Psychotropic medication nonadherence has significant consequences for patients, more so if they abuse substances. This descriptive study examined two stages-of-change measures: one for psychotropic medication adherence and one for substance cessation. Findings for these measures are presented for a sample of 105 patients on admission, a sample of 51 patients on 30-day follow-up, and a cohort of 39 patients who had measures for both time points. Stage advancement for dual behaviors was evident. Integrated treatment programs for this population may be further enhanced by providing interventions that promote psychotropic medication adherence.