Harm Reduction Hacks is the product of a series of 38 qualitative conversations with harm reduction leaders representing every region of the US that took place in the Fall of 2020 and the Spring of 2021.

For Harm Reduction Hacks, two waves of leaders representing every region of the US participated in one-on-one conversations in the Fall of 2020 and spring of 2021. These leaders represented a wide variety of organizational types and structures providing harm reduction services in the US, including stand-alone non-profits, fiscally sponsored projects, horizontal collectives, and programs embedded in both county health departments and larger community-based organizations (CBOs).

This data was then analyzed for themes, practical tips, and other information. That analysis, and the wisdom of people who have between them nearly 500 years of lived experience, are woven throughout the information, tips, and insights in Harm Reduction Hacks.

PDF version contains all harm reduction hacks for offline reading.

Featured Hacks

Roadblock Tips:
Better Boundaries

Many harm reduction leaders talked about the need to have healthy boundaries around their work life and the things they will and will not take on. Many spoke to the fact that boundaries did not come naturally to them but that learning them had been critical to doing their best work.

Succession Planning

Succession planning is the process of preparing for large transitions, often in leadership, in an organization. Harm reduction leaders agreed that it is never too soon to start succession planning and that not doing so can lead agencies to serious issues with programmatic stability in the long term.

More Resources

Don’t reinvent the wheel
During our development Harm Reduction Hacks have collected together a large number of resources from around the web you can find these in our resource folder in Google Docs. We are also always looking for more so help us by suggesting any resources we may have missed.
Suggest a Resource

Notes About Language for Harm Reduction Hacks

The language used in Harm Reduction Hacks has been deliberately chosen to de-stigmatize drug use, people who use drugs, sex workers and other marginalized people and to be philosophically consistent with the Principles of Harm Reduction. Because of this the Hacks:

  • Uses the terms “syringe service provider” (SSP) and “harm reduction service organization” interchangeably to mean doing work to reduce the harms associated with stigmatized behaviors including drug use, sex, and sex work.
  • Uses and defines “social location” as “the social position an individual holds within their society, based upon social characteristics deemed to be important by any given society.” Some of the social characteristics deemed to be important in the US include class, race, gender, sexual orientation, ethnicity, religion, physical ability, age, regional origin, and appearance.


The people who make this possible
This overview represents the synthesis of the invaluable opinions, experiences, and knowledge of nearly 70 harm reduction leaders. The author and sponsors of Harm Reduction Hacks would like to gratefully acknowledge the harm reduction leaders, old and new, who took the time to sit down and share their insights and experiences in a series of unstructured conversations and focus groups. We hope we do them justice and, in turn, ensure that newer folks starting out in harm reduction can face some of the issues addressed here prepared with the hard-fought experiences and insights shared by these amazing leaders.
This project was commisioned by NASTAD (National Alliance of State and Territorial AIDS Directors) Harm Reduction TA Center.
We thank the CDC (Centers for Disease Control and Prevention) for providing the funding to make this project possible.

More Featured Hacks

Organizational Culture and Power

Things like organizational culture and design can sound boring, abstract, or superfluous, but to build an organization that is going to last, they need to be considered from the outset. There are many tools for assessing the existing organizational style of your organization and/or learning how to adjust it.

Roadblock Tips:

Many harm reduction programs start out as DIY operations, with one person (or a few people) doing everything from outreach to vehicle maintenance to training volunteers. This “can do” attitude is laudable but becomes problematic when organizations expand and there are others who can help, yet leaders are often reluctant, or simply don’t know how, to delegate tasks to others.

Tips and Guarantees

  • These insights are offered in the spirit of saving emerging leaders the time and energy of re-inventing the wheel.
  • Apply harm reduction to your programs! This is not a book of guilty “to-dos”!! It is a menu of options to meet your program where it is at right now and make the incremental changes that will benefit the well-being of your program and, more importantly, your participants over the long term.
  • The insights and information here have been thoroughly researched against a variety of disciplines including public health, social work, business, public administration, and non-profit management.
  • There is no one-size fits all answer for the subjects discussed.
  • Jump in where you need to, this is not meant to be read from start to finish.
  • Tailor the insights and suggestions here to your organization and needs.
  • Know that this isn’t everything you will need, but it does cover some really important basics.
  • Everything here could be another book so use the resources section to learn more!


The hacks on this site are shared with you under a Creative Commons Attribution-ShareAlike 4.0 International licence. This allows you (with attribution) to adapt content for your own use, although we do ask you to then also allow others to have equal access to anything you develop. More details of this licence can be found on the Creative Commons website.


We do not claim that this is an exhaustive set of strategies, shortcuts, or tips for running an SSP. What we do suggest is that Harm Reduction Hacks offers down-to-earth, practical information for being a better leader, starting and running an SSP, and providing syringe access services. We feel we can say this with confidence because the Hacks are based on interviews with, and the experiences of, literally generations of people who have been doing harm reduction work.

Please note that nothing in this guide should be construed as legal advice. Please consult an attorney local to your area to ensure your program is in compliance with all local, state and federal regulations that apply to your situation. 

Harm Reduction Hacks site design and implimentation by Nigel Brunsdon

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