The aim of this article is to describe and explain the development of drug user groups in the UK and elsewhere by drawing on a case study of one of the earliest drug user association formed in England in 1983, known as the Drug Dependents' Association. By way of context, a literature search was conducted to find other examples of original case studies of early drug user groups. The main method of investigating the case study arose out of the recovery of research materials by two of the authors which were used as part of another research project conducted in the early 1980s. The data collected comprised a full transcript of the first meeting of the group, agendas of all of the meetings and notes taken by the authors at the time. The analysis of the search material and the case study data indicates that drug user associations have change markedly since these early forms. The main changes include the integration of drug user groups into mainstream practice through the development of service user groups, a shift away from user-led to service-led organizations, as well as a change in focus from broader political campaigning towards the details of service provision.