E

G. A. Marlatt, Advocate of Shift in Treating Addicts,

Dies at 69
#106
The New York Times
3/23/11
Dennis Hevesi
Vocabulary to Know Before You Read
longstanding
abstinence
proponent

relapse
recurring
cope

seminal
postulate
adherent

emeritus
criteria
humane

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 addicts 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 Alans 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 isnt always essential for people who drink more
than may be healthy for them, but who dont 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. Marlatts
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 bachelors 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.

Questions:
1. What is Dr. Marlatts approach to substance abuse counseling, and how does his
approach differ from that of most other researchers in the field? Explain your answer
using details from the article.
2. In what ways do Dr. Marlatts and Marc Shuckits beliefs about treatment for
alcoholism differ? Explain your answer using details from the article?
3. Where and how did Dr. Marlatt conduct much of his research on addiction?
4. Do you agree with the idea that alcoholism (or drug addiction) is a disease? Why or
why not? Explain your answer.