PROFESSOR CHALLENGED 'JUST SAY NO' MODEL

For years, the prevailing approach to confronting addiction in the
U.S. could be summed up as "just say no." Abstinence was the only
goal; addicts had to agree to quit drugs or booze entirely as a
precondition for treatment.

The pioneering work of Alan Marlatt, a professor of psychology at the
University of Washington, profoundly changed that attitude in recent decades.

Marlatt advocated "harm reduction," an approach that meets addicts
"where they are" instead of demanding immediate detox and abstinence.

Counsellors strive to reduce drug or alcohol consumption, for
example, while minimizing publichealth costs through pro-grams such
as needle exchanges.

It's a model Marlatt called "compassionate pragmatism instead of
moralistic idealism." And research shows it works.

Marlatt, director of the Addictive Behaviors Research Center at the
University of Washington, died Monday from complications of melanoma.
He was 69.

An internationally respected researcher, Marlatt wrote or edited more
than 20 books and hundreds of scientific journal articles, and
received major awards for his contributions to the fields of
alcoholism and substance abuse.

"He was a visionary and a luminary. He generated ideas that were
ahead of their time in so many different ways," said Dennis Donovan,
director of the Alcohol and Drug Abuse Institute at the university,
one of the many researchers Marlatt mentored over his career.

While now widely accepted, some of Marlatt's ideas were considered
heretical when he first started writing and talking about them
decades ago, colleagues said.

For example, counsellors once shunned discussion of relapses when
talking with alcoholics, believing it would only encourage further
drinking. Marlatt challenged that as unrealistic. His research showed
it was more effective to acknowledge the likelihood of relapses and
help patients cope with them.

"When I first heard him talk about that in the late 1970s, people got
up and accused him of killing alco-holics," said Frederick Rotgers,
president of the Society of Addiction Psychology.

Born in Vancouver, Marlatt was a Canadian and U.S. citizen. He
received his bachelor of psychology from the University of British
Columbia in 1964 and his doctorate in clinical psychology from
Indiana University in 1968. He joined the University of Washington
faculty in 1972.

A lover of travel who spent several sabbaticals overseas, Marlatt was
influenced by the pragmatic policies many other countries take toward
drug abuse, which he viewed as superior to the moralistic approach in
the United States.

"The shame that many people have about their addictions is just made
worse by that kind of model and then they don't seek treatment," said
Kitty Moore, Marlatt's wife.

"He was battling the moral model his entire life."

Katie Witkiewitz, assistant professor of psychology at Washington
State University, said Marlatt's great gift was combining scientific
rigor with compassion.

For example, he wondered whether harm-reduction approaches could have
saved troubled Seattle rock star Kurt Cobain, who committed suicide in 1994.

In an op-ed for The Seattle Times in 2004, Marlatt noted that Cobain
didn't want to give up heroin because he felt he needed it to cope
with chronic stomach pain.

Yet abstinence was the only choice offered to him during an
intervention shortly before his death.

"Like many users, Cobain was not quite ready to give up his drug use
as the first and only step to recovery," Marlatt wrote, suggesting
that alternatives to abstinence should have been offered.