Adherence to pharmacotherapy in patients with alcohol and opioid dependence.
OBJECTIVE
An important factor that has thus far limited the effectiveness of pharmacotherapies for patients with alcohol and opioid dependence is poor adherence to medication regimens. This paper presents a review of issues related to medication adherence in patients with these substance use disorders.


METHODS
A literature review was conducted of English language publications relating to medication adherence among patients with alcohol or opioid dependence.


RESULTS
The paper places the topic in the context of adherence difficulties among patients with a variety of chronic medical and psychiatric illnesses. Difficulties measuring adherence are discussed, and strategies to improve medication adherence are reviewed. These include specific interventions that prescribing clinicians can implement in their individual meetings with patients; the use of external reinforcers, such as positive and negative contingencies, and involvement of family members or significant others; and specific prescribing and dosing practices that may improve adherence.


CONCLUSIONS
As the use of pharmacotherapy for substance-dependent patients increases, rigorous and innovative approaches to encourage medication adherence should be sought.
Weiss
Roger D
RD
Alcohol and Drug Abuse Treatment Program, McLean Hospital, Belmont, MA 02478-9106, USA. rweiss@mclean.harvard.edu
D000437:Alcoholism / Q000188:drug therapy; D006801:Humans; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011615:Psychotherapy, Group; D019966:Substance-Related Disorders / Q000188:drug therapy*; D016312:Treatment Refusal