All US proposals function solely as injection sites. They "offer" help to addicts to connect them with treatment sources however; there is no legal requirement for addicts to use those treatment resources, nor the funding even if they did, nor any consequence for refusing them.

So in practice they effectively just enable addicts, while dressing up the dangers of drug abuse with a veil of safety, and turning the area they're in into an open air drug scene, further blighting the community.

Harm reduction is only meaningfully useful when you have the other major pillars of contingency management in place. Just viewing harm reduction in itself as a solution or helpful in any way is delusional, and is not born out by the data.