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Screening and Assessment for Medication Assisted Treatment for Opioid Addiction

Initial Screening, Admission Procedures, and Assessment Techniques

1. Patients who exhibit symptoms that could jeopardize their or others’ safety should be referred immediately for inpatient medical or psychiatric care.

A. True

B. False


2. If an individual with knowledge of OTP procedures and schedules makes a threat, patterns of interaction between staff and this individual should be shifted.

A. True

B. False


3. All of the following are recommended responses to indicators of suicidality, except for:

A. Be direct. Talk openly and matter-of-factly about suicide.

B. Debate whether suicide is right or wrong or feelings are good or bad. Lecture on the value of life.

C. Offer hope but not glib reassurances that alternatives are available.

D. Don’t act shocked. This puts distance between the practitioner and the individual.


4. If a program is at capacity, admitting staff should:

A. Advise applicants immediately of a waiting list.

B. Provide one or more referrals to programs that can meet their treatment needs more quickly.

C. Both (A) and (B).

D. None of the above.


5. Documentation should show that patients have been informed of all aspects of the multifaceted MAT process and its information requirements, including:

A. The consent to treatment.

B. Program recordkeeping and confidentiality requirements.

C. Program rules, including patient rights, grievance procedures, and circumstances under which a patient can be discharged involuntarily.

D. All of the above.


6. Programs should minimize delay in administering the first dose of medication because, in most cases, applicants will present in some degree of opioid withdrawal.

A. True

B. False


7. If appropriate, a program physician can invoke an exception to the 1-year addiction history requirement for:

A. Patients released from correctional facilities in the past 6 months.

B. Pregnant patients after pregnancy has been certified.

C. Previously treated patients up to 2 years after discharge.

D. All of the above.


8. When absence of a treatment history or withdrawal symptoms creates uncertainty about an applicant’s eligibility, the consensus panel recommends administering a low dose of naloxone and then observing the patient.

A. True

B. False


9. Which of the following is the riskiest stage of MAT and for which proper medical assessment requires an understanding of the pharmacology of treatment medication?

A. Induction

B. Maintenance

C. Tapering

D. Relapse


10. Multiple substance use should be identified and addressed as soon as possible because of the risk of possible overdose for patients who continue to abuse drugs or alcohol during treatment.

A. True

B. False


11. Staff members who suspect domestic violence should investigate immediately whether a patient’s children have been harmed, and inquires into possible child abuse should occur even if notice of the limitations of confidentiality in MAT has not yet been given to the patient.

A. True

B. False


12. Pending or unresolved legal charges are a contraindication for MAT.

A. True

B. False


Patient-Treatment Matching: Types of Services and Levels of Care

13. A residential treatment setting is indicated for patients who:

A. Have done poorly in other types of programs.

B. Require residential placement to support treatment and ensure their physical or psychological safety and who are unlikely to continue MAT otherwise.

C. Require opioid pharmacotherapy for long-term stabilization.

D. All of the above.


14. Treatment for adolescents and young adults should integrate knowledge of their specific development and psychosocial concerns and needs.

A. True

B. False


15. Treatment matching for pregnant patients in MAT should provide optimal, comprehensive, and intensive services related to pregnancy and birth including:

A. Prenatal care

B. Maternal nutrition

C. Psychosocial rehabilitation

D. All of the above


16. All of the following are complex medical problems commonly diagnosed in women in MAT, except for:

A. Osteoporosis

B. Gynecological infections

C. Amenorrhea

D. Pneumonia


17. The consensus panel recommends that OTPs focus on which of the following areas when working with elderly patients?

A. Monitoring the increased risk for dangerous drug interactions as elderly patients often are prescribed multiple medications.

B. Differentiating between depression and dementia.

C. Screening for and treating physical and sexual abuse.

D. All of the above.


18. Most patients can be maintained on their MAT dosage while taking long-acting opioids for pain relief.

A. True

B. False


19. Which of the following often predicts treatment failure?

A. Enhancing patient motivation for change by focusing on patient strengths and respecting patient decisions.

B. Encouraging the inclusion of motivational enhancement strategies that highlight appropriate, realistic treatment goals.

C. Using confrontational counseling or the use of negative contingencies.

D. None of the above predict treatment failure.


Administrative Considerations

20. OTP supervisors should ensure that staff members avoid:

A. Transference

B. Countertransference

C. Both (A) and (B)

D. None of the above


21. Support staff should be accepting and understanding of patients from diverse groups because these staff members often are the first people a new patient sees at the OTP and those with whom the patient interacts most.

A. True

B. False


22. Which of the following is a preferred expression in MAT?

A. Patients

B. Clients

C. Detox

D. All of the above


23. What is the benefit of a team approach?

A. Staff members usually feel less isolated and overwhelmed when a team makes treatment decisions.

B. When a lack of cohesion exists, staff members risk burnout, disillusionment, or cynicism.

C. A well-coordinated team reduces the level of intrastaff disagreements about patient care and decreases the likelihood of “staff splitting,” when patients pit staff members against one another.

D. All of the above.


24. One way to address negative staff attitudes about MAT is to include:

A. Up-to-date information about medications.

B. Up-to-date information about drugs of abuse.

C. Successful patients in training.

D. Patient sensitivity training.


25. A diversion control plan should address diversion of medication by:

A. Patients who might sell or give their take-home medications to others.

B. Staff who might steal medication or spill or otherwise waste it.

C. Both (A) and (B).

D. None of the above.


26. All scheduled substances should be accounted for rigorously and inventoried continuously.

A. True

B. False


27. SAMHSA’s approved OTP-accrediting organizations require that MAT providers demonstrate effective community relations and stigma-reduction efforts.

A. True

B. False


28. In the view of the consensus panel, incorporation of which of the following into treatment options can affect community perceptions positively because patients involved in MAT are less likely to loiter near the OTP?

A. Primary medical care

B. Day treatment

C. Short-stay residential models

D. All of the above


29. Mobile services allow more people addicted to opioids to be treated without confronting not-in-my-back-yard reactions.

A. True

B. False


30. It is essential for OTPs to take steps, possibly including staff or security patrols of the community, to curtain loitering, drug sales, and the diversion of methadone before they prompt community complaints.  These patrols should emphasize:

A. Observation

B. Intervention

C. Both (A) and (B)

D. None of the above


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