EM Psych 9: Substance Use Disorders

Question 1

the majority of worldwide illicit drug-related deaths were attributed to

Answer 1

opioids

Question 2

low-risk drinking is defined as

Answer 2

Men: no more than 14 drinks per week and no more than 4 drinks over a 2-hour occasoin

Women of all ages and men >65 y/o:
no more than 7 drinks per week and no more than 3 drinks over a 2- hour occasion

Question 3

Binge drinking is defined as

Answer 3

alcohol consumption that results in a blood alcohol level over the U.S. legal limit of 0.08 grams/dL,
which for the average male is the result of more than 4 drinks in 2 hours and for the average female is more than 3 drinks in 2 hours

Question 4

Those who begin drinking before ______ have a fourfold increased risk of developing dependence than those who begin drinking later

Answer 4

15 y/o

Question 5

severity of substance use disorder (SUD)

Answer 5

mild: 2-3 criteria
mod: 4-5 criteria
sev: 6 or more

Question 6

This treatment strategy has been associated with short-term benefits and reduction in cost and ED utilization

Answer 6

1) Screening
2) Brief intervention
3) Referral to treatment

Question 7

Standard drink is

Answer 7

1.5 oz of spirits
6 oz of wine
12 oz of beer

1 oz is 30 mL

Question 8

The first principle of promoting health behavior change is

Answer 8

that the argument for change needs to come from the patient, not the healthcare provider

Question 9

Remarks on opioid agonist therapy

Answer 9

also known as medication-assisted treatment
done with buprenorphine or methadone
vital to reduce mortality among patients with opioid use disorder

Question 10

medications for treatment of alcohol use disorder

Answer 10

Disulfiram
Acamprosate
Naltrexone

Question 11

Remarks on Disulfiram

Answer 11

oral medication that irreversibly binds to and inhibits alcohol dehydrogenase
causes the unpleaseant disulfiram-ehtanol reaction (n/v, diaphoresis, flushing, tachycardia)

Question 12

Remarks on Acamprosate

Answer 12

increases GABA transmission
but did not show efficacy in a large multicenter trialR

Question 13

Remarks on Naltrexone

Answer 13

long-acting opioid mu receptor antagonist
indirectly affects the dopaminergic reward pathway through effects on the mu opioid receptor

Question 14

remarks on benzodiazepine withdrawal

Answer 14

Symptoms of withdrawal may develop up to 7-10 days after stopping chronic benzodiazepine use, and patients may develop withdrawal seizures

Most evidence supports a prolonged benzodiazepine taper over 4-12 weeks

Question 15

reccommendations of CDC on opioid use

Answer 15

“When opioids are used for acute pain, clinicians should prescribe the lowest effective dose of immediate-release opioids and should prescribe no greater quantity than needed for the expected duration of pain severe enough to require opioids. 3 days or less will often be sufficient; more than 7 days will rarely be needed”

Question 16

Patients who are increased risk of death from overdose

Answer 16

patients who used 4 or more prescribers or 4 or more pharmacies in 6 months

patients who take 50-100 morphine mg equivalents per day