Quantum Units Education®

Introduction

1. All of the following are adverse health consequences associated with excessive alcohol consumption, except for:

2. Addiction is a treatable condition.

3. Which of the following has not been approved by the U.S. Food and Drug Administration for treatment of both alcohol and opioid dependence?

4. The most frequently reported reason, among those who needed treatment for alcohol or illicit drugs but did not receive it, was lack of health coverage.

Considerations for Covering Medications for Alcohol and Opioid Use Disorders

5. In general, scientific research has found that medications for alcohol dependence do which of the following?

6. Disulfiram works by producing sensitivity to alcohol, which results in a highly unpleasant reaction when the patient ingests even small amounts.  Symptoms include flushing, throbbing headache, nausea, and vomiting for 24-30 hours.

7. The only medication for treatment of opioid dependence that is not available in a generic version is oral naltrexone.

8. Scientific research has established that treatment of opioid addiction with medication does which of the following?

9. Which medication works by displacing any opioids on the patient’s opioid receptors and tightly binding to those receptors for 24-30 hours?

10. All of the following are true statements with regards to buprenorphine and buprenorphine-naloxone, except:

11. When treating individuals with prescription opioid dependence, a recent study found that people had good outcomes while taking buprenorphine, but relapse rates were high following tapering - even after 12 weeks of treatment.

12. Because methadone is taken orally and because it has a slow and very long period of metabolism, it does not generate the extreme euphoria of short-acting, injectable opioids.

13. Under the Controlled Substances Act, which schedule of substances include methadone and have high potential for abuse, which may lead to severe psychological or physical dependence?

14. A study found that patients who received alcoholism medications, when compared to similar patients with a diagnosis of alcohol dependence who did not fill any prescriptions for alcohol medications, had all of the following, except:

15. Which of the following may also dispense methadone or buprenorphine to a patient under the direction of the OTP medical director who is certified by SAMHSA and registered with the DEA, as long as the activity is consistent with state law?

16. Under the Affordable Care Act, prescription drug benefits are essential health benefits that must be covered under the health insurance marketplaces, and all benchmark plans must cover one drug in every United States Pharmacopeia therapeutic category and class.

Medicaid Coverage of Medications for Alcohol and Opioid Use Disorders

17. Step therapy occurs when a claims processor must verify that the patient first tried a more cost-effective medication before filling a more expensive alternative.

18. Which of the following is not one of the three drugs with the least coverage across Medicaid programs for the purpose of treating opioid addiction?

19. In general, more management techniques are used for medications to treat alcohol use disorders than those to treat opioid use disorders.

20. Studies have found that 1 year after discharge from treatment programs, _______ % of individuals relapse in using alcohol or illicit drugs.

21. In addition to quantity limits, some states establish lifetime treatment limits specifically for:

22. Acamprosate is the only medication for which Medicaid programs use step therapy due to the fact that acamprosate is a relatively expensive medication.

Innovative Coverage and Financing Models

23. During step 2 of the State of Maryland Buprenorphine Initiative, patients are considered ready to transfer to a primary care provider when:

24. With regard to Vermont’s “Hub and Spoke” system, hubs may consist of entities such as primary care medical homes, federally qualified health centers, independent physicians and psychiatrists, or specialty clinic-based outpatient substance abuse treatment providers.

25. A physician survey found that one consistently cited barrier to outpatient buprenorphine treatment expansion is a lack of adequate clinical support to meet the patient need.