Adaptive Goal-Directed Adherence Tracking and Enhancement

The purpose of the naltrexone trial is to evaluate whether AGATE effectively measures and enhances medication adherence in the context of naltrexone treatment for problem drinking. Participants will be heavy/problem drinkers, recruited from the greater Albuquerque area, who are interested in either reducing or stopping their drinking and deemed to be candidates for naltrexone pharmacotherapy by the study psychiatrist, Dr. Arenella. All participants will be prescribed naltrexone, 50 mg, once daily, for eight weeks, and receive smartphones. Participants will be randomly assigned to receive either AGATE or SASED, a web-based alcohol and side-effects diary via smartphone. The primary outcome will be percent of scheduled doses that were taken during the eight week trial, as measured by the Medication Event Monitoring System (MEMS, Aardex Group, Union City, CA), pill counts, and using the timeline follow-back (TLFB) method.

Inclusion criteria

• problem or heavy drinkers
• age 21-55 years old
• located in the greater Albuquerque NM area
• interested in either reducing or stopping their drinking
• candidates for naltrexone pharmacotherapy

Exclusion criteria

• participation in other naltrexone study
• unable to operate a smartphone
• significant psychiatric or physical illness
• current drug dependence
• current regular opioid use
• any recent nonmedical opioid use
• any lifetime opioid dependence