Deck 18: Treating Substance Abuse and Dependence

Question 1

Although many medications have been tested for treating cocaine withdrawal symptoms or dependence, most have shown little promise and none has yet been approved. What drug has found to provide the most promising results?

A) Modafinil
B) Naltrexone
C) Buprenorphine
D) Acamprosate

Answer 1

A

Question 2

What is rapid opioid detoxification based on?

A) The use of methadone to avoid withdrawal symptoms.
B) Ensuring the user experiences the full discomfort of withdrawal, while providing medical support.
C) Anaesthetizing users, and while unconscious are given an antagonist, so that withdrawal occurs while they are asleep.
D) Switching the user to a shorter-duration opioid.

Answer 2

C

Question 3

Varenicline was approved in 2007 for smoking cessation, what is it?

A) It is also used as an antidepressant.
B) It is an opioid antagonist.
C) It is a partial nicotinic-receptor agonist.
D) It blocks the metabolism of nicotine.

Answer 3

C

Question 4

Which of the following describes naltrexone?

A) It is an opioid antagonist, and it is not clear how it works with alcohol users.
B) It has never received any research support for this type of use.
C) It is not available for prescription in the U.S.
D) It is dangerous because people become deathly ill if they drink alcohol while taking it.

Question 5

After attending his best friend's bachelor party and drinking continually for 10 hours straight, now that Max has quit drinking at what point might he expect to feel withdrawal symptoms?

A) 4 to 6 hours
B) 6 to 10 hours
C) 6 to 18 hours
D) 6 to 24 hours

Question 6

Besides methadone, what is the recently approved substitute medication for maintaining opioid-dependent patients?

A) Antabuse
B) Buprenorphine
C) Zolpidem
D) Olanzepine

Question 7

You have been instructed to treat Tom who is an alcoholic with an aversion therapy drug; which one will you choose?

A) Naltrexone
B) Buspirone
C) Disulfiram
D) Acamprosate

Question 8

Although no medication has yet received Health Canada approval for treating cannabis dependence, which of the following has shown effectiveness in relieving cannabis withdrawal symptoms?

A) Naltrexone
B) Methadone
C) Cocaine
D) Oral delta-9-THC

Question 9

According to the facts presented throughout the text, what would be considered the financial burden to Canada as a result of the percentage of Canadians meeting the diagnostic criteria for being dependent on or having abused alcohol and other drugs?

A) 20 million per year
B) 40 million per year
C) 20 billion per year
D) 40 billion per year

Question 10

What is the most common form of medical treatment for opioid dependence?

A) Methadone maintenance
B) Rapid opioid detoxification
C) Naltrexone therapy
D) Buprenorphine

Question 11

What's arising since most opioid-dependent people prescribed naltrexone stop taking it?

A) It is no longer used for this purpose.
B) They typically undergo prolonged withdrawal reactions.
C) Researchers are testing a depot form that blocks heroin's effects for up to six weeks.
D) A company is developing a better tasting capsule.

Question 12

Which of these has NOT received Health Canada approval for use during the maintenance phase of alcohol treatment?

A) Naltrexone
B) Bupropion (Zyban)
C) Antabuse
D) Acamprosate

Question 13

Which statement does NOT describe the purpose of the stage of change model?

A) It provides a guideline for clinical intervention for a wide range of health-related problems including substance use disorders.
B) It provides a guideline for pharmaceutical intervention for a wide range of health-related problems including substance use disorders.
C) It provides a guideline for clinical intervention primarily for substance use disorders.
D) It provides a guideline for medical intervention for substance use disorders.

Question 14

Antabuse is to alcohol as methadone is to which of the following?

A) Cocaine
B) Heroin
C) Marijuana
D) Speedballs

Question 15

According to the facts presented throughout the text, approximately how many Canadians may meet the diagnostic criteria for being dependent on or having abused alcohol and other drugs?

A) 1/2 million
B) 1 million
C) 2 million
D) 3 million

Question 16

What is the goal of motivational enhancement therapy?

A) To help the user move to another "stage of change."
B) To help the user to first "hit bottom."
C) Confronting the user with all of the bad consequences of his or her behaviour.
D) Finding alternative activities to draw the user away from the substance.

Question 17

Which of these is NOT a Health Canada approved form of nicotine replacement therapy?

A) Nicotine water
B) Nicotine lozenges
C) Nicotine gum
D) Nicotine patch

Question 18

Because of the potential danger of alcohol withdrawal symptoms, what is administered to treat or often prevent these symptoms?

A) Opioids
B) Amphetamine
C) Antabuse
D) Benzodiazepines

Question 19

Prevention of withdrawal symptoms using medications would be considered part of what process?

A) Detoxification
B) Relapse prevention
C) Punishment
D) Maintenance

Question 20

In which phase of treatment are both drug agonist (substitution) and antagonist treatments included?

A) Detoxification
B) Relapse prevention
C) Punishment
D) Maintenance

Question 21

The behavioural strategy called relapse prevention uses which of the following approach(s)?

A) Cognitive-therapy techniques with behavioural-skills training
B) Cognitive-therapy techniques and aversion Therapy
C) Psychotherapy with hypnotherapy
D) Psychotherapy with group therapy

Question 22

All of the following students reflect the goals of Tier 4 and 5 EXCEPT which one?

A) Are designed to meet the needs of larger numbers of people
B) Are highly specialized and intensive
C) Services and supports are costly
D) Eligibility to use services is regularly based on more structured admission criteria

Question 23

Sarah has located and signed up to attend a potential AA group meeting, and she purchased a book that describes AA. This is a sign Sarah is in which stage of change?

A) Action
B) Contemplation
C) Precontemplation
D) Preparation

Question 24

Approximately what percentage of individuals seeking help for addictions also has a mental health disorder?

A) 20%
B) 30%
C) 70%
D) 50%

Question 25

Which of the following would not be considered an insured person under the Canada Health Act?

A) Mary: a member of the Canadian Forces
B) Alice: a nine-month-old baby girl living with her mother on a reserved in Ontario
C) Jarrod: a Sergeant in the Royal Canadian Mounted Police
D) Martin: convicted of a drug possession and serving his sentence in a Provincial jail

Question 26

If Mathew lacks the serious goal to undergo change in the foreseeable future, then in which of the following stage of change is he in?

A) Acceptance
B) Denial
C) Precontemplation
D) Preparation

Question 27

What takes place in the TTM of behaviour change?

A) Change does not occur at a specific moment in time.
B) Rewards may be provided for positive thinking.
C) It is exclusively used for addiction treatment.
D) Individuals move through stages without returning to previous stages.

Question 28

According to the stage of change model, if an individual does not acknowledge a substance problem, then in which stage of change would they be in?

A) Action
B) Contemplation
C) Precontemplation
D) Preparation

Question 29

Jeromy and Frank are both attending NA and have established a positive rapport, which leads Jeromy to call Frank each day to organize the meetings they will be attending. Which stage of change is Jeromy in?

A) Maintenance
B) Contemplation
C) Action
D) Preparation

Question 30

Which person would be referred to as having a concurrent disorder?

A) Andrea who is addicted to heroin and also snorts cocaine.
B) Cindy with depression who does not take the medication that was prescribed by her doctor.
C) Nick who has an anxiety disorder and also smokes marijuana.
D) Jeff who suffers from depression and is taking physician prescribed prozac.

Question 31

What is known regarding the practice of giving the user rewards for drug-free urine samples?

A) It doesn't work very well.
B) It is a form of contingency management.
C) It is a common technique in 12-step programs.
D) It is based on the "stage of change" model.

Question 32

The federal government provides direct funding for treatment and rehabilitation of members of all the following groups EXCEPT which one?

A) Members of the Canadian Armed Forces
B) Members of the Royal Canadian Mounted Police (RCMP)
C) Off reserve First Nations Peoples and Inuit
D) Persons serving a term in a federal penitentiary

Question 33

Which model is the foundation for Alcoholics Anonymous (AA)?

A) Biological model
B) Disease model
C) Moral model
D) Social learning model

Question 34

Jordan who many consider to be an alcoholic recently asked his neighbour who is an active member of AA how the program works, and if there were financial obligations to participate. This is a sign Jordan is in which following stage of change?

A) Action
B) Contemplation
C) Precontemplation
D) Preparation

Question 35

Which statement describes relapse prevention approaches to treatment?

A) They have not worked as well as traditional psychotherapy.
B) They rely on the use of medications to prevent withdrawal symptoms.
C) They use hypnotism as the major form of treatment.
D) They have the clients identify people, places, and behaviours associated with drug use and learn to avoid or change them.

Question 36

If you were participating in the first modern heroin treatment program, in what country are you living in?

A) Canada
B) Mexico
C) Sweden
D) Switzerland

Question 37

You are the executive director of a needle exchange program, thus your agency supports which approach to substance abuse?

A) Disease model
B) Harm reduction
C) Moral model
D) Moderation management

Question 38

Studies of court-ordered referrals to Alcoholics Anonymous versus other types of interventions have demonstrated what outcomes?

A) They found that none of these approaches are effective.
B) They found that AA is more effective than other approaches.
C) They found that other approaches are more effective than AA.
D) They did not find any differences in effectiveness between AA and other approaches.

Question 39

What is the best response to the question; is treatment for drug dependence effective?

A) Only if the user wants it to work.
B) Most studies do not show any effectiveness.
C) Statistically, treatment does reduce crime and increase employment.
D) Yes, more than half of those treated remain abstinent for more than a year.

Question 40

What was among the earliest harm reduction strategies to begin in the 1960s?

A) Safe injection sites
B) Needle exchanges
C) Methadone maintenance
D) Stimulant prescriptions

Question 41

Canada's mental health and addiction systems are currently independent and compartmentalized. As a result, the focus of treatment for people with concurrent disorders tends to be on one component of their concurrent disorder, but not the other.

Question 42

The only kinds of medications approved for use in smoking cessation are various forms of nicotine replacement therapy, like nicotine patches and gum.

Question 43

Acamprosate, the most recent drug approved to treat alcohol dependence, is structurally similar to the neurotransmitter GABA.

Question 44

Most effective potential medical treatment for cocaine appears to be the antidepressant drug citalopram.

Question 45

Across all disorders, men were more likely than women to have a co-occurring mental disorder.

Question 46

Who is credited for creating the first methadone maintenance treatment program, and where was it located?

Question 47

The formation of Alcoholics Anonymous (AA) in 1935 can now be seen as an unimportant milestone in treatment.

Question 48

Naltrexone is an opioid antagonist that has been approved for use in treating alcohol dependence.

Question 49

Using the stages of change in in the contemplation stage, the substance user may be aware of drug-related consequences but is ambivalent about change.

Question 50

In motivational enhancement therapy, drinkers are given Antabuse so that they will be afraid to drink alcohol.

Question 51

Most common form of treatment for opioid dependence is rapid opioid detoxification.

Question 52

In Nova Scotia, which substance was identified as creating the greatest financial burden?

Question 53

Approximately 10 million Canadians may meet the diagnostic criteria for being dependent on or having abused alcohol and other drugs.

Question 54

A key premise of the tiered model is that no two people-or their needs and wants-are alike.

Question 55

The main focus of the Alcoholics Anonymous approach to alcohol dependence is prayer and reliance on God.

Question 56

The opioid antagonist naltrexone can prevent heroin from having its normal effect in part because it has a greater affinity for opioid receptors in the brain.

Question 57

In the stages of change decision stage, the substance user may be aware of drug-related consequences but is ambivalent about change.

Question 58

Moderate doses of dronabinol can be used to reduce the symptoms associated with abstinence from marijuana.

Question 59

In the stages of change action stage, the former substance user needs to consolidate gains so as not to relapse.

Question 60

Every week at the local shopping mall you provide educational information regarding the agencies in your community that provide information regarding HIV infections and safe injection procedures. You embrace Canada's Systems Approach to Substance Use, therefore which "tier" of care would be your focus?

A) Tier 1
B) Tier 2
C) Tier 4
D) Tier 5

Question 61

What medications are used in treating people diagnosed with alcohol dependence, and how does each of these work?

Question 62

Who would have eligibility to Tiers 1 and 2 of the "tiered" model for organizing services and supports?

Question 63

When treating a person who has been diagnosed as having a concurrent disorder, what is needed in order to ensure a more effective treatment approach to improve overall client outcomes?

Question 64

On-reserve First Nations Peoples and Inuit
2. Members of the Royal Canadian Mounted Police (RCMP)
3. Members of the Canadian Armed Forces
4. Persons serving a term in a federal penitentiary
5. Persons who have not lived in a province or territory long enough to receive insured health services

Question 65

What medications are used in treating people diagnosed with opioid dependence, and how does each of these work?

Question 66

Define the term concurrent disorder.

Question 67

Give a brief description of the Alcoholics Anonymous approach to "treating" alcohol-dependent people including some of the underlying philosophy. What do we know about the effectiveness of this approach?

Question 68

What was the intention or goal, when in 2008, the National Treatment Strategy Working
Group released a document entitled A Systems Approach to Substance Use in Canada: Recommendations for a National Treatment Strategy?

Question 69

The federal government also provides direct funding for treatment and rehabilitation to five specific categories of people; who are they?

Question 70

Describe the number of Canadians dependent on or having abused alcohol and other drugs and the costs to society resulting from per year.

Question 71

When referring to the stages of change describe what occurs in the decision stage.

Question 72

Describe the process and goals of motivational enhancement therapy. Be sure to include the concept of denial and also stages of change in your answer.