Harm reduction refers to a set of strategies that reduce the harms associated with substance use. By meeting people where they are, harm reduction providers build trust with people who use drugs (PWUD), equipping them with the tools and information to protect themselves from infectious diseases and overdose. Syringe services programs (SSPs) are an effective, safe, and cost-saving strategy to prevent the spread of HIV and viral hepatitis. Comprehensive SSPs offer syringe distribution and disposal, conduct education and counseling, and provide or refer clients to HIV, STI, hepatitis, and substance use disorder services. They may also distribute the overdose reversal medication naloxone, fentanyl test strips, condoms, or other supplies to prevent infectious diseases or overdose. Local health departments (LHDs) play a critical role in providing and supporting harm reduction services. NACCHO supports LHDs by increasing buy-in, facilitating peer learning and engagement, and providing technical and capacity building assistance for harm reduction programs.