This policy brief underscores the urgent need to integrate harm reduction into the United States’ response to its escalating drug overdose crisis. Despite $2.7 trillion in public spending, overdose deaths remain high, and emergency systems are under strain. The report evaluates harm reduction policies across all 50 states, with a focus on syringe service programs, naloxone access, fentanyl test strip legality, Good Samaritan laws, and supervised consumption sites. Key recommendations include decriminalizing essential health tools, strengthening legal protections, and funding community-led initiatives to improve public health outcomes and reduce preventable costs associated with the opioid epidemic.