Quantum Units Education®

Introduction

1. Although many experts in addiction believe that patients with moderate or severe alcohol related problems should be offered medication-assisted treatment (MAT) on a routine basis, considerable resistance to the use of MAT persists.

Considering Medications

2. Which of the following is an accurate statement about the use of medications approved for the treatment of alcohol use disorder?

Screening and Assessing Patients

3. Screening for risky alcohol use is especially important in patients who are pregnant or trying to conceive, are at risk for binge drinking or heavy drinking, have one or more chronic health problems, and have social or legal problems that may be caused or worsened by alcohol use.

Assessing the Need for Medication-Assisted Treatment

4. A patient who reports five or more heavy drinking days in the past year should receive further assessment to determine severity of at-risk drinking and to provide brief interventions as needed.

Physical Examination

5. During the assessment process, the physical examination should evaluate neurocognitive function, identify sequelae of alcohol use, and look for evidence of:

Developing a Treatment Plan and Selecting a Medication

6. Steps to achieve the patient’s goal should be outlined in a treatment plan, which should be developed in consultation with the patient and address each of the following points EXCEPT:

Evaluating the Need for Medically Managed Detoxification

7. Alcohol withdrawal syndrome can be severe and potentially fatal, and generally begins within ________ after the blood alcohol level drops and can persist for ________.

Addressing Co-Occurring Disorders

8. Research studies show that the most effective way to treat co-occurring disorders is through integrated treatment, which is defined as any mechanism by which treatment interventions for multiple co-occurring disorders are delivered within the context of a primary treatment relationship or service setting.

Treating Older Adults

9. Alcohol and other substance use are significant problems among older adults, and clinicians need to recognize the various challenges that impact this age group, including shame, the problem being ignored or minimized, and:

10. Pharmacotherapies for alcohol use disorder appear to be significantly less effective and less safe for older adults than for younger adults.

Selecting a Medication

11. Disulfiram, which was approved by the FDA as an alcohol abuse deterrent in 1951, disrupts the metabolism of alcohol, resulting in an unpleasant reaction, which can be severe whenever an individual taking disulfiram consumes alcohol.

Clinical Recommendations

12. Patients who are good candidates for treatment with disulfiram include:

Naltrexone Efficacy

13. Short-term outcomes in favor of naltrexone included fewer patients relapsing to alcohol dependence, fewer patients returning to drinking, reduced craving for alcohol, and:

Clinical Recommendations: Oral Naltrexone

14. For patients who have a history of opioid use disorder and who are seeking treatment for an alcohol use disorder, naltrexone reduces the reinforcing effects of and curbs cravings for both opioids and alcohol.

Acamprosate

15. Although acamprosate has been shown to be an effective treatment for dependence on alcohol, there is significant potential for abuse among some populations and for interaction with medications commonly used to treat substance use and mental disorders.

Medication-Assisted Treatment

16. Which of the following is NOT one of the recommended steps in initiating treatment with disulfiram?  

Special Considerations in Pain Management

17. Pain management for patients using extended-release injectable naltrexone can be even more complicated than for those taking oral naltrexone, because of the long-acting nature of the injectable formulation.

Co-Occurring Medical Conditions and Complications

18. Individuals with alcohol use disorder are at high risk for co-occurring medical conditions, and patients who present to emergency departments and trauma centers with serious injuries are far more likely than members of the general population to have engaged in recent use of alcohol.

Monitoring Patient Progress

19. Monitoring patient progress is an ongoing process, during which the patient is assessed on adherence to the treatment plan, duration of and ability to maintain abstinence or reduced drinking, reduced cravings, and:

Summary

20. As improvements are made in the quality and quantity of treatment options that are included in the Patient Protection and Affordable Care Act (ACA), there is considerable potential for expanding the use of medication-assisted treatment as clinicians recognize their safety, efficacy, and: