On "Gradualism" and the building of the harm reduction-abstinence continuum

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. (C) 2003 Elsevier Inc. All rights reserved.