Medication-Assisted Treatment of Opioid Use Disorders (12 Hours) A Science 2 Service Course Quiz

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  1. Why were programs encouraged to transfer patients on LAAM to methadone?1
  2. While on opioid treatment medications, the patient should be able to function normally without impairment of perception or physical or emotion response1
  3. When treating pregnant patients, treatment providers should use buprenorphine monotherapy1
  4. When discharge is unavoidable, it should be handled1
  5. What is MAT?1
  6. VBRT is an acronym for1
  7. Usually tolerance levels for methadone1
  8. Using medication dosage as a consequence is appropriate1
  9. Use of methadone has traditionally been viewed as1
  10. Urine testing is not feasible for patients with1
  11. Types of treatment for OTPs include1
  12. Trough periods refer to the low point of the medication concentration in the blood just before the next dose1
  13. Treatment providers should treat patients for their concurrent substance abuse aggressively or refer them appropriately1
  14. Treatment providers have overcome NIMBY through outreach and education1
  15. Treatment plans should specify actions needed to1
  16. Treatment plans should be tailored to each patient’s1
  17. Treatment for adolescents should integrate knowledge of their specific1
  18. Transference occurs when treatment providers project their feelings on patients1
  19. To ensure patients swallow oral doses of methadone or LAAM they should be required to1
  20. There was a substantial increase in death rates among those involuntarily discharged for1
  21. There is a minimum requirement for services for MAT outlined in federal regulations that includes physicals and laboratory testing every two years1
  22. There is a direct correlation between the length of time and the number of appointments to complete admission to an OTP and the number of patients who actually enter treatment.1
  23. Therapeutic alliance is a joining of treatment providers and patients in an effective collaboration to assess and treat substance use disorders1
  24. The trough period for methadone is approximately1
  25. The total first day dose of methadone allowed by federal regulations is 40 mg unless the program physician documents that 40 mg was not sufficient to suppress opioid withdrawal symptoms.1
  26. The risk of accumulated toxicity increases with repeated dose replacements1
  27. The peak period for methadone is1
  28. The Narcotics Register was a list of1
  29. The MMSE, a common screening tool is the1
  30. The frequency of drug testing during the rehabilitative phase should depend on1
  31. The following play comparable roles in the etiology of some diseases:1
  32. The first dose of naltrexone is usually smaller to1
  33. The existence of co-occurring disorders should _______ patients’ admission to an OTP1
  34. The earliest significant federal attempt to place strict controls on opioids and other substances was:1
  35. The desired responses to medication that usually reflect optimal dosage include1
  36. The blocking agent in naltrexone will cease1
  37. The blockade effect of naltrexone is only present when the medication is taken regularly.1
  38. Testing for metabolites does not prevent patients from simply adding methadone to a sample1
  39. Tapering during administrative discharge should be as1
  40. Take home privileges may enhance the potential for rehabilitation by allowing patients to engage in employment, education, or other endeavors1
  41. Take home medication for patients on methadone can last up to1
  42. Sudden sever opioid withdrawal caused by precipitous incarceration does not increase the risk of suicide in individuals with co-occurring disorders1
  43. Substances1
  44. Substance-induced disorders tend to1
  45. Substance induced co-occurring disorders usually1
  46. Substance induced co-occurring disorders are1
  47. Stigma regarding methadone is a barrier to healthcare services for many methadone patients.1
  48. Staff should be alert to risk factors for suicide and homicide but should not question at risk patients routinely about suicidal and homicidal thoughts and plans1
  49. SSRI’s are1
  50. Specimen collection methods should1
  51. Specialized training is not needed for counselors who treat MAT patients who have been sexually abused1
  52. Some SSRIs increase methadone blood levels1
  53. Some patients want to taper from maintenance medication more quickly than seems advisable therefore staff should1
  54. Some patients resist counseling1
  55. Some HIV medications increase methadone levels while others lower methadone levels.1
  56. Some HIV medications increase methadone levels while others lower methadone levels1
  57. Signs and symptoms of withdrawal from CNS depressants included1
  58. Service intensity should depend on the level of care required to help patients achieve and maintain successful outcomes1
  59. Screening for suicide risk is not done as a routine part of the initial screening.1
  60. Research has shown that maintenance treatment for opioid addiction is1
  61. Remedial approaches should be considered before administrative discharge for behavior problems such as1
  62. Regulations limit the first dose of methadone to no more than 30 milligrams1
  63. Public health statutes no longer require that the US Public Health Service be notified in suspected TB cases1
  64. Psychotropic medications should be prescribed prior to treatment medication for MATS patients1
  65. Psychotherapy focuses on1
  66. Prolonged flashbacks from hallucinogens, is a substance-induced persisting disorder1
  67. Programs should develop non-punitive ways to set limits and contain disruptive behavior1
  68. Programs should1
  69. Pregnant women maintained on methadone often experience symptoms of withdrawal in later stages of pregnancy requiring dosage1
  70. Posttraumatic stress disorder can occur among both men and women who have experienced physical or sexual abuse1
  71. Positive, sustained outcomes are more attainable in a therapeutic environment with readily available supportive, qualified caregivers.1
  72. Positive, sustained outcomes are more attainable in a therapeutic environment with readily available supportive, qualified caregivers1
  73. Poorly controlled chain of custody for samples lowers test reliability.1
  74. Police and OTPs share a purpose1
  75. Planned introduction to the structure, services, and offerings used in an OTP, and to patient’s and treatment provider’s rights and responsibilities within a program is known as1
  76. Peak period refers to the point of maximum concentration of medication in the blood1
  77. Pavlov demonstrated that repeated exposure to the conditioned stimulus without the _________ stimulus would extinguish the conditioned response.1
  78. Patients with HIV who fall or are unsteady might be assumed erroneously to be intoxicated.1
  79. Patients with disabilities should be offered alternative approached to MAT such as1
  80. Patients with COD generally have been found to have poorer prognosis than those with either a substance use disorder or mental disorder1
  81. Patients with class 2 TB do not transmit the disease1
  82. Patients who wake up sick after the first week of treatment might need higher doses1
  83. Patients who wake up sick after the first few days of opioid therapy1
  84. Patients taking certain medications for HIV infection might need increases in methadone doses or split doses.1
  85. Patients shown to be hyperalgesic means that they experience1
  86. Patients should not be disciplined by having their dose1
  87. Patients should be assessed daily in the induction phase of MAT for signs of1
  88. Patients progress in MAT should be judged on drug tests.1
  89. Patients presenting with suicidal or homicidal ideation or treats should be treated immediately1
  90. Patients in OTP depend on their medication and that dependence gives providers (and the principle of beneficence) the upper hand1
  91. Patients in MAT face unique employment challenges and should be encouraged to1
  92. Patients in MAT are often under treated or denied medication for acute pain1
  93. Patients have cited factors that discourage retention such as1
  94. Patients and treatment providers might fail to realize or understand that continuing or long-term MAT is the best choice for some patients1
  95. Patient’s with paruresis should not be given special treatment if they can not provide a urine1
  96. Patient’s can’t show improvement unless complete abstinence is achieved1
  97. Patient-treatment matching begins with a thorough _______ to determine each patient’s service needs1
  98. Pain in MAT patients is often severe and refractory to non-opioid analgesics or non-pharmacologic treatments1
  99. OTPs treating elderly patients should be able to differentiate between dementia and1
  100. OTPs should be involved in efforts1
  101. OTPs should acknowledge the unique social support structures of lesbian, gay and bi-sexual patients and provide a way to counteract isolation and separation from A) community1
  102. OTPs are not required to test for pregnancy1
  103. OTP’s should automatically exclude patients from MAT who test positive for illicit drugs other than opioids1
  104. OTP staff that aren’t state licensed are excluded from the mandatory reporting of child abuse regulations.1
  105. OTP staff that aren’t state licensed are excluded from the mandatory reporting of child abuse regulations1
  106. OTP refers to1
  107. OTP leaders positively influence patient outcomes by providing sound leadership and staff management1
  108. OTP attendance or group participation should not become barriers to1
  109. Opioid addiction is a1
  110. Only doses lost to witnessed emesis should be replaced1
  111. One of the main factors that led to the cease in production of LAAM was1
  112. Once opioid abuse is stopped, patients often experience dental pain because1
  113. Office based opioid treatment settings1
  114. Nonbenzodiazepine sedatives are more likely than benzodiazepines to produce lethal overdose because people who abused them develop tolerance for their sedative and euphoric effects but not for their respiratory-depressant effects.1
  115. Nonbenzodiazepine sedatives are more likely than benzodiazepines to produce lethal overdose because people who abused them develop tolerance for their sedative and euphoric effects but not for their respiratory-depressant effects1
  116. Node-link mapping diagrams relationships between patients substance use and their1
  117. Node-link mapping appears to reduce cultural, racial, class barriers by providing a visual supplement and common language that enhance counselor-client interchanges1
  118. NIMBY is an acronym for1
  119. News accounts and other depictions of MAT often seem1
  120. Necrotizing Facitiis is caused by introduction of the bacterium streptococcus pyogenes into subcutaneous tissue via a contaminated needle1
  121. Naltrexone is approved as a preventive treatment for relapse to alcohol in alcohol dependent patients.1
  122. Naltrexone is an opioid1
  123. Mutual-help groups are a form of treatment that offer effective reinforcement and motivation1
  124. Most patients can be maintained on their MAT dosage while taking short-acting opioids for pain relief1
  125. Most patients can be maintained on heir MAT dosage while taking short-acting opioids for pain relief1
  126. Morphine was prescribed or dispensed in numerous municipal treatment programs by the1
  127. Methadone was never formally approved by the FDA.1
  128. Methadone typically can be detected in urine for1
  129. Methadone substantially _________ fluctuations in maternal serum opioid levels, protecting a fetus from repeated withdrawal episodes.1
  130. Methadone substantially _________ fluctuations in maternal serum opioid levels, protecting a fetus from repeated withdrawal episodes1
  131. Methadone maintenance treatment reduces1
  132. Methadone is toxic.1
  133. Methadone is provided in various forms including1
  134. Methadone is most often diverted to individuals1
  135. Methadone is considered medically safe.1
  136. Methadone has a half-life of1
  137. Methadone does not appear to effect natural killer cell activity, immunoglobulin or T or B cells.1
  138. Methadone can be administered orally or intramuscularly.1
  139. Methadone can be administered1
  140. Medications, drugs, and other substances that can cause acute psychomotor effects and a relatively rapid change in mood or thought are called:1
  141. Medications such as SSRIs can be administered before stabilization in MAT1
  142. Medically supervised withdrawal is not recommended in pregnant women.1
  143. MAT is any treatment for opioid addiction that includes a medication approved by the US Food and Drug Administration.1
  144. Many substances of abuse gained their early popularity as ingredients in1
  145. Managers of OTPs should1
  146. Maintenance stage of opioid pharmacotherapy begins when1
  147. Maintenance doses of opioid addiction treatment medications also relieve acute pain1
  148. Long tem use of opioid pain medication should disqualify the patient from take home dosing in MAT.1
  149. Lithium levels need to be monitored closely because the window between therapeutic and toxic dose in narrow1
  150. Level of care refers to the1
  151. Lack of childcare services is not a barrier to treatment or OTP attendance1
  152. LAAM suppresses opioid withdrawal for1
  153. LAAM must never be given on two consecutive days because its extended duration of action can result in toxic blood levels leading to fatal overdose1
  154. LAAM is shorter acting than methadone1
  155. It takes an average or _______ weeks for stabilization on methadone1
  156. It takes an average of _________ days for stabilization on buprenorphine1
  157. It is estimated that at least ________% of women in MAT experienced partner violence1
  158. It is difficult to provide high quality care and facilitate favorable treatment outcomes1
  159. It is believed that there seems to be a specific neurological basis for the compulsive use of heroine and that methadone taken in optimal doses can correct the disorder.1
  160. Initiating smoking interventions detracts from and interferes with addiction recovery1
  161. Initial doses should be determined by1
  162. Inducing mild withdrawal in pregnant women can’t cause premature labor or other adverse fetal effects1
  163. Inconvenient hours and long waits may lower retention and disrupt treatment1
  164. In terms of symptom alleviation MAT resembles the benefits of treatment for other medical conditions.1
  165. In opioid overdose, naloxone should only be given to pregnant women as a last resort1
  166. In 1994, the California Dept of Alcohol & Drug Programs published the result of a study in which patients in methadone maintenance showed the greatest reduction in intensity of heroin use, down by 2/3 of any type of opioid addiction studied.1
  167. If you are uncertain as to a patients eligibility (opioid dependence) the consensus panel recommends you should1
  168. If withdrawal symptoms persist after 2-4 hours of the initial dose of methadone, it can be supplemented with another1
  169. If there is a change affecting a patient, you can wait to update the treatment plan at his/her regularly scheduled treatment plan review1
  170. If rifampin is used to treat TB in patients receiving MAT, their addictions treatment medications should be adjusted carefully because rifampim1
  171. HIV testing no longer requires a patient’s written permission1
  172. Health care workers may misperceive pain medication requests by patients in MAT as drug seeking behavior1
  173. Gabapentin, which is effective in neuropathic pain, alters CYP450 3A isoenzymes and changes methadone levels.1
  174. Fixed, rather than “prn” or “as needed” doses of psychotropic medications should be prescribed because patients addicted to opioids have difficulty regulating medications of any kind1
  175. Fewer than _________% of patients in MAT received employment related interventions1
  176. Feeling cured after a few months of abstinence can be a relapse warning sign1
  177. Family includes any member of the patient’s social network, as defined by the patient.1
  178. Failure to report indications of abuse that results in injury to a child can lead to1
  179. Exemptions from SAMHSA’s one year dependence rule include1
  180. Essential to long term treatment retention is1
  181. Endocarditis is an infection of the1
  182. Encouraging a patient in MAT to attend mutual help programs poses some risks1
  183. Employing treatment professionals who are in recovery1
  184. Emesis is1
  185. Emesis after 30 minutes after dosing does not warrant additional medication, as the full dose has been absorbed1
  186. During pregnancy, HCV can’t be transmitted from mother to fetus1
  187. Double Trouble In Recovery is a mutual help group for1
  188. Dosage increases should be based on1
  189. Diversity exists within cultures1
  190. Discharge should not be considered for patients observed in illegal transactions or medication diversion.1
  191. Cultural heritage and traditions can play a role in patients’ communication patterns1
  192. Counter-transference is a process where the therapist projects onto the client emotional reactions either from the therapist’s own issues or in reaction to a client’s projection.1
  193. Counter transference occurs when patients project their feelings on treatment providers1
  194. Counselors should have general knowledge of common medical conditions in MAT and their treatments affecting MAT patients.1
  195. Contradictions for opioid pharmacotherapy include1
  196. Confrontation counseling and negative contingency management counseling often1
  197. Compared to other children, children of patients in MAT may exhibit more1
  198. Co-occurring disorder is a mental disorder that co-exists with at least one substance use disorder.1
  199. Co-occurring disorder is a mental disorder that co-exists with at least one substance use disorder1
  200. Chlordiazepoxide is a1
  201. Certain prescribed and over the counter medicine as well as some foods might generate1
  202. Cellulitis is often related to contaminated injection sites1
  203. Carbamazepine or phenytoin can lead to sharp reductions in serum methadone levels1
  204. By middle to late 1960’s, illicit opioid related mortality had become the leading cause of death for young adults in NYC.1
  205. Buprenorphine is available as1
  206. Buprenorphine has not been approved in the United States for use by pregnant women1
  207. Breast feeding is contraindicated for women who are on methadone.1
  208. Breast feeding is an absolute contraindication in mother’s maintained on methadone1
  209. Based on estimates from 2000, approximately ____________ % of patients in MAT are homeless or living as transients upon admission to treatment1
  210. Axis I is a DSM-IV-TR disorder classification that covers1
  211. Attitudes critical of extended pharmacotherapy have been found to be common among many counselors1
  212. At the OTP level, participation in MAT advocacy groups1
  213. Assessing and adjusting dosage levels for elderly patients is often necessary because of their1
  214. ASI is an acronym for1
  215. As an opioid maintenance medication, morphine’s short half life required several injections per day.1
  216. An estimated __________% of people who inject drugs have serologic evidence of exposure to HCV.1
  217. An estimated __________% of people who inject drugs have serologic evidence of exposure to HCV1
  218. All programs should have a DCP, which is an acronym for1
  219. Alcohol-related factors are a major cause of death among patient sin MAT1
  220. Administrators should seek staff members who1
  221. Administering SSRI’s before a patient is stabilized in MAT may1
  222. Administering naloxone can interfere with the therapeutic alliance because it is invasive and can initiate severe withdrawal.1
  223. Adequate doses of methadone seemed to1
  224. Addiction resulting from medical use of an opioid is called _______ opioid addiction.1
  225. Accuracy of screening instruments for COD may be compromised if administered to patients with1
  226. A typical first dose of methadone is1
  227. A statement concerning the certainty that a given practice produces a specific clinical outcome is called:1
  228. A state in which a mental or physical disorder has been overcome or a disease process has been halted is known as1
  229. A social anxiety disorder that leaves patient unable to urinate under observation is1
  230. A pitfall of qualitative drug testing is the increased possibility that with frequent testing a single drug use episode1
  231. A person younger than 18 must have had at least two documented attempts at detoxification or outpatient psychosocial treatment within 12 months to be eligible for opioid pharmacotherapy.1
  232. A patient who refutes test results should be taken seriously especially when results are inconsistent with the treatment profile and progress of that patient1
  233. A patient in MAT should not be considered an integral member of the treatment team in regards to treatment planning1
  234. A patient considering dose tapering should understand1
  235. A negative PPD can mean1
  236. A history of seizures or toxic psychosis during withdrawal from a sedative-hypnotic or anxiolytic drug or from alcohol is an absolute indication for inpatient detox1
  237. A fifty mg tablet of naltrexone markedly attenuates opioid effects for1
  238. A diversion control plan should address diversion of medication by1
  239. A counselor who determines that a patient is neglecting young children is not required to report the neglect1
  240. A condition in which repeated administration of a drug results in diminished effects not only for that drug but also for other drugs from a similar class to which the individual has not been exposed recently is known as1
  241. A comprehensive assessment should include1
  242. A common misconception is that children of patients in MAT are more vulnerable to physical and sexual abuse and neglect than other children1
  243. 50 to 70 % of people who begin injecting drugs contract Hepatitis B within1
  244. “Boosting” is a street term for1
  245. ” Steady state” refers to the condition in which the level of medication in a patient’s blood remains fairly steady because that drug’s rate of intake1
  246. ____________evaluation focuses on patients and their progress during or after participation in MAT.1
  247. _____________, are those in which substance-related symptoms continue long after a person stops using a drug1
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