G. Alan Marlatt, a psychologist who challenged the longstanding belief that substance addiction is incurable and that it can be controlled only by abstinence, died March 14 at his vacation home in Stanwood, Wash. He was 69 and lived in Seattle.
The cause was kidney failure, said his wife, Kitty Moore.
For 30 years, Dr. Marlatt was director of the Addictive Behaviors Research Center, an arm of the University of Washington in Seattle that nurtured a movement among therapists holding that addiction treatment should take a more moderated approach than is common in traditional 12-step programs calling for complete abstinence, like that of Alcoholics Anonymous. Dr. Marlatt was perhaps the leading proponent of the approach, called “harm reduction.”
His data demonstrated that reducing an addict’s level of alcohol use can lead directly to reduced troubles at home and at work. He maintained that while addicts may not be able to stop using a substance immediately, individualized counseling — a “meet them where they are” approach, as the movement calls it — can bring about changes in their “life conditions” and eventually lead to abstinence.
Through his research, much of it involving students on campus, Dr. Marlatt also identified factors that can predict a relapse, among them negative emotions, conflicts with others and recurring thoughts that the substance will make the addict feel better.
“Alan found that these high-risk situations can be planned for, and that by being taught appropriate coping responses the person can learn to avoid relapse,” said Mary Larimer, who worked with Dr. Marlatt for 27 years and is now associate director of the research center. “Prior to Alan’s work there was a perception that relapse was an inevitable part of the disease of addiction, primarily triggered by biological processes.”
In his book “Relapse Prevention” (1985, revised in 2005), considered a seminal work in the field, Dr. Marlatt drew a distinction between a lapse and a full relapse. He postulated that a lapse can be seen as a warning sign, not as failure, and that the addict can get back on track through counseling.
While his approach has gained many adherents, it has also been the subject of debate.
“Alcoholism causes brain damage, and Marlatt never considered that in his analyses,” said Irving Maltzman, an emeritus professor of psychology at the University of California, Los Angeles, who specialized in alcoholism. “I support complete abstinence.”
But Marc Schuckit, a professor of psychiatry at the University of California, San Diego, and an expert in genetic factors contributing to alcohol and drug dependence, saw value in both approaches.
“Where Alan and I differed was where the problems with alcohol get really serious,” Dr. Schuckit said. “I agree that abstinence isn’t always essential for people who drink more than may be healthy for them, but who don’t have serious problems. However, when somebody meets criteria for alcohol dependence, I read the data as saying it is very unlikely they will ever be able to go back to controlled drinking.”
Frederick Rotgers, president of the Society of Addiction Psychology, said Dr. Marlatt’s work was “the foundation for much of the psychological research in treatment today,” having “shifted it toward a more humane and respectful approach.”
Gordon Alan Marlatt was born in Vancouver, British Columbia, on Nov. 26, 1941, to Vera and Sholto Marlatt, a Royal Canadian Air Force flight officer who died in a plane crash in England during World War II.
Besides his wife, he is survived by a son, Kit; a stepson, Colin; two stepdaughters, Charlotte and Melanie; a half-brother, Robert; a grandson; and two stepgranddaughters. His three previous marriages ended in divorce.
Dr. Marlatt received a bachelor’s degree in psychology from the University of British Columbia in 1964 and a Ph.D. in clinical psychology from Indiana University four years later.
After teaching at the University of British Columbia and the University of Wisconsin, he joined the University of Washington faculty in 1972.
In recent years, Dr. Marlatt took a lead role in efforts to deal with alcohol abuse on college campuses.
He developed a counseling program called Basics — Brief Alcohol Screening and Intervention for College Students — that uses so-called harm-reduction techniques. It is now in place at more than 1,800 colleges.
