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Types of Fixed Harm Reduction Service Sites

When thinking about creating safer, more humane, trauma-informed harm reduction spaces, it’s important to begin by assessing the kind of space that you have. Not all harm reduction sites are the same, and each have their own challenges as well as assets to consider. They also, of course, provide different services. Some are more like permanent harm reduction supply access points, and others are places where people can wash their clothes, eat a meal, take a shower, or even safely use drugs.

  • Fixed Site SSP or HR Services—One kind of common harm reduction service site is a fixed site syringe access service or other harm reduction supply service. These sites only provide harm reduction supplies and/or syringes and few if any adjunct services like testing or access to MAT. Frequently this will be hosted at another location like a church, or bookstore, or in an office or storage locker specifically used for that purpose.
  • Embedded SSP of HR Service Site—This will often look like a clinic or other service site that offers additional harm reduction services, or a center with other services including harm reduction supplies. Some organizations operate a permanent harm reduction supply space in the front of their services site and then offer other/adjunct services in the back.
  • Drop-Ins—By definition, drop-ins offer more services than merely harm reduction supplies. They may offer services such as showers, lockers, hot meals, a hangout space, medical care, bathrooms, free clothing closet, assistance in signing up for benefits, medication assisted treatment, alternative medical treatment, services for sex workers, movie nights, pet care, educational seminars or classes, support groups, emotional healthcare, or other services that may be useful to the population served by the organization.
  • OD Prevention Sites—OD prevention sites have gone by many names over the years, but what they have always been are safe places to learn how to use, and use, drugs more safely. Overdose prevention sites have been the norm in Europe for many years, and the first one was opened in North America in 2001 in Vancouver, British Columbia. Overdose prevention sites have been proven time and again to reduce overdose events, and prevent disease transmission and injury from drug use.

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. 

Many of the harm reduction leaders that were interviewed for Space Hacks talked about how critical it is to effectively manage services, supplies, and inventory in order to maintain community tranquility. It may not feel intuitive, but OGs report that ineffective management of supplies is the number one potential flashpoint for escalated situations during harm reduction services.
Generally, it’s important to use “person first language” when describing people who are marginalized due to some part of their identity being stigmatized, such as folks struggling with their substance use, people who do sex work, and folks living outside.