Needle exchange programs are often debated from a distance. Michael Cline writes about them from the inside. He remembers using the Lower East Side Needle Exchange during active heroin addiction in the 1990s, learning safer injection practices, accessing clean supplies, and avoiding HIV. His piece is pro-harm reduction, but not simplistic. It asks what these programs can prevent, what they do not solve, and how they could connect more people to recovery.

Rob Kent, Esq. writes from nearly 20 years of work in state and federal drug policy, including his time as general counsel at the New York State Office of Addiction Services and Supports. In this Harm Reduction Series article, he explains how witnessing preventable loss changed his view of harm reduction and strengthened his belief in the full continuum of care. His central question is direct: how can we help people stay alive and get better?

Harm reduction is not permission to use. It is a practical plan to keep people alive long enough to have choices. John Makohen offers a direct, compassionate guide to building an overdose safety plan before the most dangerous moment arrives. He covers naloxone, fentanyl risk, reduced tolerance after a break, using a safety buddy, avoiding substance mixing, choosing a safer space, using clean supplies, and writing the plan down so people know what to do under stress.