While in the short term some drug user organizations may gain extra funding for mainstream service delivery, in the longer term they risk losing their relevance to IDU and possibly their core funding. The 'Us and Them' divide that is created by the provision of mainstream service delivery will eventually mean that they are no longer seen as the drug user organisation by local users.

Drug user-based organizations are funded for the things that mainstream service cannot provide. Drug user organisations do not need to become like mainstream service organizations. They need to become better providers of service to drug users.

One of the roles of drug user organizations is to make sure they do it. We cannot play that role if we are in direct competition with and open to the very same criticisms from drug users as mainstream services.

The main way drug user organizations can improve services for drug users is by informing and empowering drug users about their rights as service users, monitoring and evaluating existing services, representing the drug users perspective on key committees and developing and running service provider training programmes to help change attitudes and values over time.

If is often said that many drug users are so alienated by services and service providers that unless alternative services are provided in a friendly environment such as a drug user organisation then drug users simply would not have access to services at all.

While there is certainly truth to the alienation issue, the question is whether the best and most effective way of addressing their problem in the long term is for drug user organisation to provide the services directly.

(The issue is highlighted further when the organisation is supposed to be a state or territory organisation but has a primary focus on providing mainstream services to a relatively small number of drug users who are at the back and call of service provider. When this happens drug users outside of the immediate service area, at best feel let down and forgettable by the organisation and at worst, stop seeing the organisation as having anything to do with them).

However, if that aspect of the organisation work becomes the major focus, and major power differences develop between those working in the organisation (with the power to punish and reward) and those using the services. Then it is time to ask some hard questions.

Ultimately it is the drug users involved in the organisation (other than staff) who are in the best position to give an honest assessment of whether the organisation is seen by and large as a drug user organisation run by and for users with the main aim of promoting users rights and empowering users or do they see it as an organisation that provides services to drug users in much the same way as a number of other services? The present complexities of drug use and its inevitable services will be double fold if we continue to endure on this current issue within this confined community.

Partnership as a way to meet the needs of users and prevent the erosion of users organisation:
Some drug user-based organisations have to address the needs for "user -friendly" and appropriate services for users by organising innovative ways to retain their core identity and function as user self- organizations, while also ensuring that users have access to quality services in safe environments.

One of the main ways this has been achieved was through the development of partnerships with mainstream service providers. Under the model, rather than the drug user organisation receiving funding to provide the service directly, the organisation works with a variety of health professionals to provide their services on a sessional basis from the user group premises. This way, organizations have been able to hold primary health clinics for testing, check-ups, monitoring for a couple of days, a week or month with the doctor, nurse, specialist, etc., coming in just for those set times.

Other organisation have health clinics, counselling sessions and alternative therapy sessions in the same way. The advantage to this approach is that the organisation gets a strong say on what the service is and how it is running. The users get access to services in a safe environment but the core business and identity of the user self - organisation is maintained.

Other user group favoured establishing partnerships with other services based in the community such as community health centres, clinics, support services, etc., to improve service delivery to users without having to offer those services on user group premises. Under this approach, drug user organizations or network will often be involved in the planning of the services offered and simply provide referrals for users based on their needs.

While partnerships with external service is one way of approaching some of the complex issue raised, ultimately it is partnerships of another kind that are at the centre of the crux or this entire issue. The pressure to abandon user organising and become more like mainstream service organisation is often coming from Govt, funding bodies and non-drug users both within and outside drug user organisation.

The increasing shift from drug user controlled decision making and the removal of drug user from key position within drug users organisation and non-drug user organisation is leading to the collapse of user self organising in Manipur. Drug users are increasingly being seen as incapable of running their own organisation without the direct involvement at all strategic levels of non drug users.

Alternative options

Not all users needs are entrenched within a medical mode of drug treatment while there is more diverse substitute - prescribing and better understanding of the effects of drug use on one's mental and physical health, we need to be open to the widest possible range of options.

If we only seek to meet drug users needs through the development of "traditional drug services" we run the risk of individuals falling through the net. Many users do not attend drug services and will not attend drug services. Key to success of any response or intervention is to ensure that drug users are evolved in the initiating development and delivery of any responses.

Partnerships are key to the future of any responses meeting the needs of drug users. However, it is vital that the expertise of drug users is valued and included. Drug use, whether you agree with it or not, is part of today's society.

Once again this allows drug users organizations to remain independent and be able to make a crucial appraisal of the service required. Partnership approaches to meeting the mainstream service needs of drug users not only provides a sustainable way of providing high quality and responsive services for users but also eliminates the need for drug user organisation to go down the extreme flawed path of mainstream direct service delivery.

Trying to be both a drug user organisation and a mainstream service provider forced these organizations into trying to represent the threats of both service users and service providers.

It should be simply unthinkable that vacancies within drug user organizations might be filled by someone other than a skilled and experienced drug user. Activities making sure that skilled and experienced drug users apply for and get position within drug user organisation should be the number one priority, not just of the organisation, but for the funding body and other services in the area.

The fact that skilled and experienced drug users are being overlooked and ignored when it comes to strategic vacancies within drug user organizations, is a demonstration that user phobia is alive and well in the sector when it comes to vacancies in the manager positions in particular, skilled and experienced drug users who have worked their way through organizations are increasingly being overlooked in favour of outsiders, this situation is demoralizing the drug users in the organisation.

They are good enough to do all the hard ground work and to give the organisation credibility but they are not good enough to manage their own organizations. After number of years, this should not even be an issue. But it is, and it is because when all is said and done, drug users are not supported to run their own organisation, their way, regardless of all the rhetoric.

I have deliberately not held back in this article because, quite frankly, I'm sick of holding back while selfish do-gooders destroy our organisation. For too long drug user based organisation have self censored what they have to say in the hope that playing the game and being seen as a reasonable would help us in achieving our aims - it wasn't too often drug users are seen as the ones who need to stand up and be counted and save drug user organisation from extinction.

The fact is, however, that is not up to users to keep user groups from going under. Drug user based organisation would be doing just fine if it wasn't for the constant criticism from the sidelines, the undermining and games and the seemingly endless parade of non drug users within to build their careers and reputations on the back of drug user organisation.

True partnership when it comes to drug user organisation is about govt, funding bodies. Services and non-drug users actively and honestly supporting us to do what we need to do. Partnership is not about taking our jobs, showing us how it's done or setting our agendas to suit personal or careerist motivation.

Many non drug users involved in drug user organizations reading this articles are probably thinking "How unfair", "why do I even bother to be invol-ved if this is how I get treated"? But I would like to asked the same question.

Why are you involved in drug users organizations?
Who are you doing it for really?
What are you trying to achieve?
Are you really willing to completely surrender to the drug users in the organizations and accept (for better or worse) what they identify as the aims and objective of the organisation?
If not why are you there?
Why indeed?

Drug user organisations who by their very nature are openly are under attack. Being forced to conform to the "professional" agenda is resulting in a dilution of peer-based processes.

The process of survival for many drug users organisation is leading to disempowerment and a compromise of philosophy and culture. More than ever, drug users, including the most marginalised drug users must be allowed and supported to take the driving seats, with both recognition and affirmation of their expertise.

Conclusion

Drug users of Manipur have been generally considered as criminal and bad peoples and we have felt the devastating impact of this attitude in nearly every area of our lives - our ability to work has been restricted, our ability to receive appropriate health care is compromised except a few who liaisons with the NGOs and we have not been treated as capable of functioning productively in society.

These conditions underscore the need for a peer driven network of drug users comprising of both active and former drug users, our groups overarch-ing goal is to promote the dignity and respect for the basic human rights of people using drugs. Without the achievement of basic rights, such as the right to health, the HIV/AIDS epidemic is in our society and community can never be successfully resolved.

At the same time by promoting equality and respect for rights, we can ensure that people using drugs can have a better quality of life. Changing attitudes may take sometime, but at least now with our voice and participation through the users network, we can correct misconceptions, provide a different perspectives and join in the fight to reduced drug related harm, particularly through the improvement of policies and services.

Through these activities the Manipur Network of Drug Users hope to "re-humanize" the people who use drugs in our society and help people realize that most of the time, fear arises from a lack of information, improving our self and our understanding of how to be safe and how to respect rights will be our model in working with society towards a better future.

Drug user activism is about feeling empowered, capable, confident and able to create to change, a position within our community that we are all entitled to have. Drug user activism is not about turning the substitution therapy clinic into an Astroturf where dribbling skills of hockey players can be showcased. Nor a memory of Berlin wall where the divide between users and ex-users can be bulldozed or the attitude between a service provider and clients are too revered to be bridge.

Access to drug treatment service including Buprenorphine is indeed a human rights. Sadly it is a right that we need to continue to fight for.