Substance use disorders treatments

Question 1

What addiction is NOT

Answer 1

*A lack of willpower
*A condition limited to certain populations or classes of people
*An untreatable or hopeless state

Question 2

If a drug screen result affects any clinical decision making, please _____ prior to making changes

Answer 2

please send to lab for confirmatory
testing

Question 3

Low-Dose Induction AKA

Answer 3

microdosing

Question 4

Alcohol Use Disorder treatments - pharmacotherapy

Answer 4

• Naltrexone
• Acamprosate
• Disulfiram
• Off-label options with evidence of benefit if goal is not abstinence:
• Gabapentin
• Baclofen
• Topiramate (high-dose)

Question 5

Is Individual counseling/therapy appropriate for alcohol use disorder?

Answer 5

Yes
* Appropriate for most or all patients; barriers are time and finances to engage
in one-on-one therapy session
* Psilocybin-assisted therapy (only legal in Oregon) or ketamin-assisted therapy
may be particularly helpful

Question 6

Support groups for Alcohol use disorder

Answer 6

• Alcoholics Anonymous – often abstinence based, may not support their desire
  to continue social drinking, but could try a few of the local chapters and see if
  there is a good fit
• SMART Recovery – slightly less available/well-known than AA, but less rigid
  and may be a better fit for this patient
• Other community groups – variability is high, may need to try several to find a
  good fit

Question 7

Naltrexone in alcohol use disorder

Answer 7

• Can be used for abstinence or reduction in use; decreases
  craving/drive to use alcohol as well as decreasing pleasurable
  response to drinking
• Oral vs LAI formulations available

Question 8

Acamprosate in alcohol use disorder

Answer 8

• Best evidence if started after patient is already abstinent to decrease craving

Question 9

Hospital role in addiction care

Answer 9

Hospital

Question 10

Inpatient/”rehab” role in addiction care

Answer 10

used for patients who need the most
aggressive counseling, support, monitoring

Question 11

Intensive outpatient role in addiction care

Answer 11

used for patients who are safe and have resources to be in the community but also need very frequent
care and support

Question 12

Outpatient/clinic role in addiction care

Answer 12

most access, but least support (for patient and for you!)

Question 13

Carceral role in addiction care

Answer 13

limited resources in prison/jail settings that vary from place to place. Obviously not a referral site, but may be a major
part of patients’ past history