Acceptance of Pharmacotherapy for Relapse Prevention
by Chronic Alcoholics

The willingness to take medication is a major prerequisite for compliance with biological treatment approaches in psychiatric disorders. The aim of this study was to investigate the willingness of alcoholics to improve relapse prevention using drug therapy, since there has been little information about the acceptance of such a medication as yet. 261 chronic alcoholics consecutively referred for detoxification completed a newly developed questionnaire containing items on drinking history, recent treatments, and beliefs about drug therapy for relapse prevention. In order to draw comparisons, 67 self-help group attendees and 29 alcoholics consulting an outpatient advice service were also recruited. 67.8 % of the recently detoxified alcoholics were prepared to take medication for relapse prevention, if prescribed, while 60 % the self-help group attendees refused drug therapy. There was no correlation between the acceptance of drug treatment and duration of dependence. Subjects willing to take a medication more often believed their alcoholism to be curable, and they reported a higher craving frequency. 55 % of those willing to take a medication were willing to pay for the drugs, but in most cases, at a level lower than the equivalent of 5 beers. As drug therapy acceptance is a crucial part of compliance with, and success of medical relapse prevention, our results underscore the necessity of a thorough exploration into the health beliefs of the patient and joint development of a treatment rationale prior to prescription.

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1 In Germany, all prescribed medications costing more than DM 12 per package are paid for by the national HMO organization (AOK) or its substitutes. A package of 168 tablets of acamprosate (28 daily dosages a 6 tablets), the only available drug for relapse prevention in Germany, costs about DM 181 (DM 6,48 per day). However, the patient only has to pay DM 12 per 28 days in total, or DM 0.43 per day, and the HMO covers the main cost.