Why Do Persons With Alcohol Use Disorder Not Adhere To Naltrexone Treatment?

MedicalResearch.com Interview with:
“Alcohol” by zeevveez is licensed under CC BY 2.0Sarah Dermody PhD

Assistant professor
School of Psychological Science
College of Liberal Art
Oregon State University 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Naltrexone is an FDA-approved medication to treat alcohol use disorder. We know that people have difficulty adhering to the prescribed daily medication regimen, and that people who do not adhere to the medication tend not to fair as well in treatment as people who take the medication regularly.

This particular study attempted to address the question of why do people with alcohol use disorder have difficulty taking the medication daily? What we found was that people were less likely to take naltrexone after days of heavy drinking or strong alcohol craving versus typical drinking and craving levels. Furthermore, individuals were less likely to take the medication on weekends versus weekdays, which is particularly worrisome because heaviest drinking episodes tend to happen on the weekends.

MedicalResearch.com: What should readers take away from your report?

Response: What this study tells us is that we need to do more than write a prescription to help individuals with alcohol use disorder. Having some sort of reoccurring contact with the patient is really important, even if the sole purpose is to assist with medication management and adherence. And in this case, the data suggests that the contact does not have to be human-to-human. Simply having participants track daily alcohol use and craving may lead to some improvements in medication taking behaviors on a day-to-day basis. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Additional research is needed to establish what interventions would improve adherence to naltrexone in this context. In light of the results from the present investigation, texting interventions warrant further investigation and could be tailored to prompt individuals to take naltrexone on days after they have reported heavy drinking or strong craving. 

The authors have no conflicts of interest to disclose.


Sarah S Dermody, Jeffery D Wardell, Susan A Stoner, Christian S Hendershot. Predictors of Daily Adherence to Naltrexone for Alcohol Use Disorder Treatment During a Mobile Health Intervention. Annals of Behavioral Medicine, 2018; DOI: 10.1093/abm/kax053 

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Last Updated on February 13, 2018 by Marie Benz MD FAAD