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Drug overdose death rates in the United States have more than tripled since 1990 with more than 36,000 dying in 2008. In 2007 the estimated cost of drug use to U.S. society due to lost productivity, increased health care, and criminal justice costs was over $193 billion. Previous researchers have found that harm reduction is a viable treatment option within the field of addiction. The guiding premise in the harm reduction approach is that all people can achieve improved psychological and physiological health even if they are unable to be substance-free. However, there remains an important gap in the current literature regarding factors that may influence substance abuse counselors' use of the harm reduction model. Specific individual counselor independent variables (recovery status, education level, age, length of time in the field, and understanding of substance abuse conceptualizations) may play a role in counselors' acceptance of the harm reduction approach as a viable treatment for substance abuse. Therefore, the purpose of this quantitative study was to investigate which variables played a role in counselors' acceptance of the harm reduction model. This research sampled 100 professional substance abuse counselors selected from the American Counseling Association (ACA) database. Multiple regression analyses were utilized to examine study research questions. Findings of this study indicated that disease and eclectic orientation conceptualizations were significant predictors of harm reduction acceptance, suggesting training targets for increasing acceptance of the harm reduction model among counselors. This is an important contribution to the existing literature and enhances social change initiatives by expanding the use of effective substance abuse treatment options.