Harm Reduction is Traditional
For Native American Community Clinic (NACC), Harm Reduction is Indigenous
The philosophy of harm reduction guides our work at NACC because it draws on the strength, wisdom, and connection within our community. We know there are many approaches to care, this is the one that feels true to us. The values that guide us teach us to see the world as it is, not only as we hope it might be. That means acknowledging substance use and mental health challenges without minimizing their risks, so we can respond with compassion. We focus on reducing harm over making moral judgments, meeting relatives where they are, and working toward restoration and balance. We see both substance use and mental health as existing on a spectrum, with wellness shifting over time, and we believe each person holds the strength to improve their own life when given respect, support, and connection.
Harm reduction as a philosophy allows us to meet people where they are and put them in charge of their health. We all engage in harmful behaviors every day, driving in cars, eating unhealthy foods, smoking cigarettes. Harm reduction in these cases might mean wearing a seatbelt, taking medications for diabetes or high cholesterol, cutting back on smoking, or using nicotine replacement products. We talk through these with patients every day. And we would never turn our back on someone who continued to take risks or chose a different path than the one we recommended. In this way, harm reduction is already infused into the care we give.
For people who use drugs, the system often does not have a plan for those who are actively using. Too often, this leaves people isolated, stigmatized, and without access to care. The burden of infectious disease, trauma, and mental health challenges can become overwhelming. At NACC, we try to make a plan with our relatives who are using drugs, building bridges so they already have the relationships and trust in place when they’re ready for help. We hold everyone in unconditional positive regard and believe each person can make positive changes, no matter where they are on their journey.
One of the teachings that shapes our work is the spiritual principle of acceptance. The first step in changing a situation or improving health is to see it clearly as it is right now. Acceptance doesn’t mean giving up, it means meeting reality with honesty so we can walk with our relatives toward the next right step. That’s how we build trust and open the door to healing.
Our mission is to support the health of mind, body, and spirit for Native American families. Harm reduction is part of how we live that mission every day. We meet people without judgment and help them find the safest, healthiest options available to them.
We have a focused nine-member harm reduction team that brings this philosophy into action, out in the community, reaching our relatives who use drugs through street outreach, weekly gatherings at the back of NACC, and partnerships with other community organizations. We build relationships with relatives who may be staying outside because there’s nowhere safe to go, and we make sure they have the tools, resources, and connections they need.
Our harm reduction services include:
• Rapid HIV and HCV testing
• Safer use supplies to prevent infectious diseases, wounds, and overdose
• Naloxone distribution and overdose response training
• Hygiene kits, food, clothing, and seasonal gear
• Housing and shelter navigation
• Case management
• Mobile nursing services
• Syringe clean-up and disposal
A big part of our work is making quick, low-barrier connections to care at any stage of someone’s journey. That might mean linking someone directly from outreach into primary care, infectious disease treatment (HIV, syphilis, HCV), substance use disorder treatment (including Brixadi), prenatal and postpartum care, wound care, and more.
Wherever we meet our relatives, we show up with humility, compassion, and respect. We create spaces where people can be honest about their experiences without fear of judgment. To us, harm reduction isn’t just a public health strategy, it’s an Indigenous way of caring for each other, practicing acceptance, protecting life, and making sure no one has to walk alone.