In this article, we report on our work at St. Ann's Corner of Harm Reduction, a multi-service agency committed to implementing effective public health strategies in disenfranchised communities from a harm reduction perspective. Based on our experiences, we hope to contribute to the ongoing dialogue about the definition of harm reduction, while proposing to integrate harm reduction and abstinence-oriented treatment modalities into a model of comprehensive drug prevention and care. The five components of our harm reduction service provision are discussed, and a vignette is provided. We conclude with a plea for close collaborations between innovative researchers and harm reduction agencies, and a call for the full integration of harm reduction approaches into the substance abuse field at large.