Allow me to preface my thoughts by saying that I am not a trained therapist or even peer specialist.  Life experience and maybe reading are my credentials and, perhaps, they lack in grasping this topic. I hear about harm reduction as an approach and I understand it.  Rather than using opiates daily, a lethal habit certainly, one uses MAT to kick that habit.  If one continues to drink, or smokes grass, well then there is less harm being done. When I entered recovery there was a bright line -- abstinence on one side and any use whatsoever on the other. Methadone was a maintenance drug and, generally, frowned upon.  Times have changed.  There is even a method (I will not name it) that uses one drug as a means to continue drinking.  Here is my sense.  In the book, Alcoholics Anonymous, it says, "Some of us have tried to hold on to our old ideas and the result was nil until we let go absolutely."  Later in that same section, "No one among us has been able to maintain perfect adherence to these principles.  We are not saints."  My experience is that for the time I tried to hold on to my old ideas I was denying myself the joy of recovery and minimizing the opportunity for a spiritual awakening here for all to have.  I must note that I continued to use nicotine for five years in recovery.  Perhaps that is little different except that it is legal.  Again from the book, "We claim spiritual progress rather than spiritual perfection".  I think that the goal is abstinence.  I think that a commitment to a program of spiritual awakening is the joy.  BTW, having a spiritual awakening does not suggest that I became a monk :-)