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Clinical Use of Extended-Release Injectable Naltrexone in Treating Opioid Use Disorder

Assessing the Need for Treatment

1. The objectives of the assessment are which of the following?

A. Determine the patient’s need for treatment.

B. Develop a treatment plan.

C. Establish a baseline measure for evaluating the patient’s progress.

D. All of the above.


2. The patient assessment should screen for all of the following infectious diseases, except:

A. Hepatitis A

B. Hepatitis B

C. Hepatitis C

D. HIV/AIDS


3. Ideally, the substance use history should include each of the following, except for:

A. The nature of the patient’s substance use disorder.

B. Underlying or co-occurring disease or conditions.

C. Past traumatic events leading up to the substance use.

D. The effect of opioid use on the patient’s physical and psychological functioning.


4. A combination of recent and old injection sites suggests that the patient may be currently using opioids and may have a complex opioid use disorder.

A. True

B. False


5. Elements of a treatment plan for an opioid use disorder should include which of the following?

A. A discussion of the involvement of family or significant others in treatment.

B. A plan for treating co-occurring medical or psychiatric disorders.

C. Criteria for discontinuing use of medication.

D. All of the above.


6. Whenever a medication is to be used, the treatment plan should give attention to steps that will promote medication adherence.

A. True

B. False


7. Patients should abstain from using any opioids, including opioid-containing medicines, for a minimum of _____ days before starting extended-release injectable naltrexone to avoid precipitation of opioid withdrawal.

A. 2 - 3

B. 5 - 7

C. 7 - 10

D. 10 - 14


8. Naltrexone is an agonist at the opioid receptors in the brain.

A. True

B. False


9. Following a person’s treatment with extended-release injectable naltrexone, the patient’s opioid tolerance is reduced from pretreatment baseline, and the patient is vulnerable to a potentially fatal overdose during all of the following, except:

A. At the end of a dosing interval.

B. At the mid-point of a dosing interval.

C. After missing a dose.

D. After discontinuing treatment.


10. Each of the following patient categories may be good candidates for extended-release injectable naltrexone, except for:

A. Patients who have not had treatment success with methadone or buprenorphine.

B. Patients who experience protracted abstinence symptoms following withdrawal.

C. Patients who have been successful on opioid agonists who wish to discontinue agonist therapy.

D. Patients who are not interested in agonist therapy to treat their opioid use disorder.


11. Patients may resist attending NA meetings since the organization does not support medication use.

A. True

B. False


12. Whenever a patient enters treatment for either a substance use disorder or a psychiatric disorder, he or she should be assessed for the co-occurrence of the other.

A. True

B. False


13. Extended-release injectable naltrexone interacts with several antiretroviral treatments for HIV.

A. True

B. False


14. Which of the following is approved by the FDA for the treatment of patients younger than 18 years of age?

A. Methadone

B. Buprenorphine

C. Extended-release injectable naltrexone

D. All of the above


Initiating Medication-Assisted Treatment

15. Because methadone normalizes endocrine functions, it is not unusual for women in the early phases of medication-assisted treatment to become pregnant unintentionally, especially if they do not receive counseling for this possibility.

A. True

B. False


16. The patient should be advised to carry a medical alert card that communicates which of the following?

A. Identifying the use of extended-release naltrexone.

B. Describing any potential adverse effects.

C. Providing contact information for the treating clinician or institution in an emergency.

D. All of the above.


17. Spontaneous withdrawal is much more severe than precipitated withdrawal, and patients undergoing spontaneous withdrawal can become very ill.

A. True

B. False


Monitoring Patient Progress and Adjusting the Treatment Plan

18. Monitoring patient progress is an ongoing process that assesses the patient on all of the following dimensions, except:

A. Evaluating symptoms of protracted absence syndrome.

B. Adherence to the treatment plan.

C. Ability to maintain abstinence.

D. Levels of cravings.


19. At a minimum, patient records should contain:

A. Treatment plan

B. Consultants’ reports

C. Informed consent

D. All of the above


Deciding Whether and When to End Medication-Assisted Treatment

20. Ideally, all of the following are reasons the patient and practitioner will use to reach a decision about whether and when medication-assisted treatment should be discontinued, except for:

A. The patient reports substantially diminished craving.

B. The patient has maintained stable abstinence over a sustained period.

C. The patient has side effects to the medication.

D. The patient feels ready to discontinue the medication.


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