject Drugs’, Australian Institute of Health and Welfare (Web Report, 11 December 2025) <https://www.aihw.gov.au/reports/alcohol/alcohol-drugs-inject>.
3 Christine Ramdin et al, ‘Improvement in Substance Use and Quality of Life in Patients Engaged in a Peer Navigator Program for Opioid Use Disorder’ (2026) The Journal of Emergency Medicine (advance).
4 Self Help Addiction Resource Centre, Alcohol and Other Drug (AOD) Lived Experience Workforce Discipline Framework (Report, 2025) <https://www.sharc.org.au/wp-content/uploads/2025/03/AOD-Lived-Experience-Workforce-Discipline- Framework.pdf>.
5 Janet Long et al, Mapping the Ecosystem of Addiction Strategy, Support, and Service Provision in Australia: Towards Better Care For Those Harmed by Addiction (Report, December 2025); Victorian Alcohol and Drug Association, State Budget Submission 2026 (Report, 2025) 9 <https://www.vaada.org.au/wp-content/uploads/2025/11/State-Budget-Submission_VAADA_ 2025-1.pdf>.
6 Natalie Skinner et al, Review and Revision of the National Alcohol and Other Drug (AOD) Workforce Development (WFD) Strategy (Discussion Paper, 2021) <https://nceta.flinders.edu.au/application/files/7016/3969/7235/AOD_WFD_Strategy_Discussion_Paper_-_FINAL_.pdf>.
7 Brett Scholz, Sarah Gordon and Brenda Happell, ‘Consumers in Mental Health Service Leadership: A Systematic Review’ (2017) 26(1) International Journal of Mental Health Nursing 20.
