This event will explore harm reduction services and drug policy in New York from a historical perspective. Overdose mortality is a public health crisis. Deaths from overdose spiked during the COVID-19 pandemic, with rates for 2021 exceeding 100,000, more than all prior years. Amidst these devastating deaths, there has been more widespread recognition of the value of harm reduction, as well as new resources made available to address the crisis. For example, late last year New York City opened the first-in-the-nation Overdose Prevention Center. The New York Academy of Medicine’s research in 2018 informed former Mayor de Blasio’s decision to allow such sites. This conversation focuses on the equity challenges and opportunities in this watershed drug policy moment.