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Opioid Addicted Patients: Medical Problems

Associated Medical Problems in Patients Who Are Opioid Addicted

1. Referral services should be part of a patient’s opioid addiction treatment plan, and the consensus panel recommends that primary care responsibility be established either on site or through a community provider because specialists are more likely to accept patients if their primary care responsibility has been assigned.

A. True

B. False


2. The consensus panel recommends testing which of the following every 6 to 12 months?

A. Hepatitis A, B, and C

B. Syphilis

C. HIV

D. All of the above


3. Which of the following requires a patient’s written permission, along with counseling before and after the test?

A. Hepatitis A, B, and C

B. Syphilis

C. HIV

D. All of the above


4. Which of the following should be considered when pain at an injection site is more severe than expected from the redness or warmth at the site?

A. Soft-tissue infections

B. Necrotizing fasciitis

C. Endocarditis

D. Wound Botulism


5. If needed, addiction treatment medication should be withheld to ensure adherence to TB medications.

A. True

B. False


6. Treatment of syphilis is particularly important because syphilis has been shown to facilitate sexual transmission of HIV.

A. True

B. False


7. Which of the following is transmitted at the highest rate among injection drug users?

A. Hepatitis A

B. Hepatitis B

C. Hepatitis C

D. HIV / AIDS


8. Treatment decisions for HCV are based on all of the following, except for:

A. Patients’ symptoms

B. HCV genotype

C. Level of liver disease

D. Co-occurring illnesses


9. Patients receiving _____ for opioid addiction may be barred from transplant programs or accepted only if they taper from their maintenance medication before transplantation.

A. Methadone

B. LAAM

C. Buprenorphine

D. All of the above


10. Education about HIV should be part of the intake process for all patients and should include:

A. A description of the modes of transmission

B. Assessment of risk status

C. Guidelines for prevention

D. All of the above


11. Which HIV medication increases methadone levels?

A. Nevirapine

B. Fluconazole

C. Efavirenz

D. Ritonavir


12. A maintenance dose of opioid addiction treatment medication also relieves acute pain, therefore, additional pain treatment to patients in MAT should not be provided.

A. True

B. False


13. Partial agonists such as buprenorphine, butorphanol tartrate, and nalbuphine should be avoided for acute pain management because they can cause opioid withdrawal in patients receiving MAT.

A. True

B. False


Treatment of Multiple Substance Use

14. Which of the following is especially dangerous when used with opioids?

A. Alcohol

B. Benzodiazepines

C. Barbiturates

D. All of the above


15. The effects of concomitant alcohol and methadone, levo-alpha acetyl methadol, or buprenorphine use are additive and more sedating than either alcohol or treatment medication alone.

A. True

B. False


16. Continuous alcohol use may induce enzyme activity that increases the metabolism of treatment medication, reducing medication plasma levels and resulting in symptoms of undermedication that further complicate treatment.

A. True

B. False


17. Nonbenzodiazepine sedatives such as intermediate- or short-acting barbiturates or glutethimide are less likely than benzodiazepines to produce lethal overdose.

A. True

B. False


18. The consensus panel recommends that OTPs do not withhold treatment medication, even for patients who appear intoxicated with a sedative-type drug.

A. True

B. False


19. Adequate doses of methadone seem to reduce _____ use even though methadone does not target that directly.

A. Cocaine

B. Alcohol

C. Both (A) and (B)

D. None of the above


20. Patients in MAT sometimes use THC to self-medicate for:

A. Anxiety

B. Insomnia

C. Both (A) and (B)

D. None of the above


21. Research has shown that smoking interventions _____ addiction recovery.

A. Detract from

B. Interfere with

C. Both (A) and (B)

D. None of the above


22. When a patient in MAT abuses a CNS depressant:

A. The depressant should be withdrawn medically from the patient’s system.

B. The opioid treatment medication should be continued with consideration of the need for a dosage increase.

C. Both (A) and (B).

D. None of the above.


Treatment of Co-Occurring Disorders

23. All of the following factors have been found to increase the prevalence of co-occurring disorders, except for:

A. Younger age

B. Lower socioeconomic status

C. Residence in urban areas

D. Incarceration


24. A brief preexamination of cognitive functioning during a mental status examination is recommended for individuals who:

A. Are disoriented with respect to time, place, or person.

B. Have memory problems.

C. Have difficulty understanding information in their first language.

D. All of the above.


25. OTP staff members should focus on the condition that is most severe and threatening, rather than all of the patient’s disorders simultaneously.

A. True

B. False


26. To aid in screening and referral for suicidality and homicidality, all programs should have protocols in place that specify:

A. Who asks what questions or uses what specific tool to identify these types of risk.

B. How identified risks are documented.

C. Who is informed about risks and is responsible for taking actions and what resources he or she can use.

D. All of the above.


27. The consensus panel believes that patients who have a history of benzodiazepine abuse should be disallowed from receiving previously prescribed benzodiazepines.

A. True

B. False


Medication-Assisted Treatment for Opioid Addiction During Pregnancy

28. Because methadone normalizes endocrine functions, it is not unusual for women in the early phases of MAT to become pregnant unintentionally, especially if they receive no counseling for this possibility.

A. True

B. False


29. Women who are methadone maintained often experience symptoms of withdrawal in later stages of pregnancy and require dosage increases to maintain blood levels of methadone and avoid withdrawal symptoms.

A. True

B. False


30. Medically supervised withdrawal from methadone is usually conducted in the _____ trimester.

A. First

B. Second

C. Third

D. None of the above


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