Harm Reduction Hacks in Focus: Space Hacks
General Space and Service Management Hacks
There are 2 hacks in this section
Building Harm Reduction Spaces with Intention
Whether you’re new or seasoned, every harm reduction space benefits from honest reflection, practical structure, and room to grow
Though most readers will already be working in established programs, this section starts from the premise that you are at the beginning of your journey starting harm reduction services and are more or less naive about how these services work. However, it is also written with the knowledge and understanding that this is just a useful literary device to ensure that all important details are covered and most of the people reading and utilizing these hacks will already be working in established programs.
This means that that if you’re reading this, that you view it from the perspective of the following questions:
- How can we better serve our participants?
- How well do we HONESTLY adhere to these practices?
- What are we doing well and what are our opportunities for growth?
- What are the biggest missing pieces for our participants?
- Where can we jump in right now in an incremental way to bring our program into greater alignment with this research and insight from OGs?
- What long-term goals and steps towards them should we set?
Be fearless when you begin to question your current policies, practices, and procedures. It’s very easy to fall into the trap of “everything’s fine” denialism and fronting like you all have it all figured out—but harm reduction best practices insist on continuous, fearless examination of, and accountability for, our behavior; and that includes the organizations we run.
Remember that NO ONE, literally no one, you have ever met or admire in this work, is doing it all perfectly. We are all in need of the grace that harm reduction offers, so be fearless but also kind to yourselves and each other in your examinations. Employ a forgiving lens.
Types of Mobile Service Harm Reduction Provision
Posted in General Space and Service Management Hacks.
Mobile harm reduction services come in many forms—each shaped by local needs, available resources, and the creativity of the people providing care. From backpack outreach to vans, bikes, and home delivery, these models offer flexibility, build trust, and reach people who may never visit a fixed site. This section explores the unique strengths and limitations of different mobile approaches
Types of Fixed Harm Reduction Service Sites
Posted in General Space and Service Management Hacks.
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.
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“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 -
“Boundaries help me to give all that I can and still come back tomorrow.”
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"We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
Jules Netherland -
"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 -
“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 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 -
“In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
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“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.”
-
"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 -
“Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
Audre Lorde -
"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 -
"Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
Martin Luther King Jr. -
"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. "
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“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.”
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“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 -
"Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
Dominique de Villepin -
"Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
Gabor Maté -
“One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
Charles M. Blow -
"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 -
"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 -
"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 -
“As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
-
"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 -
"There isn’t a way things should be. There’s just what happens, and what we do."
Terry Pratchett -
"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”
- “The bottom line is that overdose prevention sites — which exist in more than 100 cities around the world — offer compassion for fellow human beings,”
- “Boundaries help me to give all that I can and still come back tomorrow.”
- "We don’t need to professionalize the people closest to the crisis. We need to recognise them as professionals already.”
- "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."
- “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 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."
- “In general, it is antithetical to harm reduction best practices to call the police except under the most extreme life-or-death circumstances.”
- “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.”
- "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."
- “Caring for myself is not self-indulgence, it is self-preservation, and that is an act of political warfare.”
- "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.”
- "Darkness cannot drive out darkness: only light can do that. Hate cannot drive out hate: only love can do that."
- "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. "
- “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.”
- “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."
- "Between an uncontrolled escalation and passivity, there is a demanding road of responsibility that we must follow. "
- "Not all traumas are the result of what happened to you; some are the result of what didn’t happen for you"
- “One doesn’t have to operate with great malice to do great harm. The absence of empathy and understanding are sufficient.”
- "The conflict between the will to deny horrible events and the will to proclaim them aloud is the central dialectic of psychological trauma."
- "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."
- "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."
- “As always, be transparent with participants about what you have, what you don't have, and/or what's for only special populations.”
- "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."
- "There isn’t a way things should be. There’s just what happens, and what we do."
- "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”