North America is in the grips of a drug epidemic; with the introduction of fentanyl, the chances of a fatal overdose are greater than ever, prompting many to rethink the war on drugs. Public opinion has slowly begun to turn against prohibition, and policy-makers are finally beginning to look at addiction as a health issue as opposed to one for the criminal justice system. While deaths across the continent continue to climb, Fighting for Space explains the concept of harm reduction as a crucial component of a city’s response to the drug crisis. It tells the story of a grassroots group of addicts in Vancouver's Downtown Eastside who waged a political street fight for two decades to transform how the city treats its most marginalized citizens. Over the past twenty-five years, this group of residents from Canada's poorest neighborhood organized themselves in response to the growing number of overdose deaths and demanded that addicts be given the same rights as any other citizen; against all odds, they eventually won. But just as their battle came to an end, fentanyl arrived and opioid deaths across North America reached an all-time high. The "genocide" in Vancouver finally sparked government action. Twenty years later, as the same pattern plays out in other cities, there is much that advocates for reform can learn from Vancouver's experience. Fighting for Space tells that story—including case studies in Ohio, Florida, New York, California, Massachusetts, and Washington state—with the same passionate fervor as the activists whose tireless work gave dignity to addicts and saved countless lives. Among the stories told in the book are those of Liz Evans and Mark Townsend, who founded the Portland Housing Society in 1993 which in 2003 forced Vancouver Coastal Health to open and run the then-illicit safe injection site, the first of its kind in North America; and Philip Owen, the former right-of-centre Vancouver mayor who made a surprising policy reversal by advocating for the Four Pillar Approach to drug addiction (prevention, treatment, enforcement and harm reduction), a decision that made him a pariah among his former conservative supporters. The book also includes chapter-long “case studies” of experiences on the frontlines of addiction and its treatment in Ohio, Florida, New York, California, Massachusetts, and Washington state. In the context of the current fentanyl crisis, Fighting for Space is a useful reminder of the work that’s been done by activists and medical and legal professionals to contain drug addiction in positive and meaningful ways.