Walk With Me was developed by Dr. Karsten and her research team throughout the past four years with intent to combat stigma and create systems change in relation to the toxic drug poisoning crisis – a public health emergency that has enacted more deaths in BC than suicides, car accidents and homicides combined. This team has been working in Vancouver Island communities of various sizes, and within Island Health acute care facilities, to better understand the ways in which the drug poisoning crisis is impacting communities and systems. Through deep listening, peer engagement and leadership, and collaborative design, the team has developed recommendations designed to close service gaps and reduce stigma. In the summer of 2022, Island Health released its first Harm Reduction Policy. Stemming from this release is an opportunity to deepen this existing partnership, through the co-creation of a Harm Reduction Learning Health System. This system, developed through patient/peer insights and leadership, and alongside clinicians, management and staff, will enable Island Health to respond effectively to a rapidly-evolving public health crisis.