The concept of service user involvement has gained traction in recent decades and many countries have introduced measures to promote the active participation of patients and clients. Current policy in Ireland treats service user involvement as crucial to improving drug treatment, recovery and harm reduction services. Not only should drug treatment service users have the opportunity to participate in decisions about their own care, it is argued, they should also be able to participate in the development and redesign of services at local, regional and national levels through appropriate forms of representation.

Pressure to enable users to have a greater say in their treatment has increased in recent years as a result of a series of interrelated processes, including the affirmation of the New Public Health and New Public Management models, grassroots movements promoting user empowerment and the influence of the recovery and harm reduction paradigms. A number of obstacles to involvement have also been identified, including social disadvantage, social isolation and stigmatisation.