There’s a trite expression—“meet people where they’re at”—that is synonymous with the ethos of harm reduction. But what does that actually mean? It’s more than just a talking point for politicians, lobbyists, or conferences. It goes beyond simple semantics
into something much more complex, real, gritty… and hard to do.
So, what is harm reduction? At its core, it’s about minimizing the harm associated with an action. Do you wear a seatbelt while driving? That’s harm reduction. Do you brush your teeth after eating? Again, harm reduction. The same principle applies when someone uses sterile needles for injecting drugs or a condom during sex. They’re still engaging in the activity, but in a way that reduces risk.
When you “meet people where they’re at” through a harm reduction lens, you’re meeting them at the intersection of support and individual behavior. In the social support realm, especially when working with People Who Use Drugs (PWUD—a more person-centered term than “drug addict”), this often means providing safer use supplies without judgment and without conditions. But harm reduction is much deeper than that for two key reasons:
It’s not easy to watch someone suffer the consequences of substance use
Some people can use substances casually while maintaining employment, stable housing, financial security, balanced mental health, and healthy relationships. Others can’t. For those individuals, substance use spills over into other areas of their life, affecting their ability to thrive holistically. (Think of someone who can drink on a Friday night and wake up refreshed the next morning, versus someone who calls in sick to work on Monday because of that same night out.)
Harm reduction is about being okay with that reality. This becomes even harder when it’s someone you care about—a client you’ve grown close to, a coworker, a childhood friend, a family member. Part of you wants to grab them by the shoulders, look into their eyes, and say, “Look at what your substance use is doing to you and the people around you! I’m worried. I don’t want you to die. I’m scared.” But that’s meeting them where you’re at—not where they’re at.
When you tell someone to “look at what their substance use is doing to them,” it’s also about what it’s doing to you. It’s uncomfortable, difficult, and forces you to confront moral questions about suffering, autonomy, and care. But harm reduction is about supporting people on their journey—whatever that looks like—and accepting that sometimes, all you can do is offer a warm greeting, safer supplies, a bottle of water, and a granola bar. And that’s enough. That’s harm reduction.
Meeting people where they’re at doesn’t mean giving up on change
This is an overlooked aspect of harm reduction, yet it’s just as important. Meeting people where they’re at doesn’t mean stopping at acceptance; it also means leaving the door open for change. This is tough because it requires balancing unconditional support with a non-judgmental approach to recovery.
Bringing up change—such as recovery or treatment—can be tricky. Many people are not ready to even consider it, and for some, the mere suggestion can trigger a tsunami of shame. That shame can turn you from a trusted support into an adversary, which could mean the difference between them continuing to access life-saving care or shutting you out completely.
It’s important to remember: addiction is often a way of coping. When supporting someone with a substance use disorder, you’re not just addressing the addiction—you’re addressing everything else first: diet, social connections, meaningful use of time, shelter… the basic foundations of life that the privileged take for granted.
Most people aren’t simply chasing the next high on a hedonic treadmill; they’re surviving. Life is hard, and for some, unimaginably so.
Think about it: have you ever heard someone dismiss an unhoused person by saying, “They should just get a job”? That statement ignores the many layers of hardship that led to their situation. To them, asking for change on a street corner might not feel like a bad idea—it might be the only idea that makes sense.
For harm reduction practitioners, these two principles should always be at the forefront:
-Meet people where they’re at, no matter what you believe is best for them.
-Provide opportunities for change, without forcing it.
Opportunities can take many forms: pamphlets in an office, a conversation about available programs, a connection to a support worker, a meal for someone who is hungry, a safe place to stay. You never know what the catalyst for change might be.
Sometimes, all a person needs is another chance. But if they’re not ready for change, that’s okay, too.
