The harm reduction continuum of care refers to a set of strategies and interventions that aim to minimise the negative consequences associated with drug use. It acknowledges that not everyone is ready or willing to abstain from drug use and instead focuses on reducing harm and promoting safer practices.

The continuum of care typically includes a range of services and interventions that progress from the least to the most intensive based on individual needs and goals. Réseau ACCESS Network supports the following services through in-house programming, referral, and accompaniment. 

1. Information and education: The team and network provide accurate and up-to-date information about drugs, their effects, and safer use practices. This helps individuals make informed decisions and reduce the risks associated with drug use. Information on toxic drug overdoses and deaths is disseminated through the team and network. See the education section for Réseau ACCESS Network’s changing offerings. 
2. In-Reach|Outreach and engagement: Réseau ACCESS Network offers 7-day-a-week services to connect with People Who Use Drugs (PWUD) and engage in services and support. This includes meeting people where they are, building trust and rapport, and connecting them to appropriate resources. The agency partners with The Red Coats, which provides outreach services by L’Association Des Jeunes De La Rue Inc., which provides services to people living rough.  Any donations received (coats, blankets, tents, etc.) are given to the Red Coats, which offers direct services provision and transportation. 
3. Needle and syringe programs: Réseau ACCESS Network provides access to sterile needles, syringes, and other drug-use equipment to individuals who use drugs. This helps prevent the spread of blood-borne infections, such as HIV and hepatitis C, promotes safer injection practices, and offers engagement and referral services. Réseau ACCESS Network also provides wipes (bath in a bag), sexual health supplies, season-dependent sunscreen, bug repellent, and hand warmers. Réseau ACCESS Network partners with the 
4. Drug checking: Testing strips (as available) are offered to check the contents of drugs. This helps individuals make informed decisions about drug use and reduces the risk of accidental overdose or adverse reactions. Sudbury’s SCS provided in-house drug checking services through the federal section 56 exemption. 
5. Safe consumption sites Provide supervised facilities where individuals can use drugs under the watch of trained staff. These sites offer a safe and hygienic environment, access to sterile equipment, and health support in case of overdose. Alongside these services, wrap-around provision of social and health services was provided. Réseau ACCESS Network’s SCS The Spot closed on March 31, 2024, and awaits word from the MOH as to its CTS application.
6. Safe Supply: Provides prescribed medications as a safer alternative to the toxic illegal drug supply for people at high risk of overdose. This approach aims to reduce the risks associated with drug use in a criminalized context, decrease overdose deaths, and improve overall health outcomes by offering regulated pharmaceutical-grade substances. Réseau ACCESS Network applied through SUAP for a Safe Supply program with wrap-around supports – unfortunately, the application was unsuccessful. 
7. Mental health services: The Réseau ACCESS Network team addresses co-occurring mental health conditions and provides brief counselling, group sessions, mindfulness training, art groups, and other support services. Wrap-around services help individuals cope with underlying issues that may contribute to drug use and support their overall well-being. NISA/Northern Initiative for Social Action offers a wide range of MH programs to which the agency refers members/patients. 
8. Housing support: Referring and supporting individuals in finding stable and safe housing options. These services help address social determinants of health and provide stability.
9. Peer Support Programs: For 15+ years the agency has included People With Lived and Living Experience/Expertise (PWLLE). Utilising the lived experiences of individuals who may be actively using or engaged in recovery programs or treatment.  The agency works alongside individuals engaging in paid training and community outreach. Peer support workers offer brief emotional and social support, creating community connections and providing overdose response. Members’ lived experiences are valuable assets, fostering mutual empowerment and understanding.

Treatment Models: Réseau ACCESS Network works with members/patients who use drugs and wish to attend treatment to find the best fit and availability.  Some services include:

1. Land-Based Indigenous Treatment: Incorporates traditional Indigenous healing practices that connect individuals with the land, culture, and community. This approach may include sweat lodges, healing circles, and other ceremonies rooted in Indigenous knowledge and spirituality. Facilitated by Indigenous healers, knowledge keepers, and/or Elders, these practices aim to restore balance and harmony in individuals’ lives, addressing wellness holistically – physically, mentally, emotionally, and spiritually.
2. Mindfulness-Based Therapies: Incorporate meditation and mindfulness practices to help individuals become more aware of thoughts and triggers, teaching skills to manage cravings and emotions without using substances.
3. Therapeutic/Residential Communities: Short-term and Long-term residential treatment programs that provide highly structured environments focused on resocialization. These programs typically last 2-12 months or longer.
4. Opioid agonist therapy (OAT): Referrals and accompaniment to OATs treatment services as requested. Offering medications that help manage withdrawal symptoms and cravings, such as methadone or buprenorphine, alongside counselling and support services. The therapy involves taking the opioid agonists methadone (Methadose) or buprenorphine (Suboxone).
5. Outpatient Treatment: Allows individuals to live at home while receiving treatment, ranging from intensive daily programs to weekly counselling sessions. This approach provides flexibility for those with work or family commitments.
6. 12-Step Programs: A structured approach based on the principles of Alcoholics Anonymous and similar programs. It emphasizes acceptance, surrender, and active involvement in recovery, preparing individuals to engage in 12-step mutual support groups.
7. Cognitive Behavioral Therapy (CBT): Focuses on identifying and changing negative thought patterns and behaviours related to substance use. It teaches coping skills and strategies to prevent relapse and can be done individually or in groups.

The harm reduction continuum of care recognises the importance of meeting people where they are in their drug use journey and offering a range of support options. Réseau ACCESS Network offers a wide variety of wrap-around services and has created partnerships and relationships with service providers to provide warm referrals and accompanied support when requested.  The agency promotes an individualised and member/patient-centred approach that focuses on reducing harm, improving overall health and well-being, and supporting individuals where they are in their substance use journey.