Harm Reduction Hacks

Project Background
and Process

Harm Reduction Hacks is the product of a series of 38 qualitative conversations with harm reduction leaders that took place in the Fall of 2020 and the Spring of 2021. The information gleaned from those conversations has been combined with existing work from Balanced Imperfection and the Chicago Recovery Alliance’s Capacity Building Leadership Institute, which brought together another 28 harm reduction leaders in 2018.

The Capacity Building Leadership Institute (CBLI) was sponsored by the Open Society Foundation and the Comer Family Foundation and was administered by Chicago Recovery Alliance (CRA). The CBLI, held in the wake of CRA founder Dan Bigg’s unexpected death, was designed as a substantially expanded focus group of both emerging and experienced leaders in harm reduction. Participants discussed many of the same themes that are addressed by Harm Reduction Hacks. Catherine Swanson of Balanced Imperfection facilitated the CBLI and had access to those primary records and permission to utilize that data in furtherance of the larger movement goal of ensuring that the insights generated there were accessible to as many people and programs as possible.

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).

These conversations lasted an average of 80 minutes with a range of 45 to 240. The first cohort of leaders were people who had been working in harm reduction for 10 years or fewer. The second cohort of leaders were people who have worked in harm reduction for more than 10 years (up to 32 years). In addition to the baseline topics discussed with all leaders, questions and considerations raised by the first group were given to the second group for consideration.

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.


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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