{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T04:01:56Z","timestamp":1747368116019,"version":"3.40.5"},"reference-count":15,"publisher":"Royal College of Psychiatrists","issue":"3","license":[{"start":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T00:00:00Z","timestamp":1747267200000},"content-version":"unspecified","delay-in-days":14,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["cambridge.org"],"crossmark-restriction":true},"short-container-title":["BJPsych open"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Summary<\/jats:title>\n\t  <jats:p>In modern healthcare, decision-making favours neatly delineated, categorical imperatives. We prefer to say: \u2018This practice is good\u2019 and \u2018That one is bad\u2019, believing that each decision has a straightforward yes-or-no resolution. However, medicine thrives in uncertainty, partial improvements and small steps that can lead to life-altering gains. Harm reduction, whether for tobacco use, opioid dependence or beyond, embodies the acceptance of imperfect solutions. It is precisely in these areas that black-or-white thinking can be most destructive. Insisting on total cessation or complete eradication of risk, rather than supporting incremental progress, alienates many patients and perpetuates preventable morbidity and mortality. Recognising this pattern and transcending \u2018all-or-nothing\u2019 mindsets is crucial for compassionate, evidence-based care. Accordingly, we ask: \u2018How does binary thinking in medical decision-making impact the effectiveness of harm reduction strategies?\u2019 Such an inquiry addresses how well we can truly meet patient needs in real-world practice, especially amid complexity.<\/jats:p>","DOI":"10.1192\/bjo.2025.69","type":"journal-article","created":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:42:07Z","timestamp":1747284127000},"update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":0,"title":["Beyond all-or-nothing: why binary thinking undermines harm reduction in addiction medicine"],"prefix":"10.1192","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-9887-395X","authenticated-orcid":false,"given":"Luke","family":"Manietta","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-5676-9871","authenticated-orcid":false,"given":"William","family":"Drake","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"170","published-online":{"date-parts":[[2025,5,15]]},"reference":[{"key":"S2056472425000699_ref10","doi-asserted-by":"publisher","DOI":"10.1002\/jclp.20669"},{"key":"S2056472425000699_ref14","doi-asserted-by":"publisher","DOI":"10.1146\/annurev-publhealth-071723-112620"},{"key":"S2056472425000699_ref3","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp2302857"},{"key":"S2056472425000699_ref5","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-9-200505030-00012"},{"key":"S2056472425000699_ref7","doi-asserted-by":"publisher","DOI":"10.1016\/j.amepre.2021.04.017"},{"key":"S2056472425000699_ref9","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-017-0158-x"},{"key":"S2056472425000699_ref2","first-page":"11782218221118462","article-title":"Barriers and facilitators to substance use disorder treatment: an overview of systematic reviews","volume":"16","author":"Farhoudian","year":"2022","journal-title":"Subst Abuse"},{"key":"S2056472425000699_ref6","doi-asserted-by":"publisher","DOI":"10.1186\/s12889-016-3079-9"},{"key":"S2056472425000699_ref15","doi-asserted-by":"publisher","DOI":"10.1111\/1468-0009.12649"},{"key":"S2056472425000699_ref11","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMp1601154"},{"key":"S2056472425000699_ref1","doi-asserted-by":"publisher","DOI":"10.1016\/j.addbeh.2018.06.024"},{"key":"S2056472425000699_ref12","doi-asserted-by":"publisher","DOI":"10.1186\/s12954-017-0196-4"},{"key":"S2056472425000699_ref4","doi-asserted-by":"publisher","DOI":"10.6004\/jnccn.2023.0013"},{"key":"S2056472425000699_ref13","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-023-08231-2"},{"key":"S2056472425000699_ref8","doi-asserted-by":"publisher","DOI":"10.1186\/s13011-021-00417-3"}],"container-title":["BJPsych Open"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S2056472425000699","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,15]],"date-time":"2025-05-15T04:42:07Z","timestamp":1747284127000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S2056472425000699\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5]]},"references-count":15,"journal-issue":{"issue":"3","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["S2056472425000699"],"URL":"https:\/\/doi.org\/10.1192\/bjo.2025.69","relation":{},"ISSN":["2056-4724"],"issn-type":[{"value":"2056-4724","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,5]]},"assertion":[{"value":"\u00a9 The Author(s), 2025. Published by Cambridge University Press on behalf of Royal College of Psychiatrists","name":"copyright","label":"Copyright","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (https:\/\/creativecommons.org\/licenses\/by\/4.0\/), which permits unrestricted re-use, distribution and reproduction, provided the original article is properly cited.","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}},{"value":"This content has been made available to all.","name":"free","label":"Free to read"}],"article-number":"e109"}}