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Chronic Pain and Opioid Misuse

1. Which of the following is defined as opioid use for non-medical intentions?

A. Misuse

B. Abuse

C. Addiction

D. All of the above


2. Two studies found that older age appeared to increase the risk of opioid misuse.

A. True

B. False


3. Which of the following was associated with increased risk for opioid misuse among chronic pain patients?

A. Depression

B. Anxiety

C. PTSD

D. All of the above


4. Chronic non-cancer pain patients with a past or present history of opioid or other substance use disorder appear to be at greater risk for prescription opioid misuse.

A. True

B. False


5. Chronic non-cancer pain patients with comorbid substance use disorder are more likely to be prescribed opioids, and higher doses, than chronic non-cancer pain patients without substance use disorder.

A. True

B. False


6. Without strong evidence to guide decision-making based on the results of standardized instruments to assess for problematic substance use, these tools appear to lack significant utility in the clinical setting.

A. True

B. False


7. Urine drug testing:

A. Is the most objective method of assessing opioid misuse in chronic pain patients.

B. Is often considered a “gold standard” monitoring approach.

C. Presents a high potential for false negative or false positive results that may compromise diagnostic accuracy and the patient-provider relationship.

D. All of the above.


8. Which of the following correctly describes treatment agreements for chronic pain patients?

A. They help promote transparent patient-provider dialogue and there is some evidence that treatment agreements may promote beneficial clinical outcomes in other patient populations.

B. There is weak and insufficient evidence to support the efficacy of treatment agreements in reducing harmful opioid use behaviors or related adverse clinical outcomes in patients with chronic pain.

C. Both (A) and (B).

D. None of the above.


9. If opioid treatment is considered for pain management in individuals with past or present substance misuse, weaker opioids are preferable to stronger opioids, as some evidence has found lower risk for abuse with weaker opioids.

A. True

B. False


10. Extended-release formulations are less abused, and therefore preferred, compared to immediate-release formulations.

A. True

B. False


11. Why might buprenorphine / naloxone be favorable over methadone?

A. The lower risk for respiratory depression.

B. Potentially lower risk for hyperalgesia or tolerance.

C. Lower dispensing burden.

D. All of the above.


12. It was found that psychotherapeutic interventions for concurrent pain and substance misuse using _____ may reduce pain severity and opioid misuse.

A. Mindfulness

B. Cognitive behavioral therapy

C. Either (A) or (B)

D. None of the above


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