Canada is in urgent need of a comprehensive harm reduction policy that jettisons the failed, costly model of drug prohibition that has ravaged so many lives, from fueling the spread of HIV and hepatitis C virus (HCV) to contributing to over-incarceration, to creating conditions for the ongoing epidemic of overdose fatalities. A harm reduction approach must include measures to reduce the harm sometimes associated with various substances (legal or illegal), and also a commitment to end the harms produced by the existence and enforcement of punitive drug laws and policies.