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S.H. Kellogg / Journal of Substance Abuse Treatment 25 (2003) 241–247
able to improve on its record of success. Second, by creating a
continuum of care, a therapeutic ‘‘safety net’’ can be created
(see also Marlatt, 1998b). The goal would be that the life and
health of relapsing patients would be preserved through the
work of the harm-reduction organizations, and, using the
momentum of a gradualist approach, they would be able to
return more rapidly to a drug- and alcohol-free life.
6. Conclusion
We are currently living in a time of rich therapeutic
possibilities for working substance-using and substancedependent
patients. This creativity is taking place both
within the harm-reduction and abstinence-oriented spheres.
To optimize care for those who are addicted, it would be
ideal to connect harm reduction and abstinence treatment
into a continuum that has the cessation of drug and alcohol
use and the healing of mind and body as the desired end
point. Gradualism has been put forward as an organizing
principle to facilitate this development.
Acknowledgments
This paper is adapted from a presentation that was given
on April 6th, 2001, at a conference entitled, ‘‘The Great
Debate: Abstinence vs. Harm Reduction in Addiction
Treatment’’ that was held at The New School University.
This conference was conceptualized and sponsored by the
New York State Psychological Association Division on
Addictions Executive Committee, whose members include:
Julie Barnes, F. Michler Bishop, Lisa Director, Scott
Kellogg, Robert Lichtman, A. Jonathan Porteus, Marlene
Reil, Debra Rothschild, Suzanne Spross, Andrew Tatarsky,
and Alexandra Woods. It was co-sponsored by the Masters
Program in Mental Health and Substance Abuse Counseling
at The New School University. Support for this work was
received from the Division on Addictions of the New York
State Psychological Association and from NIH-NIDA Grant
P60-DA05130. I would like to thank the NYSPA Division
on Addictions Executive Committee, McWelling Todman
(at The New School University), Mary Jeanne Kreek, and
Nadine Kellogg for their support and assistance.
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