In the past decade, clinical research has suggested various strategies to optimize the effectiveness of naltrexone for alcoholism treatment. For example, the use of compliance-enhancing techniques improves medication adherence and treatment retention. The BRENDA approach utilizes motivational enhancement techniques that can be easily integrated into an office-based practice to improve compliance with pharmacotherapy. Clinical research also had identified patient characteristics that are likely to have a positive response to naltrexone. For example, patients who experience high initial levels of alcohol craving or a strong family history of alcoholism have better clinical outcomes when taking naltrexone compared with similar placebo patients. Clinical research studies have typically used a dose of naltrexone of 50mg per day taken orally. Recent studies show that higher doses of naltrexone are well tolerated and, given the considerable patient variability in naltrexone metabolism, some patients respond better to higher doses. Also, results of clinical trials over the past decade show that, like the treatment of other chronic medical disorders, pharmacological treatment of alcoholism depends on patients remaining compliant with treatment and on identifying subgroups of patients who respond well to naltrexone treatment.