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G. Alan Marlatt, a pre-eminent behavioral researcher whose keen intellectual curiosity and groundbreaking scholarship significantly shaped the field of addictive disorders, has died at the age of 69 from complications of melanoma. Alan was a professor of psychology at the University of Washington, where he also founded and directed the Addictive Behaviors Research Center.

Born in Vancouver, British Columbia, Alan completed studies for the bachelor's degree in psychology from the University of British Columbia in 1964. His PhD in clinical psychology was awarded by Indiana University in 1968.

In the late 1960s and early 1970s, as he began his academic career and a focus on addictive behaviors (University of British Columbia, 1968–69; University of Wisconsin, Madison, 1969–72; University of Washington, 1972–), alcoholism and addiction treatment in the United States was undergoing substantial growth. Also, the establishment of the National Institute on Alcohol Abuse and Alcoholism (NIAAA), and a few years later the National Institute on Drug Abuse (NIDA), greatly increased the US government's investment in alcoholism and addiction research.

The stage was set for a new era of inquiry concerning the nature and mechanisms of addiction as well as the manner in which it is overcome. Early on, Alan's work in these arenas was recognized as pioneering. At the university, the excitement in and around his laboratory was palpable. The numbers of graduate students and postdoctoral fellows seeking the chance to work with him grew rapidly.

I had joined the University of Washington faculty in the same year as Alan and saw firsthand the intellectual synergy he stimulated across academic disciplines. At the invitation of the Vice President for Health Sciences, Alan recruited an interdisciplinary faculty group to join him in establishing a new university-wide research center that came to be known as the Alcohol and Drug Abuse Institute. Concurrently, his own laboratory in the Psychology Department was increasingly being visited by alcoholism and addiction scholars. One learned to arrive early to obtain a coveted seat at the many lectures and symposia that Alan sponsored each year.

He asked compelling questions and often led the field in challenging accepted wisdom that had not been founded on empirical evidence. As an example, he wondered if physiological changes were in fact the sole or even the primary cause of how people behaved after drinking. Creating the BARLAB (Behavioral Alcohol Research Laboratory), a fully furnished cocktail lounge with the capacity to covertly observe and videotape the behaviors of research subjects, made it possible to explore this issue. Many studies in the BARLAB employed the Balanced Placebo Design, a novel method he had developed in Wisconsin in which individuals were either told that they were receiving alcohol or that they were receiving a placebo. The twist was that what participants were told was either true or false, allowing for a separate exploration of psychological and physiological effects of alcohol on behavior.

Noting the disturbingly high rates of failure to maintain successful change following treatment for addictive disorders, Alan sought to understand the determinants of relapse and how they might inform the design of addiction therapy. In a book that quickly became a classic (Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors[1]), Alan and Dr Judith Gordon described a cognitive–behavioral model of relapse and identified specific intervention strategies to fit with each element in the model. In the book's foreword Professor Terry Wilson lauded the authors, writing: ‘The most recent advances in such demanding sub-specialty areas as social psychology, personality psychology, classical conditioning research, social learning theory, and behavior therapy are all smoothly woven together with well-informed and incisive analyses of the nature of the addictive disorders themselves, into an integrative whole.’

Alan loved to travel. As a consequence of his many international talks and the visiting scholar appointments he accepted while on sabbatical leave, he became interested in alternative drug and alcohol control policies. Beginning in the 1990s, his work in harm reduction was influenced by the pragmatic approach a number of countries take towards addictive behaviors. Believing that insistence on abstinence probably obstructed many from seeking treatment or beginning the process of self-change, Alan designed and tested interventions that met the individual where he/she was in terms of readiness for change, a concept he referred to as compassionate pragmatism. In an interview he said: ‘For some, 12-step programs will be the right approach, but others may need something else. What I want to do is help people find a path that works for them.’ To that end, Alan, along with his colleagues, developed and tested BASICS (‘Brief Screening and Intervention for College Students’), an early intervention approach adopted subsequently by many universities. More recently, he and his team at the Addictive Behaviors Research Center demonstrated that a non-abstinence-based housing program (known as Housing First) for chronically homeless individuals with substance use problems reduced residents' drinking levels and the need for emergency room care and detoxification.

Meditation and Buddhist teachings were important to Alan. His research with Drs Sarah Bowen and Neha Chawla on mindfulness-based relapse prevention incorporated cognitive–behavioral skills training with mindfulness meditation to enhance the client's ability to cope with relapse triggers such as stress, craving, depression and anxiety.

Alan was known for his warmth, generosity and genuineness. He was also highly respected for his intellectual boldness, integrity and courage. In the early 1980s, when Mark and Linda Sobell were charged erroneously with having reported fraudulent data concerning their controlled drinking research, he was one of the few researchers who ardently defended them.

Over the course of his career, Alan wrote or edited 23 books and published more than 300 papers. The significance of his scholarship was acknowledged in the many honors he received, including the Jellinek Memorial Award for Outstanding Contributions to Knowledge in the Field of Alcohol Studies, the Robert Wood Johnson Foundation Innovators in Combating Substance Abuse Award, the Distinguished Researcher Award from the Research Society on Alcoholism and the Distinguished Scientific Contributions to Clinical Psychology Award from the American Psychological Association.

News that Alan was gravely ill came as a shock, and elicited messages of love and prayer from people in many parts of the world. Within a very few days he was gone. Recognizing that so many had felt desperate knowing the end was near, Alan's son Kit wrote to share thoughts about his father and give us a glimpse of Alan's last hours:

He loved moments of peace and quiet, the gathering of friends and colleagues and moments of joy. He laughed with a twinkle in his baby-blues. He was a writer, a mentor and a muse. He played piano and had a deep love of music. . . . He was in no pain, no suffering. He was in his beloved summer home in Warm Beach, Washington looking up through the skylights, watching the eagles soar and the rain gently fall.

Rest in peace, my friend.

Reference

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  • 1
    Marlatt G. A., Gordon J. R. Relapse Prevention: Maintenance Strategies in the Treatment of Addictive Behaviors. New York: Guilford Press; 1985.