Harm Reduction Hacks

Notes About Language

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.
  • Uses and defines “structural violence” as “the multiple ways in which social, economic, and political systems expose some groups to disproportionate risks and vulnerabilities leading to increased morbidity and mortality.” Those systems include income inequality, racism, classism, homophobia, sexism, ageism, ableism, lookism and other means of social exclusion leading to increased vulnerabilities, such as poverty, stress, trauma, mental illness, substance misuse, crime, incarceration, and lack of access to care, healthy food, and physical activity.
  • Uses and defines “cultural humility” as “the ability to maintain an interpersonal stance that is other-oriented and open to others in relation to aspects of cultural identity that are most important to the other person.”
  • Uses and defines “cultural competency” as “the ability to understand, appreciate and interact with people from cultures or belief systems different from one’s own.”
  • Uses and defines “drug use” as “a complex, multi-faceted phenomenon that encompasses a continuum of behaviors from intense chaos to complete functionality and acknowledges that some ways of using drugs are clearly safer than others.”
  • Uses and defines “peer-reviewed evidence” as “research that has been evaluated and critiqued by researchers and experts in the same field before the information is published.”
  • Occasionally uses the phrase “proximate community members” to mean all of the friends, loved ones and neighbors who may not use drugs that harm reduction programs provide services to in addition to people who use drugs.
  • Refrains from using the stigmatizing and binary language of “addiction” with preference for the more accurate description of drug use as a continuum from chaotic to functional, and people who use drugs as physiologically dependent or not.


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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