The United States is experiencing an epidemic of drug overdose deaths that cuts across economic, racial, and geographic boundaries. In the midst of this devastation, people are struggling to find ways to save the lives of their community members. While the “war on drugs” created tough enforcement policies that resulted in a bloated justice system, there is increasing momentum for a smarter and more compassionate approach to people who use drugs. This report describes how some innovative jurisdictions are implementing harm reduction strategies in order to reduce overdose deaths, improve the wellbeing of justice system-involved people, and advance the health and safety of their communities. It shares perspectives from stakeholders in law enforcement, the court system, corrections agencies, drug policy, and the community about what strategies are being implemented, how they have overcome barriers, and what work remains to be done.