The document outlines a continuum of harm reduction approaches from levels 1 to 5. Level 1 focuses on abstinence and no substance use on site. Level 2 accepts that clients may be under the influence but prohibits use on site. Level 3 acknowledges substance use and implements basic safety measures. Level 4 provides various supports to reduce harm like clean equipment. Level 5 offers administering substances on site and comprehensive on-site medical services.

1. Wesley Harm Reduction Continuum
Level 1 2 3 4 5
Substance Use Abstinence Substance Influence Accepted Acknowledged Use Support Substance Administration
Description Abstinence No substance use on site, but Use is acknowledged formally or Various forms of support to reduce Offering and administering safe beverage
required program –site access is informally, basic safety measures harm are provided such as, clean alcohol on site;
allowed if under the influence. for individual, staff and injection equipment, clean inhalant
Abstinence is recognized as a community are used such as equipment , sexual health counseling
choice sharps containers –disposal units, and equipment; safe disposal for all
public clean-up measures used equipment is provided
Medical Non-Medical Non-Medical Partial Medical Enhanced Medical Comprehensive Medical
Services
Description No on-site or No on-site or visiting medical Some on site or visiting medical Some on site primary care, limited Access to 24/7 comprehensive medical
visiting services services visiting medical-nurse services, targeted services, provided by RPN,RN nurses,
medical discussions of understanding and physicians on-site
services reducing harm are undertaken by Community based health care supports
qualified medical staff provided by CCAC
Some medication – vaccine Visits from other health care
administration professionals
Prescriptions provided by physician Palliative Care might be provided
Supportive Custodial Care Outreach Outreach Case Management Outreach Case Management Social Care - Case Management
Counselling
Individual Outreach by trained Outreach by trained experienced Outreach by trained experienced staff Formal harm reduction and substance
monitoring experienced staff using staff using motivational and using motivational and solution focused administration records are kept
and motivational and solution solution focused approaches, approaches, formal goal based plans are Negotiation over substance use occurs
supervision, focused approaches formal goal based plans are developed. regularly
group developed Outreach by medical and addiction MARs recording used for medication
supervision Clients are connected to specialists. Formal case management is provided,
and behaviour community based specialists and Clients can be connected to community case plans, discharge plans, case file
management programs if they choose based specialists-programs notation used