Harm Reduction in the South with Tim Santamour
Harm Reduction in the South with Tim Santamour

Challenging Pathos

Today we sit down with Tim Santamour, Executive Director, Florida Harm Reduction Collective, is a person with Living/Lived Experience in Substance Use and has over 33 years of experience in harm reduction. He began his work with ACTUP/Western New York...

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1:01:37•13 Aug 2026

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Harm Reduction, HIV and Southern Politics with Tim Santamour

Episode Overview

Harm reduction in the United States grew directly out of HIV and AIDS activism, with early needle exchanges often run by ACT UP chapters.
Legal syringe access varies widely by state, and delayed implementation in Southern states has contributed to preventable deaths and infections.
Policies such as drug-induced homicide laws and restrictions on syringe programmes disproportionately harm marginalised communities, especially Black and brown people.
Stigma around sexuality and drug use can block access to care, making queer-affirming and community-specific harm reduction spaces crucial.
Recovery groups and harm reduction programmes can complement each other when both centre lived experience and prioritise keeping people alive while they decide their own path.

“We’ve got the data, we’ve got the charts, we’ve got the graphs.”

Curious about how others navigate their sobriety journey? This conversation with harm reduction veteran Tim Santamour pulls you straight into the messy, political, and deeply human side of drug policy in the American South.

Tim shares more than three decades of experience, starting with ACT UP Western New York in 1991 after, as Tim recalls, "I'd lost the last of my really close circle of friends from high school to HIV, to AIDS." From underground needle exchanges in Buffalo and New York City to work with DanceSafe in rave and club cultures, you'll hear how HIV activism and harm reduction grew up together and still shape each other today.

The hosts dig into why syringe services were legal in New York in the early ’90s, yet only arrived in places like North Carolina in 2016 and Florida in 2019. Tim breaks down the patchwork of Florida programmes – from hospital-led services to grassroots collectives – and the frustrating reality that there are just eight authorised syringe programmes in a state with massive need.

A big part of the chat focuses on stigma: being a gay person who uses drugs, facing homophobia in services, and dealing with political hostility. Tim’s line, "We’ve got the data, we’ve got the charts, we’ve got the graphs" captures the exasperation with policymakers who ignore both science and lived experience. The group also tackles awkward but vital questions, like how to serve people whose politics clash with your own and why recovery and harm reduction shouldn’t be at war.

If you care about HIV, overdose prevention, or simply keeping people alive while they figure out their path, this episode offers hard-earned lessons and plenty of heart. How might Tim’s story reshape the way you think about harm reduction and recovery in your own community?

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