Deck 11: Opiode Use, Abuse, and Addiction

Question 1

In research, volunteers who are not in pain but are given a therapeutic dose of narcotic analgesics usually report feeling

A) dysphoria.
B) euphoria.
C) mania.
D) pain.

Answer 1

dysphoria.

Question 2

The English word "opium" can be traced to and means "poppy juice."

A) Latin
B) Greek
C) Old English (used prior to 1300 a.d.)
D) India

Answer 2

Greek

Question 3

Which of the following narcotic analgesics was developed for long-term pain management?

A) Codeine
B) Oxycodone
C) Morphine
D) Fentanyl

Answer 3

Oxycodone

Question 4

Which of the following is an accurate statement about the science of pain control?

A) There is no objective measure of pain.
B) The AST blood test provides a way to measure the average level of pain the individual has experienced in the past week, but cannot be more accurate than this.
C) Similar levels of acute trauma will cause the exact same level of pain for different individuals.
D) Chronic pain is more easily assessed than is acute pain.

Question 5

According to your text, as many as of patients in moderate to severe pain receive less than adequate doses of prescription narcotic analgesics.

A) 25 percent
B) 51 percent
C) 65 percent
D) 73 percent

Question 6

By the year 1900, approximately of all Americans were thought to be addicted to narcotics.

A) 0.3 percent
B) 4 percent
C) 3 percent
D) 1 percent

Question 7

Morphine, the active agent in opium, was first isolated in the year

A) 1861.
B) 1906.
C) 1914.
D) 1806.

Question 8

Besides controlling pain, opium can also

A) control diarrhea.
B) decrease cholesterol.
C) increase concentration.
D) decrease congestion.

Question 9

Which of the following statements is true?

A) The legal definition of "narcotic" is based on the pharmacological characteristics of that compound.
B) The legal definition of "narcotic" is not based on the pharmacological characteristics of that compound.
C) There is no legal term "narcotic;" the correct legal term is "a compound that produces morphine­like effects."
D) The legal term for "narcotic" applies to every compound that alters the individual's sense of consciousness.

Question 10

What is a "chipper?"

A) An occasional heroin user
B) A methadone addict
C) A recovered heroin addict
D) Someone who crushes Oxycontin capsules to disengage their time-release effects

Question 11

The methadone molecule is structurally similar to the molecule.

A) codeine
B) sigma
C) morphine
D) heroin

Question 12

Chronic opioid abuse often results in significant for the user.

A) pain
B) "flashes"
C) constipation
D) insomnia

Question 13

One function of endogenous opioid molecules released in the amygdala is the

A) suppression of the "fight or flight" response.
B) initiation of a pleasure response when we do something right.
C) suppression of the pleasure response.
D) increase in respiration so we will remember what we did more clearly.

Question 14

According to your text, research has demonstrated

A) 73 percent of patients report adequate levels of pain control when asked.
B) 56 percent of patients experiencing pain achieve adequate levels of analgesia using oral medications alone.
C) 73 percent of patients in mild to moderate pain do not receive adequate analgesia.
D) the public understands how to control pain better than do physicians.

Question 15

The region of the brain has a large number of opioid receptor sites.

A) hippocampus
B) frontal cortex
C) medulla
D) amygdalae

Question 16

Current theory suggests that narcotic analgesics relieve pain by their ability to

A) mimic the actions of opioid peptides.
B) counter the effects of the opioid peptides.
C) activate the release of serotonin in the amygdala.
D) activate the release of massive amounts of acetylcholine in the basal ganglia.

Question 17

Which of the following is a symptom of heroin abuse?

A) Ataxia
B) Emotional liability
C) Slurred speech
D) Nodding off

Question 18

The invention of made it possible to rapidly and painlessly introduce morphine directly into the body.

A) the capsule
B) codeine
C) the hypodermic needle
D) the nasal aspirator

Question 19

Narcotic analgesics currently in use tend to preferentially activate the receptor site in the brain.

A) mu
B) epsilon
C) sigma
D) delta

Question 20

By the time the Harrison Narcotics Act was passed in 1914

A) narcotics abuse was reaching its peak in the United States.
B) narcotics abuse had been on the decline for about 10 years.
C) narcotics abuse was limited to smoking opium by Chinese immigrants.
D) physicians were no longer able to prescribe narcotics to patients.

Question 21

According to your text, one in three to one in four opioid abusers will

A) develop cardiomyopathy.
B) become addicted.
C) develop classic pinpoint pupils.
D) call for early refills of prescribed medications to support their addiction.

Question 22

The active agent in codeine is

A) codeine itself, without other compounds being involved.
B) morphine obtained from biotransformation of codeine.
C) able to bind at the opioid sigma receptor site to initiate the blockade of pain signals.
D) best absorbed when this compound is injected into muscle tissue.

Question 23

Addiction to a narcotic

A) can develop after just a few days of continuous use.
B) requires at least 6 months of continuous use before it develops.
C) is seen only in cases of intravenous drug abuse.
D) is most often seen in heroin addiction.

Question 24

Why is heroin considered more potent than morphine, from which it is derived?

Question 25

The danger of iatrogenic addiction is

A) estimated to be about 1 in every 14,000 cases when the narcotic analgesic is used for short term control of pain.
B) estimated to be about 1 in every 1,000 cases when the narcotic analgesic is used for short term control of pain.
C) estimated to be about 1 in every 1,400 cases when the narcotic analgesic is used for short term control of pain.
D) determined in part by the patient's age and sex.

Question 26

Explain how the distribution of opioid receptors across the brain results in the wide range of effects.

Question 27

Describe the current medical uses for narcotic analgesics.

Question 28

A long-term opioid addict

A) will rarely experience constipation since the opioids do not influence the muscle (meiotic) movements of the gastrointestinal tract.
B) will become totally tolerant to the respiratory depressant effects of their drug of choice.
C) will achieve the "rush" or "flash" experience by switching to another class of drugs.
D) is prone to constipation due to the effects of narcotics in the gastrointestinal tract.

Question 29

Discuss the influences on neuroadaptation to narcotic analgesics.

Question 30

According to your text, narcotic abuse most commonly involves

A) heroin.
B) demerol.
C) the diversion of prescribed medications in the U.S.
D) Dilaudid®.

Question 31

The uncomplicated narcotic withdrawal syndrome

A) is usually fatal unless supervised by a physician.
B) usually is no more uncomfortable than a bad case of the flu.
C) raises the individual's risk for viral infections such as influenza.
D) is more intense in oral abusers of narcotics.

Question 32

Which of the following analgesic compounds has the longest elimination half life?

A) Morphine
B) Demerol
C) Methadone
D) Codeine

Question 33

Tolerance to the respiratory depressant effects of narcotic analgesics

A) does not completely develop, even with continual use.
B) requires 3 months of continual use to completely develop.
C) is seen only with longer lasting compounds.
D) is seen only in older patients placed on narcotic analgesics.

Question 34

Discuss the reasons behind and the need for developing synthetic opioid narcotics.