This study examined the relationship between treatment attrition, psychological distress, and interpersonal problems in 120 patients participating in an alcohol and drug intensive outpatient program. Results indicated a relationship between attrition from alcohol and drug treatment and psychological distress and interpersonal problems. Specifically, patients who did not complete treatment scored higher on both depression and anxiety than treatment completers. Further, two types of interpersonal problems, Domineering and Vindictive, were positively related to treatment attrition. These findings suggest that routine assessment and early identification of psychological distress and interpersonal problems may minimize attrition from alcohol and drug treatment by helping clinicians identify at risk patients and provide early adjunctive intervention strategies.