Harm Reduction Services

Inclusion Criteria: * at least 18 years of age * self-identified as misusing opioids +/- other substances (stimulants) in the past 30 days, confirmed by interview using DSM-5 criteria * English or Spanish speaking * able to provide informed consent. Exclusion Criteria: * inability to provide informed consent or participate in the study procedures as proposed in the consent * active suicidal or homicidal ideation or an unstable psychotic disorder (schizophrenia, schizoaffective disorder) or mood disorder (bipolar disorder, severe major depressive disorder) * an unwillingness to be randomized. * are prisoners