Balanced Imperfection
is pleased to announce
Harm Reduction Hacks in Focus:
SPACE
HACKS
hacks for creating functional
harm reduction spaces
Space Hacks is the culmination of surveys, qualitative interviews, and community collaboration. Balanced Imperfection initiated the project by researching various aspects of space management, trauma-informed care, transformative and restorative justice models, and de-escalation techniques. This groundwork informed the development of a survey tailored for frontline staff and individuals with experience in harm reduction settings.
Following the analysis of 180 completed surveys, Balanced Imperfection conducted detailed interviews with twelve leaders in the harm reduction field, who collectively offered 261 years of combined expertise, shaped by extensive national and international involvement in harm reduction. These leaders had managed diverse fixed-site harm reduction facilities, including drop-ins, overdose prevention sites, syringe access services, and medication-assisted treatment programs. Interviews, held between March 15 and May 16, 2024, ranged from 67 to 128 minutes each, resulting in 939 minutes of insightful discussions. Their experiences, predominantly from the Northeast and Pacific coast, were pivotal in shaping Space Hacks, which integrates their insights into best practices across prevention, immediate response, and long-term strategies. This collaborative effort was finalized through a community editing process by harm reduction experts, ensuring Space Hacks provides a comprehensive PDF resource for practitioners and organizations in the field.
The Space Hacks is being finalised and will be availiable soon!
The Project
Balanced Imperfection has guidance for fixed-site harm reduction programs on responding to escalated situations. It contains policy and protocol resources for harm reduction programs such as stand alone and embedded fixed site outdoor, drop in, or other Syringe Services Programs (SSPs), Recovery Community Organizations (RCOs), and Overdose Prevention Centers (OPCs).
In the true spirit of harm reduction, this resource emphasizes non-punitive de-escalation intervention and prevention, drawing inspiration from restorative and transformative justice practices.
The guidance aligns with the SAMHSA Harm Reduction Framework, emphasizing equity, rights, and social justice, and aims to equip communities and participants with the tools necessary to prevent and better respond to challenging situations. This effort supports capacity building and technical assistance for Local Health Departments and harm reduction programs.
-
“In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
-
“The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
Mayor Jim Kenney -
"One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
Jonathan Giftos -
"I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
Marilou Gagnon -
“When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
Thich Nhat Hanh -
"We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."
Fred Rogers -
“Boundaries help me to give all that I can and still come back tomorrow.”
-
"One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
-
"Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
Gabor Maté -
We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
Jonathan Giftos -
"The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
Judith Lewis Herman -
“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde -
"If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."
Haven Wheelock -
"What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
Kurt Vonnegut Jr. -
“People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
Danielle Sered -
"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
“Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
-
“One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
Charles M. Blow -
"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
“As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
-
"Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
Christopher Abert -
"We have to be ready and able to reach clients where they are, not where we want them to be”
-
"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
“Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
-
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
"Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
Thich Nhat Hanh -
"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr.
- “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- "One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
- "I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
- “When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
- "We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."
- “Boundaries help me to give all that I can and still come back tomorrow.”
- "One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
- "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
- We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
- "If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."
- "What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
- “People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- “Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
- “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- "Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
- "We have to be ready and able to reach clients where they are, not where we want them to be”
- "There isn’t a way things should be. There’s just what happens, and what we do."
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- “Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- "Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
The Hacks
We have divided the hacks into logical sections for ease of navigation, but you also have the option of viewing the hacks as one big collection… we’ve even included the option to view a random hack for you if you just want to allow serendipity to guide you.
Featured Hacks
These featured hacks highlight creative, practical solutions from harm reduction leaders on the ground. From DIY tools to clever workarounds, each one reflects the ingenuity, care, and real-world experience that keeps this movement alive.
Hacks for Reaching Affirmation & Accord
Featured in: Featured, De-Escalation In the Moment
One of the main goals of active listening with an agitated person is reaching affirmation and accord. You are looking to try and find ways to agree with the person who is agitated. Even if you don’t entirely agree with the person, try to find at least a small way in which they may be right, or in which you can be on the same page, or team, with them.
Trauma-Informed
Featured in: Featured, Section 2: Using Space Hacks
The term “trauma-informed” emerges from a growing understanding of the far reaching ways that trauma impacts health and well-being. Trauma is defined here, in keeping with the scientific literature, as a deeply distressing or disturbing experience(s) that overwhelms an individual’s ability to cope, and significantly impacts their mental, emotional, and physical well-being.
-
“The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
Mayor Jim Kenney -
"Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
Christopher Abert -
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
“Boundaries help me to give all that I can and still come back tomorrow.”
-
“Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
-
“As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
-
"What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
Kurt Vonnegut Jr. -
"We have to be ready and able to reach clients where they are, not where we want them to be”
-
"Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
Gabor Maté -
We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
Jonathan Giftos -
"We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."
Fred Rogers -
"Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
Fred Rogers -
“One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
Charles M. Blow -
“In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
-
"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr. -
“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde -
"One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
Jonathan Giftos -
“People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
Danielle Sered -
"I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
Marilou Gagnon -
“When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
Thich Nhat Hanh -
"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
"One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
-
"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
“Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
-
"The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
Judith Lewis Herman -
"Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
Thich Nhat Hanh -
"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
"If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."
Haven Wheelock
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- "Opponent’s of syringe service programs and harm reduction in general typically remark that it “sends the wrong message.” The message they are referring to is, “We love you and want you to be safe.”
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- “Boundaries help me to give all that I can and still come back tomorrow.”
- “Many of the harm reduction leaders interviewed talked about the importance of not having too many policies and involving your participants in the development of policies—especially those that impact them directly.”
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- "What should young people do with their lives today? Many things, obviously. But the most daring thing is to create stable communities in which the terrible disease of loneliness can be cured."
- "We have to be ready and able to reach clients where they are, not where we want them to be”
- "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
- We need to play that game where we require politicians to finish every sentence denouncing supervised injection facilities with the phrase, “and that is why I think injecting alone in a McDonald’s bathroom is better.”
- "We live in a world in which we need to share responsibility. It's easy to say "It's not my child, not my community, not my world, not my problem." Then there are those who see the need and respond. I consider those people my heroes."
- "Anything that’s human is mentionable, and anything that is mentionable can be more manageable. When we can talk about our feelings, they become less overwhelming, less upsetting, and less scary. The people we trust with that important talk can help us know that we are not alone."
- “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
- “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
- “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
- "One of the most important things we can do as advocates is to define & make concrete the vague terms used by politicians. What does it mean to “take a public health approach”? What you mean when you say “treatment”? Politicians rarely know. Our job is to make it plain for them."
- “People who cause harm are often also survivors of harm. If we want to address the roots of violence, we have to honour both truths.”
- "I describe my experiences as a nurse volunteer at the overdose prevention site as “being in the right place at the right time doing the right thing.” And that’s exactly where I want to be as a nurse: working outside the system to make a real difference in people’s lives, showing up in the community when it matters most and challenging rules that directly contribute to the overdose crisis, and exposing government inaction by being part of the solution on the ground. For me, this is what nursing is all about."
- “When another person makes you suffer, it is because he suffers deeply within himself, and his suffering is spilling over. He does not need punishment; he needs help. That's the message he is sending.”
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- "One of the problems that arises with the term “people who use drugs” is that it is intentionally pluralistic in its embrace of ALL people who use drugs—from recreationally to deeply problematically. This makes using it to talk about the things that especially impact people who are using drugs problematically very difficult. "
- "There isn’t a way things should be. There’s just what happens, and what we do."
- “Identify five things that you can see, four things that you can touch, three things that you can hear, two things that you can smell and one thing that you can taste.”
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- "Letting go gives us freedom, and freedom is the only condition for happiness. If, in our heart, we still cling to anything - anger, anxiety, or possessions - we cannot be free."
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- "If you question harm reduction works, I can’t help but wonder if you have ever actually seen what happens in these spaces. We promote health safety and dignity, and it works. It is simple, beautiful and changes peoples lives."