Substance use disorder is a common cause of morbidity and mortality in the United States. Comprehensive harm reduction programs have emerged as a public health strategy to help those with substance use disorder. At this time little is known about the population of people who use comprehensive harm reduction programs. To address this gap in knowledge we examined health needs and priorities among people who utilize a comprehensive harm reduction program. We conducted in depth semi-structured interviews with 29 people who access services at a harm reduction program. Themes from the qualitative interviews revealed priorities included improving housing stability, sobriety, and reunification with children. Lack of trust of the health care system was often reported as a barrier to optimal medical care. Comprehensive harm reduction programs are in a position to offer services that can help improve physical health and social determinants of health for people with substance use disorder.