This ethnography attempts to capture what San Antonio provides with its pilot needle exchange program and how harm reduction advocates have interacted with the complicated legal landscape in Texas. First, breaking down the legal landscape within Texas to build an understanding of how San Antonio is legally allowed to operate a pilot program and then jumping into the major themes presented from participant data to unpack the intersection of identity, stigma, and access to healthcare. I draw upon my own experience volunteering with harm reduction outreach and the experiences of seven participants who live and work as harm reduction advocates in San Antonio. Ethnographic data was gathered following semi-structured interviews conducted over the phone and transcribed. The data was thematically assessed to facilitate the unpacking of consistent themes among interviews which dealt with socioeconomic position, communication and support among the community, nationwide political narratives, and the morality of the drug user.