Coleman Cox regularly travels over an hour to Vinita, Oklahoma, where he administers a harm reduction program focused on providing clean syringes to individuals battling addiction. This approach seeks to prevent the risks of drug overdoses and the transmission of infectious diseases, rather than emphasizing complete abstinence from substances.

The opioid epidemic has significantly impacted the Cherokee Nation, with Chief Chuck Hoskin highlighting that no one in the extensive 7,000-square-mile reservation is immune to addiction. Many individuals began misusing opioids after receiving prescriptions, and this has led to a concerning statistic where over 100,000 Americans died from overdoses in 2022, with Native Americans facing a double risk compared to their non-Native counterparts.

Cox, along with colleague Chris Rich, distributes sterile syringes in an alley, believing that harm reduction initiatives, while often contentious, play a crucial role in the community. Critics have argued against needle exchange programs, fearing they could foster homelessness and enable drug use; however, supporters like Cassy Abbott-Eng recognize the difficulties in successfully implementing these programs, describing them as sometimes born out of desperation.

Donald Cody, a local resident with a long history of addiction, expresses his fatigue with his struggles but acknowledges that such programs provide a safer option for those who will use drugs regardless. Cox, who has also faced addiction, emphasizes that his work enables individuals to survive and ultimately can guide them toward seeking treatment and recovery.

In its battle against the opioid crisis, the Cherokee Nation has achieved significant victories, including legal success against multiple pharmaceutical companies that led to over $100 million in settlements, some of which support the harm reduction efforts. The initiative reflects the Cherokee value of "gadugi," signifying cooperative work within the community to support those in need.