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On "Gradualism" and the building of the harm reduction-abstinence continuum
1Laboratory of the Biology of the Addictive Diseases, Box 171, The Rockefeller University, 1230 York Avenue, New York, NY 10021-6399, USA. kellogs@mail.rockefeller.edu
Abstract:
This paper makes the case that a perspective called "Gradualism" could serve as a foundation for building a therapeutic continuum between the harm reduction and abstinence-oriented treatment worlds. In contrast to other integrationist writers (Denning, 2001; Marlatt, Blume, & Parks, 2001), this paper argues for the incorporation of abstinence into harm reduction approaches. The goal is to build on the strengths of both perspectives while reducing their weaknesses, and examples of each are provided. Lastly, with the frequent occurrence of relapse among addicted patients, building a continuum could also serve to provide a therapeutic "safety net" for those in need.