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Opioid Use, Misuse, and Overdose Among Women

Background

1. A national multisite effectiveness trial suggests that women who use opioids:

A. Progress to dependence more quickly than men.

B. Experience more cravings than men.

C. Both (A) and (B).

D. None of the above.


Issues in Prevention

2. What factor is responsible for the telescoping differences seen between the sexes?

A. Body fat percentages

B. Metabolic rate

C. Hormonal fluctuations

D. All of the above


3. A study examining opioids found cravings to be significantly higher among women than among men.

A. True

B. False


4. Psychological and emotional distress have been identified as risk factors for prescription opioid nonmedical use among:

A. Women

B. Men

C. Both (A) and (B)

D. None of the above


5. Research has shown that physical and sexual trauma followed by post-traumatic stress disorder is more common in drug-misusing women than in drug-misusing men.

A. True

B. False


6. Prescription drug monitoring programs:

A. Are effective at changing prescriber behavior.

B. Reduce the number of patients who visit multiple providers seeking the same or similar drugs.

C. Have an impact on opioid-related overdose deaths and other adverse events.

D. All of the above.


7. In general, _____ women have the highest risk of dying from a prescription opioid overdose.

A. White

B. American Indian or Alaska Native

C. Non-Hispanic black

D. Hispanic


8. Compared to men, women are:

A. At a decreased risk for chronic pain

B. Less likely to be prescribed opioids

C. Given higher doses of opioid pain medication

D. All of the above


9. Long-term opioid use often begins with treatment of chronic pain.

A. True

B. False


10. High-quality evidence shows that exercise can reduce chronic pain for which of the following?

A. Knee

B. Hip

C. Low back

D. All of the above


11. Caregiving for a family member has been shown to lead to increased levels of depression, anxiety, and other mental health symptoms, which have been identified as risk factors for hazardous prescription opioid use among women, therefore, caregiving may place women at a greater risk of substance misuse.

A. True

B. False


12. The recommended treatment for pregnant women with an OUD is _____ assisted therapy, which improves pregnancy outcomes and can potentially reduce risky behavior associated with illicit drug use in the mother.

A. Methadone

B. Buprenorphine

C. Either (A) or (B)

D. None of the above are recommended for pregnant women


13. Most adolescents who misuse prescription pain relievers obtain a prescription from a medical professional.

A. True

B. False


14. All of the following are primary reasons for why teens use opioids rather than other drugs, except for:

A. Peer pressure

B. Easy to obtain from their parents’ medicine cabinet

C. Not illegal

D. Can be claimed as their own prescription if caught


15. Compared to males, which of the following is more likely to misuse prescription drugs?

A. Females 18 years old and older

B. Females 12 - 17 years old

C. Both (A) and (B)

D. None of the above


16. Women age 65 years and older have a higher percentage of long-term use of prescription opioids than women below 65 years and than men in all age groups 18 years and older.

A. True

B. False


17. According to data from the U.S. Department of Justice, approximately _____ of state and federal prisoners meet the DSM-IV criteria for substance use disorders.

A. 33%

B. 50%

C. 67%

D. 75%


18. The majority of jails report that they do not provide medications for opioid detoxification and those that do often do not use evidence-based practices.

A. True

B. False


19. Failure to provide safe and effective detoxification, treatment, and counseling for incarcerated individual’s dependence on heroin puts them at high risk for:

A. HIV and viral hepatitis transmission through unsafe injection in prisons.

B. Loss of tolerance after detoxification that could result in fatal overdoses.

C. Recidivism upon release.

D. All of the above.


20. A 2016 study found that women were nearly three times more likely than men to receive naloxone in Emergency Medical Services opioid overdose resuscitation efforts.

A. True

B. False


Issues in Treatment

21. What often leads to treatment failure and the perception that the MAT medications are ineffective, further reinforcing the negative attitudes toward their use?

A. Insufficient dosing

B. Limitations on the duration of use

C. Both (A) and/or (B)

D. None of the above


22. To increase the use of MAT for women, services need to:

A. Be comprehensive

B. Be woman-focused

C. Address concerns about what will happen to her children if she seeks treatment

D. All of the above


23. Approximately _____ of women entering substance use disorder treatment services have children, yet many of the existing, traditional residential drug treatment programs do not allow children to be present, resulting in parenting women feeling torn between seeking the needed treatment and caring for children.

A. 90%

B. 70%

C. 50%

D. 30%


24. The Mental Health Parity and Addiction Equity Act requires insurance plans to:

A. Offer coverage for services that are no more restrictive than the coverage for medical and surgical conditions.

B. Offer coverage for SUD.

C. Cover specific treatments and services for SUDs.

D. All of the above.


Meeting Summary

25. What is the OWH’s main goal in addressing opioid use in women?

A. Foster a national conversation on best practices to prevent, diagnose, and treat opioid misuse and death among women.

B. Bridge gaps between researchers and public health practitioners by creating platforms to share best practices, promising approaches, and priority questions.

C. Consolidate what is already known about opioid use and opioid-related harm specific to, or more pronounced in, women.

D. All of the above.


26. It was once taught to medical school students that opioid medications are not addictive if they are given to someone with legitimate pain.

A. True

B. False


27. Providers rarely ask patients _____, which is a question that can help with developing an appropriate pain management strategy or addiction assessment.

A. What benefits they receive from drug use

B. If they are aware that effective treatment is available for substance use and addiction

C. If they understand what is entailed in maintaining recovery

D. All of the above


28. What do healthcare providers need to do to get people into recovery?

A. They need to learn what addiction is, how it manifests itself, how to ask about it, and what to do when a patient says he or she is addicted.

B. They should know the resources available in the community, and if resources are not available, they should be a part of the team to build them.

C. Both (A) and (B).

D. None of the above.


29. Although babies born to mothers with an opioid addiction are born addicted and undergo withdrawal, neonatal abstinence syndrome is treatable with no long-term consequences.

A. True

B. False


30. Prevention tends to be focused on:

A. Primary care providers

B. Systems of care

C. Both (A) and (B)

D. None of the above


31. Healthcare providers need to ask questions to understand and address:

A. Population-level norms

B. The patient and concerns based upon her condition

C. Both (A) and (B)

D. None of the above


32. Addressing a patient’s need for sleep prior to surgery could decrease the need for opiates post-operatively, which in turn would lower the risk of chronic opiate use.

A. True

B. False


33. How do women differ from men with regard to substance use?

A. Consequences of use

B. Motivations and barriers to accessing help

C. Treatment and recovery support needs

D. All of the above


34. Which of the following is a principle of trauma-informed care?

A. Trustworthiness and transparency

B. Peer support and mutual self-help

C. Empowerment, voice, and choice

D. All of the above


35. A 2015 study outside of a controlled trial found that more dramatic advantages were found for:

A. Buprenorphine

B. Buprenorphine plus naloxone

C. Naloxone

D. Methadone


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