It is crucial to investigate factors that may have an immediate impact on the catastrophic rates of fatal overdose in Canada and the United States over recent years, a central aspect of the phenomenon known as the opioid crisis. Supported by research and critical writings from a number of different fields, both in Canada and the United States, this research explores the following question: What is the therapeutic potential in the relational process that occurs between providers and individuals accessing services in harm reduction contexts? “Therapeutic potential” was preliminarily defined by a wide range of potential outcomes, including an experience of demarginalization, consistent or increased engagement in services, an experience of emotional connection with a provider or agency, and a reduction in harm to the individual and to society, the notion broadly encapsulated by the bottom-line agenda of harm reduction approaches. Utilizing a constructivist grounded theory approach, themes identified from a series of intensive interviews with frontline providers point to an underlying relational process by which therapeutic potential may emerge in even brief moments of contact between providers and drug users accessing services in harm reduction settings.