Analysis of the obstacles related to treatment entry, adherence and drop-out among alcoholic patients.

Alcoholism is a complex syndrome involving social, psychological and individual factors in addition to a series of obstacles regarding treatment entry, adherence, and drop-out. These obstacles contribute negatively to both clinical evolution and prognosis of the patients, affecting their quality of life and raising the social costs. This is a bibliographical study in which we address this theme as well as other experiences observed in our daily practice in the Alcohol and Drug Research Unit (UNIAD) based at the Federal University of São Paulo (UNIFESP). The analysis of the obstacles related to treatment entry, attendance, and drop-out among alcoholic patients shows that systemic, social, cultural, and individual factors are all involved, including the structural ones. Women have more obstacles compared to men, and what is thought to be a barrier to one patient may be a factor motivating another patient to search for help. We conclude that several factors at different levels exist that prevent the patient from overcoming these treatment obstacles.