SEATTLE – 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. Counselors strive to reduce drug or alcohol consumption, for example, while minimizing public-health costs through programs 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.

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“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.

For example, counselors once shunned discussion of relapses when talking with alcoholics, believing it would only encourage further drinking. But Marlatt’s research showed it was more effective to acknowledge the likelihood of relapses and help patients cope with them.

 


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