Ottawa Inner City Health’s Managed Alcohol Program administers alcohol to its patients who are struggling with alcohol dependency. Although it may seem like a paradoxical approach, this program is a harm-reduction strategy intended to help some of the most marginalized peoples in Ottawa. A qualitative discussion group composed of individuals utilizing various substance use support programs in Ottawa comments on various strategies to reduce stigma against inner-city individuals, support illicit drug users, and prevent overdoses. Healthcare professionals are well positioned to ensure these strategies are put to action by advocating for patients with substance use issues and promoting equitable healthcare.