Quantum Units Education®

Executive Summary

1. Which of the following is an effective medication used to reverse opioid overdose?

2. All states reimburse for buprenorphine, buprenorphine-naloxone, oral naltrexone, extended-release naltrexone, disulfiram, acamprosate, and methadone as medication-assisted treatment.

3. Reimbursement of medications as MAT means that they have preferred status within state Medicaid programs.

4. Most prior authorization requirements for buprenorphine monotherapy exist because:

5. Lifetime treatment limits are disappearing, which is consistent with clinical evidence and best practices, given that addiction is a chronic disease.

Introduction

6. Addiction is:

7. According to research that tracks individuals in treatment over extended periods, most people who get into and remain in treatment do all of the following, except:

8. Although reliance on medication alone is not uncommon, a combination of psychosocial treatment and medication generally is recommended for the treatment of alcohol or opioid use disorders.

9. MAT for opioid use disorders using _____ is associated with substantial reductions in the risk for all cause and overdose mortality.

10. Among individuals who recognized a need for treatment and tried to obtain it, _____ was the most frequently reported reason for not receiving treatment.

State Considerations for Covering Medications for Alcohol and Opioid Use Disorders

11. The FDA:

12. The FDA evaluates a product’s safety, efficacy, and cost as part of the drug approval process.

13. The FDA describes generic drugs as “copies of brand-name drugs and are the same as those brand name drugs in dosage form, safety, strength, route of administration, quality, performance characteristics and intended use.”

14. Which of the following is not yet available in generic form?

15. In general, scientific research has found that medications for alcohol use disorders:

16. Acamprosate may be most effective among individuals who are motivated for complete abstinence from alcohol and when provided over a long period of time.

17. Disulfiram, administered orally as a tablet:

18. Expert consensus recommends using disulfiram only:

19. Naltrexone has the advantage of:

20. Consistent bioavailability of the long-acting formulation of naltrexone contributes to an improved adverse effect profile compared with its oral counterpart.

21. Naltrexone for alcohol use disorders is effective at reducing all of the following, except:

22. Which of the following plays a significant role in the effectiveness of naltrexone?

23. Buprenorphine should not be used during pregnancy.

24. Buprenorphine combined with naloxone can be used for which phase of treatment?

25. Naloxone is combined with buprenorphine to reduce the risk of buprenorphine being misused by injection.

26. Those with higher buprenorphine-naloxone doses had fewer aberrant drug tests and greater retention in treatment than those required by a payer to reduce their dosage to _____ or lower.

27. All of the following describe methadone, except for:

28. Oral naltrexone is a short-acting opioid antagonist that works by tightly binding to opioid receptors for 8 to 12 hours.

29. To prevent severe iatrogenic opioid withdrawal, patients must abstain from opioids for a minimum of _____ days before beginning the naltrexone treatment; thus, it is effective when used following medical detoxification from opioids or after a period of abstinence such as during incarceration.

30. Naloxone requires a prescription because it is a controlled substance due to its abuse potential.

31. Studies of the comparative effectiveness of different treatments for alcohol use disorders have found greater savings from use of MAT than from use of psychosocial treatment alone.

32. Which of the following is the most effective at reducing the cost for alcoholism-related inpatient hospitalizations and detoxification among individuals treated with MAT?

33. Annual cost per patient was lower for those taking methadone than for those taking buprenorphine, largely because of longer hospitalization for those receiving buprenorphine.

34. Among those treated with medication, methadone had:

35. Which of the following is classified as a schedule II drug with a high potential for abuse and may lead to severe psychological or physical dependence?

36. Which of the following can be prescribed by a physician, nurse practitioner, or physician assistant?

37. Which of the following regulations has been identified as possibly impeding the provision of integrated care, including behavioral health?

38. Which of the following is not MAT per se but is used to reverse opioid overdose?

39. New York law defines an “opioid antagonist recipient” as:

Medicaid Coverage of Medications for Alcohol and Opioid Use Disorders

40. Given that methadone is involved in one out of every three accidental overdose deaths, it has been suggested that the process for obtaining methadone to treat pain might benefit from greater control.

41. Providers are not permitted to prescribe drugs on a preferred drug list without seeking prior authorization.

42. Which of the following occurs when a claims processor must verify that the patient first tried a more cost-effective medication before filling a more expensive alternative?

43. Attributing preferred status to _____ as a form of MAT is not possible, given the different method of dispensing and strict restrictions on access governed by federal law.

44. Quantity or dosing limits are least common for:

45. Quantity or dosing limits for _____ are used by 45 states.

46. Lifetime treatment limits are most commonly applied to:

47. New York regards any treatment using _____ for longer than 1 year as “investigational” and not medically necessary.

48. Step therapy requirements are more common for the _____ drugs.

49. Studies have found that 1 year after discharge from treatment programs, almost 100 percent of individuals relapse in using alcohol or illicit drugs.

50. All 50 states and the District of Columbia cover at least one of the three formulations of:

Innovative MAT Provision, Coverage, and Financing Models

51. The successful integration of MAT into SUD and co-occurring disorders treatment led Missouri to require all Certified Community Behavioral Health Clinics in the Prospective Payment System demonstration provide all form of MAT other than:

52. Missouri has found that addressing negative perceptions of SUD treatment, whether held by providers, patients, or patients’ families, is critical to success.

53. Missouri has found best prescribing practice to be for prescribers providing particular medications uniformly.

54. Which of the following is a factor that may affect access to MAT?

55. Although qualifying nurse practitioners and physician assistants will now be allowed under federal law to receive a DATA 2000 waiver and prescribe buprenorphine, some states have explicit restrictions in place on prescribing buprenorphine by non-physicians.

Conclusion

56. Research on the use of prior authorization with psychiatric medications has revealed that prior authorization may reduce medication expenditures but also may have the unintended consequences of reducing use of the medication and access to treatment.