The New York Academy of Medicine (NYAM) and the Drug Policy Alliance (DPA) jointly researched and drafted a Blueprint for a Public Health and Safety Approach to Drug Policy. We examined New York’s current drug policies and reimagined how those policies could realize better health and public safety outcomes. Believing that good public policies should be developed in collaboration with those directly affected by them, we spent over a year holding community consultations with 500 New Yorkers across the state, asking how drug use and drug policies affected people and their neighborhoods and what should be done to move the state forward. We also met with experts, policymakers, and service providers and conducted an extensive review of the literature. The Blueprint is the result of these research activities and concludes that, by integrating the four pillars of prevention, treatment, harm reduction, and public safety, New York can establish a more coordinated, effective, and evidence-based approach to drug policy that will improve the health and safety of communities across the state.