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Adults with an opiate addiction have a higher rate of noncompliance with treatment, which limits its effectiveness and increases the burden of care for society. Effective treatment decreases emergency room visits, and overdoses. The tristate area of Kentucky, West Virginia, and Ohio has experienced increased opiate-related arrests and deaths. This study sought to measure the extent to which treatment type (medical treatment (MS) or faith-based component of service (FBS)) predicts compliance when measured by number of clean urine drug screens (UDSs) and number of kept pill count, over and above dual diagnosis, college education, and income. The on-site records of voluntary enrollees in an outpatient facility that used either MT alone or MT with FBS were reviewed. Spearman's rho and multiple stepwise regression revealed that, with respect to clean UDSs or kept pill count, the association between dual diagnosis and college education was not found to be statistically significant. Rather, income explained about 5% of the variance in clean UDSs with a significant f change of .019, while type of treatment did not significantly impact clean UDSs. Dual diagnosis, income, and college education were not found to be significantly associated with the number of kept pill count. According to this study, type of treatment did not significantly impact compliance in the tristate area of Appalachia as measured by clean UDSs or kept pill count. Since MT and FBS are so similar in their relationship to compliance, attendance and participation in treatment may be areas for future study.