Addiction Medicine

Question 1

Withdrawal symptoms in the absence of a drug

Answer 1

Physical dependence

Question 2

A neurobiologic disease with genetic and psychosocial contributions leading to compulsive use and cravings despite harmful consequences

Answer 2

Addiction

Question 3

4 common themes in clinical practice that can lead to addiction

Answer 3

1. Early exposure, depression, difficulty coping with loss
2. Unsafe recovery environment
3. Family history, childhood abuse, and neglect
4. Inappropriate gateway prescription use, co-morbid mental illness

Question 4

3rd leading preventable cause of death in the US

Answer 4

Alcohol

Question 5

More than half of alcohol related deaths are linked to ___ ___

Answer 5

Binge drinking

Question 6

Drinking 8 or more drinks 4 or more times/month

Answer 6

Binge drinking

Question 7

Do all binge drinkers show all behaviors characteristic of a substance abuse disorder?

Answer 7

NO

Question 8

What is the most critical time period in a patient receiving outpatient treatment for addiction?

Answer 8

The first few weeks

Question 9

Relapse prevention is a form of?

Answer 9

CBT

Question 10

Identifies cognitive, behavioral, and environmental risk factors for relapse, as well as rehearsing coping responses for those risk factors

Answer 10

Cognitive behavioral therapy

Question 11

What is generally efficacious in reducing substance use and improving psychosocial outcomes when compared to other active treatments, no treatment, or other control conditions?

Answer 11

Relapse prevention

Question 12

What is one factor that is commonly associated with relapse? (There are many but this one was bolded and italicized, so it must be important)

Answer 12

Low motivation for recovery

Question 13

What are the two NTs associated with ETOH withdrawal?

Answer 13

GABA and Glutamate

Question 14

GABA is a _____ NT

Answer 14

inhibitory

Question 15

Glutamate is an ___ NT

Answer 15

excitatory

Question 16

How do alcoholics function at an alcohol level that would normally induce sedation or coma?

Answer 16

EtOH binds to GABA receptors and supplements ordinary inhibitory signals

Question 17

Sudden EtOH cessation leads to DECREASED ???

Answer 17

INHIBITORY tone

Question 18

EtOH interferes with glutamate-triggered ____ receptor activation

Answer 18

NMDA

Question 19

What happens to glutamate with sustained and increasing alcohol use?

Answer 19

Accommodation occurs and more glutamate receptors are produced

Question 20

Sudden etOH cessation leds to INCREASED ???

Answer 20

EXCITATORY tone that is unopposed by the concurrent lack of inhibitory tone

Question 21

What is the warning sign of minor withdrawal symptoms in patients who suffer from EtOH abuse?

Answer 21

BP, HR, and temp aberrations 6-36 hours after last drink

Question 22

Alcohol withdrawal is a ___ diagnosis

Answer 22

Clinical

Question 23

Peak symptoms of heroin withdrawal occur after?

Answer 23

3-4 days

Question 24

How do you treat EtOH withdrawal?

Answer 24

IV fluids, vitamins/electrolytes, PRN medications, seizure/DT prophylaxis drugs (benzos, phenobarb, tegretol)

Question 25

What is very prevalent among opiate users?

Answer 25

Hepatits C

Question 26

Withdrawal characterized by: Increased anxiety, palpitations, tachycardia, restlessness, peripheral sensory disturbances

Answer 26

Benzodiazepine

Question 27

Stopping benzodiazepines at high doses carries a risk for ?

Answer 27

Seizure

Question 28

Benzodiazepines increase which neurotransmitter?

Answer 28

GABA

Question 29

What can you use for a benzo detox?

Answer 29

Phenobarbital

Question 30

Should you ever ask a patient struggling with substance abuse if they want to quit smoking at the same time as they are recovering from another drug?

Answer 30

NO leave them alone and let them have their sin sticks