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Editorials |2 December 2008

Drinking and Drugs: When Is Enough Too Much?

Carol Golin, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
Acknowledgment: The author thanks Catherine Grodensky for administrative and editorial assistance.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Carol Golin, MD, University of North Carolina at Chapel Hill, 725 Airport Road, Campus Box 7590, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; e-mail, Carol_Golin@med.unc.edu.
  • From the University of North Carolina at Chapel Hill, Chapel Hill, NC 27599.
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Acknowledgment: The author thanks Catherine Grodensky for administrative and editorial assistance.
Potential Financial Conflicts of Interest: None disclosed.
Requests for Single Reprints: Carol Golin, MD, University of North Carolina at Chapel Hill, 725 Airport Road, Campus Box 7590, University of North Carolina at Chapel Hill, Chapel Hill, NC 27599; e-mail, Carol_Golin@med.unc.edu.
Studies have consistently shown that patients with chronic, often asymptomatic diseases, such as diabetes and hypertension, frequently do not adhere to their medication regimens. One meta-analysis demonstrated that only 40% of chronically ill patients take all of their prescribed doses (1). Not only is poor adherence common in treatment of chronic illness, but several studies have shown that it leads to a broad range of important adverse health outcomes in patients with coronary artery disease, HIV, diabetes, and hypertension (2–6). Thus, effective interventions to help patients achieve and maintain optimal adherence are crucial to providing high-quality, cost-effective medical care.
A first step toward developing effective interventions is to understand factors that affect adherence and that clinicians can influence. The effect of substance abuse on adherence to HIV treatment has been the target of much research, perhaps because substance abuse is common among persons living with HIV and because survival depends on adherence to antiretroviral therapy. Many recent studies have found an inverse association between alcohol use and antiretroviral therapy adherence (3, 7), but few of them have involved general medical patients. Although the association between alcohol misuse and antiretroviral therapy adherence does not necessarily indicate...
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Golin C. Drinking and Drugs: When Is Enough Too Much?. Ann Intern Med. 2008;149:830–832. doi: 10.7326/0003-4819-149-11-200812020-00012

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Published: Ann Intern Med. 2008;149(11):830-832.

DOI: 10.7326/0003-4819-149-11-200812020-00012

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