Consumer participation in decision making about service planning is common in certain areas of health service provision in Australia but is thought to be largely underdeveloped in drug treatment services. This paper 1) describes the current practices within Australian drug treatment services that aim to include consumers in the process of service planning and provision; and 2) determines how much consumers know about the existing opportunities for involvement. Sixty-four randomly selected service providers (representing 64 separate services) completed interviews about the current arrangements for consumer participation within their services (response rate =82%). 179 consumers completed interviews assessing their knowledge of the consumer participation activities available at the service they attended. Findings show that consumer participation activities are not uncommon in drug treatment services, although the existing activities are largely concerned with providing information to or receiving information from consumers. Activities that include consumers in higher forms of involvement, such as those in which consumers share in decision-making, are largely uncommon. The paper also reveals the considerable lack of knowledge that consumers have about the participation activities available to them, revealing a lack of communication between providers and consumers. Thus, while service providers are making efforts to engage consumers in service planning and provision (despite the general lack of State or Commonwealth policy directives and extra funding to do so) these appear ineffectual because of a lack of communication between providers and consumers. As a starting point, a critical part of any meaningful consumer participation initiative must include systems to ensure that consumers know about available opportunities.