AbstractThere is growing interest in a number of medications with proven clinical efficacy or potential for treating substance abuse. At the same time, many treatment programs make little, if any, use of pharmacotherapy. The reasons for this circumstance are not clear. An exploratory survey using focus groups and telephone interviews with medical personnel and administrators from 38 programs and three professional associations suggests that program staff perceive a variety of drawbacks to pharmacotherapy, which may help account for the lack of more widespread use of this treatment modality.†The research reported in this article was supported by the U.S. Department of Health and Human Services, National Institute on Drug Abuse, contract number 271-90-2200. Opinions stated in the article are those of the author and do not necessarily represent the position or policies of the U.S. Department of Health and Human Services.