This study demonstrates that harm reduction (HR) education has a significant positive impact on nursing students’ knowledge, attitudes, ethical awareness, and clinical confidence. Exposure to lived and living experience of people who use drugs (PWUD), opportunities for critical reflection, and practical skill development enable students to navigate stigma, systemic constraints, and complex ethical challenges. In the fall of 2024 and 2025 the University of Victoria, School of Nursing and School of Social Work offered an elective HR course for graduate and undergraduate students. The course served both as a corrective to prior stigma-laden training and as a catalyst for deeper engagement with HR values and evidence-based practices. In this Interpretive Descriptive study, we assessed the impact of the course on students and also inquired into the experiences of those involved in the course development and delivery. The study highlights that education alone is insufficient to overcome political, institutional, and structural barriers that limit the implementation of HR in clinical practices with PWUD. Sustained institutional policies, leadership support, and political commitment are necessary to create environments that align with evidence-based approaches to HR education.