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The Problem of Prescription Drug Use in the United States

Introduction

1. Opioid-related overdose deaths now outnumber overdose deaths involving all illicit drugs, and in addition to overdose deaths, emergency department visits, substance treatment admissions and economic costs associated with opioid abuse have all increased in recent years.

A. True

B. False


The Problem of Prescription Drug Use

2. The problem of prescription drug abuse and overdose is complex and multi-faceted, and experts report that there are multiple drivers of the problem, including each of the following EXCEPT:

A. Poor provider clinical practices

B. Insufficient oversight to curb inappropriate prescribing

C. The belief by many that, while they know that prescription drugs can be dangerous, they are not at risk because they are in control

D. Insurance and pharmacy benefit policies


Background

3. An effective response to the abuse of prescription drugs is a multi-pronged, _________, and sustained approach that can only be achieved through a coordinated effort among public health, clinical medicine, public safety, and other stakeholders.

A. Targeted

B. Comprehensive

C. Universal

D. Balanced


Epidemiology of Prescription Drug Abuse

4. In addition to opioid analgesics, other prescription drugs such as benzodiazepines and antidepressants may be involved in overdose deaths, often in combination with opioid analgesics.

A. True

B. False


5. The rate of chronic nonmedical use of opioids is slightly higher among men than women, yet more women visit emergency departments and die of prescribed drug overdoses than men.

A. True

B. False


6. Although chronic pain may be a contributing factor of prescription drug use and abuse, there is no evidence to suggest that the majority of people who die from prescription overdoses have chronic pain histories.

A. True

B. False


Drivers of the Epidemic

7. Which of the following is an accurate statement about the prescribing of opioid analgesics and other drugs?

A. The majority of opioid analgesics are prescribed by primary care physicians and emergency department doctors

B. Although the number of opioid-analgesic prescriptions has increased in recent years, the amount prescribed per prescription and the days’ supply has generally decreased

C. Since many insurance policies are now beginning to cover non-opioid and non‐pharmacological therapies because of addiction issues, experts predict that trends will likely be changing

D. Multiple studies have shown that a small percentage of prescribers are responsible for prescribing the majority of opioids


General Patients and the Public

8. Patients receiving legitimate prescriptions for prescription drugs prone to abuse may be knowingly or unknowingly contributing to prescription drug abuse by sharing medications with people who abuse them or not storing or disposing of them properly.

A. True

B. False


Current HHS Prescription Drug Abuse Activities and Opportunities to Enhance Activities-Prevention

9. Drug abuse prevention has shown that the most effective programs are those that create an environment that supports healthy behaviors and:  

A. Address general risk factors and those that are tailored to specific populations

B. Enhance family bonding and relationships

C. Help individuals develop the intentions and skills to act in a healthy manner

D. Are able to reach clients in multiple settings, throughout multiple communities


10. Research has clearly indicated that medication disposal programs reduce drug use and abuse, yet very few of these disposal sites exist.

A. True

B. False


11. Studies show that teens and young adults perceive prescription drug abuse as safer, less addictive, and less risky than using illicit drugs, and that drugs obtained from a medicine cabinet or pharmacy are believed to be less risky than drugs obtained from a drug dealer, and that such perceptions result in subsequent abuse.

A. True

B. False


12. Education and training in both pain management and substance abuse can meet the dual goal of reducing abuse of and overdose from opioid analgesics and:  

A. Maintaining legitimate and appropriate access to these drugs

B. Offering alternatives that may have previously been unknown

C. Helping professionals feel more comfortable with chronic pain management and make informed decisions

D. Holding professionals and federal agencies accountable for safety in this area


13. Which of the following is NOT a correct statement about prescription drug monitoring programs (PDMPs)?  

A. These programs are designed to monitor prescribing and dispensing of controlled substances and can provide a prescriber or pharmacist with critical information regarding a patient’s prescription history

B. Less than half of the states in the U.S. have PDMPS and in the states that have them they are underutilized

C. Research suggests PDMPs reduce the prescribing of Schedule II opioid analgesics, lower substance abuse treatment admission rates, and result in lower annual increases in opioid misuse or abuse in states with PDMPs compared to those without them

D. Clinical decision support tools and use of electronic health records that incorporate PDMP and other pertinent clinical data show promise for improving prescribing behaviors and reducing adverse events


Drug Abuse Treatment

14. Although effective drug abuse treatment exists, the majority of people who need treatment do not receive it because of inadequate accessibility or availability of treatment, a belief that they don’t need treatment, financial and privacy concerns, or lack of referral from healthcare providers.

A. True

B. False


Overdose Prevention

15. Buprenorphine, an opioid antagonist that can reverse respiratory depression associated with opioid overdose, is now being prescribed by some providers to patients taking high doses of opioids as an overdose risk mitigation intervention.

A. True

B. False


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