DSM IV Axis II traits can influence compliance to treatment with oral naltrexone: A preliminary study on 30 opiate dependent patients

• Adherence to oral naltrexone treatment after opiate detoxification is low.
• We report that the intensity of Axis II traits is associated with poor adherence to oral naltrexone treatment.
• Axis II profile might be a potential indicator of oral naltrexone adherence.
• Behavioral protocol could be adjusted accordingly.

For many decades, health specialists have successfully used their clinical ingenuity to increase the efficiency of opiate detoxification protocols. However, even if drop-out rate has decreased significantly in today's protocols, relapse after opiate detoxification remains a major problem. Therefore, naltrexone hydrochloride, an opiate antagonist, has been considered by many as a potential tool to support abstinence in what has been called “antagonist-assisted abstinence” (AAA). Nevertheless, while naltrexone implants are becoming more accessible, a large majority of centers still use oral naltrexone and adherence to treatment remains a major obstacle to AAA's efficiency. As the personality profile could give an insight into compliance, we investigated the relationship between personality profiles and naltrexone adherence in a cohort of 30 patients. The results indicate that the Axis II profile influences the likely pattern of oral naltrexone compliance. As clinicians need to identify opiate dependent patients who are most likely to benefit from oral naltrexone treatment, it therefore carries important implications and could lead to a better adjustment of therapeutic strategies for opiate dependent patients.