Co-production in community-based substance use disorder treatment services: a scoping review

The personal and social harms from unmanaged substance use disorders (SUD) are substantial. Too few people with SUD are engaged in treatment, partly due to the acceptability and accessibility of services. Co-production - sharing power and decision-making between professionals and people with lived experience (PWLE) - could address barriers to improve uptake and outcomes of SUD treatment. This scoping review examined recent (01/09/2023-08/03/2025) literature on co-production in community SUD treatment services.

Co-production has been used to address barriers to care and co-design new interventions and services, especially for marginalised populations and groups with complex needs. Methods, processes, and the degree of meaningful involvement of PWLE varied across projects. Most work occurred in higher income countries and the impacts on PWLE were rarely explored.

Co-production is feasible and can inform the development of more patient-centred SUD treatment services. Projects should be grounded in theory and power differentials in decision-making addressed to ensure equitable and meaningful participation throughout the process. There is a need to explore co-production in the design and evaluation of general SUD treatment, sustainability, impacts on participants, and evaluation of long-term outcomes.