This project brought together opioid substitute treatment (OST) recipients, researchers from the University of Bristol, Bristol City Council, Bristol Drugs Project, Developing Health and Independence, and Harm Reduction Mothers2Mothers. In 2025, we co-produced a booklet with graphic designer Michael Linnell to empower OST recipients and promote mutual respect between them and pharmacy staff. The booklet is freely available here.
The idea was born from a 2023 workshop in Bristol, where people with lived experience of drug-related stigma and professionals from local services identified stigma in pharmacies as an issue, amplified by the common requirement to attend pharmacies daily, especially early in treatment. This led to three co-production workshops in 2024, involving OST recipients, academics, pharmacy staff and other key stakeholders.
We followed the National Institute for Health and Care Research’s principles of co-production: sharing power, valuing all perspectives, reciprocity and relationship-building. The first workshop, held at The Community Farm near Chew Magna, Dorset, focused on building trust and exploring experiences of pharmacy care.
The second, at Barton Hill Micro-campus, Bristol, centred on booklet content. The name ‘Voice of the Voiceless’ was proposed by a lived experience member, reflecting the group’s desire to be heard and respected.
The booklet includes personal vignettes and outlines rights and responsibilities for both pharmacy staff and OST recipients. These were designed to support OST recipients in advocating for themselves, promote understanding and compassion in pharmacy interactions, and reduce stigmatising attitudes and behaviours.
Participants described the co-production process as empowering and inclusive. The booklet is now being disseminated across the UK, with plans to evaluate its impact and explore further training and engagement opportunities.
We hope this work will resonate with pharmacy teams and encourage further dialogue and action to reduce stigma in OST provision.
Vicky Carlisle, study lead, research fellow, University of Bristol (vicky.carlisle@bristol.ac.uk)
Jenny Scott, pharmacist and senior lecturer, University of Bristol (jennifer.scott@bristol.ac.uk)
Adam Holland, clinical research training fellow, University of Bristol (adam.holland@bristol.ac.uk)
