In recent decades, community organizing among people who use drugs has evolved within diverse social milieus. In order to explore issues surrounding peer networking for the reduction of drug-related harm, Canada's first National Harm Reduction Conference was preceded by a collaborative participatory research process involving people who use drugs and other stakeholders. Prior to the conference, an anonymous 40-item web-based questionnaire was completed by individuals recruited through advertising, the internet and word-of-mouth. Almost 900 stakeholders responded. Peer-based networks for the reduction of drug-related harm were seen as potentially effective, efficient health promoters. Respondents reflected that networks were timely, and that governments should take some responsibility to provide means of direct support. Current networks were identified as models for further development, and building upon existing networks were seen to allow for the consolidation and sharing of information, skills and understandings. Electronic communication infrastructure was singled out as highly useful given its ability to disseminate information and ideas across large geographic areas. Safety and anonymity of network members were identified as critical due to the stigma, discrimination and potential legal ramifications associated with drug use. Peer-based approaches to the reduction of drug-related harm were seen to promote a socially-inclusive community-based response to a growing public health issue. However, there was some skepticism regarding the feasibility of such networks given the currently criminalised status of many drugs in Canada. While the literature suggests networking for people who use drugs may be challenged by community context and social structure, findings suggest in Canada some harm minimising subcultural change has, and can continue to occur, as a result of peer networking activities.
