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Counseling
Q:
Discuss the idea of and idea behind controlled drinking as a treatment goal.
Q:
Discuss some of the most common causes of relapse.
Q:
Discuss some of the factors that might contribute to, or protect against, a relapse back to active chemical abuse.
Q:
Discuss the idea of treatment noncompliance and some of the reasons for it.
Q:
Even in cases where hair samples test "positive" for substances of abuse
a. the hair sample does not accurately indicate when the substance was used.
b. they also identify persons who were only exposed to a chemical, not just those who used it.
c. you must wait 4-6 weeks for the hair to grow long enough to determine whether a person used a compound in the past 24 hours.
d. the rate of hair growth is not variable, but is 1 cm per month.
Q:
The rare social user of marijuana will have detectable traces of THC and its metabolites on standard urine tests for a. up to 4 weeks.b. 7-9 days.c. 20-45 days. d. 3-5 days.
Q:
Under normal conditions, cocaine can be detected on urine toxicology tests for a. up to 12 hours after the person's last use of this compound.b. 72-96 hours after the person's last use of this compound. c. 1-4 weeks after the person's last use of this compound.d. about 8 hours after the person's last use of this compound.
Q:
Alcohol can be detected in a urine sample for about a. 8 hours after the person's last drink.b. 4 hours after the person's last drink.c. 2 hours after the person's last drink.d. as long as they would test positive on breath analysis.
Q:
Clients' attempts to "deceive" the urine toxicology test so that it does not identify actual substance abusea. are very rare. b. are common.c. only involve certain compounds such as marijuana. d. can easily be detected.
Q:
Research has suggested that the "false positive" rate for some commercially available urine toxicology testing kits is as high asa. 30-35 percent. b. 25-30 percent. c. 45-50 percent. d. 15-20 percent.
Q:
A popular misconception about urine toxicology testing is that ita. identifies people who are impaired by the substances identified. b. will identify all drugs of abuse.c. does not involve the risk of cross reactions between various compounds possibly in the person's body.d. does not require that the person report over-the-counter medications taken when the urine sample was collected.
Q:
Urine toxicology testinga. is efficient because of the ease of sample collection.b. samples a number of compounds that might either directly or indirectly be identified. c. offers the opportunity for collection of serial samples over a number of days.d. is not a perfect therapeutic tool.
Q:
What percentage of dreams are REM dreams?a. 45 percent b. 85 percent c. 15 percent d. 30 percent
Q:
Opioid treatment contractsa. attempt to strike a balance between the legitimate need for treatment of chronic pain disorders and treatment noncompliance.b. are lifelong states of being for the average addicted person.c. are the same in all clients, with little if any variation between persons. d. are not affected by environmental substance use "cues."
Q:
Research suggests that ____ of persons on methadone maintenance programs present with a severe chronic pain syndrome.a. 17 percent b. 6 percent c. 37 percentd. 11 percent
Q:
Patients who have a substance use disorder and a chronic pain disorder might not respond to prescribed medications because ofa. familial pressure not to take prescribed medications because they may be addictive. b. partial tolerance to medications being prescribed.c. substance induced negative alterations in liver function.d. operant conditioning in which the individual associates the use of a given compound with intravenous administration.
Q:
An estimated ______of the general population in this country suffers from a chronic non-cancer-related pain disorder. a. 35 percentb. 45 percent c. 15 percent d. 20 percent
Q:
Patients with acute injury, who have a history of substance abusea. are more likely to have inadequate pain control than non-abusers.b. are more likely to be left in pain until the physician orders medications to treat the pain from their injuries. c. will suffer needless pain as do non-abusers.d. are easier to treat following a painful injury because their substance use helps with their need for analgesia.
Q:
A proximal factor for a relapse is one that ____, while a distal factor is one that predates the relapse by a significant period of time.a. occurs unexpectedlyb. precedes the relapse by a short period of time c. might potentially trigger a relapsed. is comprised of periods of ill humor followed by short periods of remorse interspaced with normal mood
Q:
It has been discovered that if clients abstain from all chemicals for _______, they are unlikely to relapse.a. 6 weeks following discharge from a rehabilitation programb. 90 days c. 6 yearsd. 16 weeks
Q:
A rarely discussed relapse trigger is the individual'sa. sense of balance (loss of balance while intoxicated being equated with further substance use). b. sense of touch (feel of what it is like to touch the desired substance just one more time).c. sense of smell.d. spousal permission to go and abuse chemicals.
Q:
In addition to the percentage of substance abusers who eventually learn to abstain from substance use, what percentage of treatment graduates develop a pattern of more or less problematic use?a. 50 percent b. 20 percent c. 15 percent d. 30 percent
Q:
Those individuals who are least likely to break down in a stressful situation are those who a. are able to withdraw into a fantasy land or dream world.b. retreat from the stressor as much as possible. c. believe they can cope.d. are able to prioritize the stressors into those that do, and do not, affect the "self."
Q:
Surprisingly, it is not the stress itself that triggers a relapse but a. fear of the unknown.b. preoccupation with id-based memories and urges. c. "command" hallucinations or thought insertion.d. demoralization and depression in the face of stress.
Q:
When stressed, adults tend toa. choose to delay gratification as a way to cope with immediate stressors. b. activate regions of the brain involved in habitual responses.c. interpret visual stimuli through the cognitive regions of the brain.d. activate those regions of the brain active in cognitive assessment and control functions.
Q:
One factor that has been identified as predictive of the probability of an individual's ability to achieve long-term abstinence isa. their coping skills.b. their past legal history.c. whether they are facing current legal charges.d. the amount of money spent in pursuit of alcohol or drugs prior to the individual's admission to a rehabilitation facility.
Q:
It has been estimated that ____ of clients with a substance use disorder who successfully complete treatment develop a progressive form of the disorder that might prove fatal. a. 30 percentb. 70 percent c. 25 percent d. 40 percent
Q:
The recovery success rate from a substance use disorder is about a. the same as that seen in lung cancer.b. one half that seen in lung cancer.c. three times that seen in lung cancer. d. five times that seen in lung cancer.
Q:
Using the medical or disease model as a template, the addictions a. can be arrested, but never cured.b. can only be cured if the person does not relapse in the first five years of the recovery program.c. can only be considered resolved if the person has not developed any concurrent medical problems before starting abstinence.d. and their resolution depend on the assessment of those around the individual.
Q:
Between _____ of those who successfully complete an inpatient substance abuse rehabilitation program will experience at least one relapse in the first year following discharge. a. 10 and 25 percenb. 30 and 50 percent c. 50 and 90 percent d. 10 and 60 percent
Q:
Surprisingly, treatment noncompliance isa. very common for the treatment of most medical conditions. b. common for some medical conditions.c. rare for most conditions, but there are exceptions. d. most common in the treatment of addiction.
Q:
Moderate drinkers are ____to have a prescription filled when compared to a nondrinker being treated for the same condition.a. less likelyb. about as likely c. more likelyd. one-third as likely
Q:
One way to deal with a client who wishes to share a secret with a staff person is for that staff person to
a. agree to keep the client's secret in confidence as part of the process of building a therapeutic relationship.
b. agree to keep the client's secret in confidence as long it is does not involve a felony offense.
c. suggest the therapeutic environment is not one of trust, and that the client should thus keep this information to him- or herself.
d. inform the client that any information revealed will be made part of a chart note, and thus available only to other staff members and not to other persons in treatment.
Q:
The stance that substance abuse rehabilitation must be effective the first time and that the individual must not ever relapse againa. identifies those clients who lack commitment to the treatment process.b. is consistent with the "medical model" that dominates substance abuse rehabilitation programs.c. tends to force individuals to wait until they are ready to renounce substance abuse before seeking treatment. d. demonstrates a double standard for substance abuse rehabilitation programs as opposed to other disease treatment programs
Q:
Discuss some of the various nicotine replacement systems used in treating tobacco use disorders.
Q:
Describe the three subcategories on medications used in the treatment of opioid use disorders (OUDs).
Q:
Why might an opioid antagonist like naltrexone be used in the treatment of AUDs?
Q:
Discus the subgroups of medications that might be utilized as adjunctive treatments for SUDs.
Q:
Discuss the "development" of pharmaceutical agents used in the treatment of SUDs, including the issue of "off label" applications.
Q:
Varenicline can cause all of the following side effects EXCEPTa. vivid dreams. b. dry eyes.c. extended periods of sleep. d. gingivitis.
Q:
Naltrexone will block the euphoric effects of a narcotic analgesic for ______ after it was ingested. a. up to 72 hoursb. only 12 hours c. 5-7 daysd. no longer than one day
Q:
Buprenorphine is thought to be ______times as potent as morphine. a. 5b. 15c. 25-50 d. 80
Q:
Research has suggested that for every $1 invested in a methadone maintenance program, the return to society is about _______in terms of reduced hospitalization, crime, etc.a. $5 b. $24 c. $38 d. $15
Q:
The minimum effective dose of Methadone has been found to be a. 50 mg per day.b. 60 mg per day. c. 70 mg per day. d. 80 mg per day.
Q:
In spite of methadone's proven effectiveness in lowering morbidity and mortality rates among intravenous opiate abusersa. the Drug Enforcement Administration still threatens those who prescribe it to narcotics addicts. b. 13 states do not have methadone maintenance programs.c. 4 states require the total number of persons on methadone maintenance programs in that state be limited to under 300 people.d. 4 states do not have methadone programs at all.
Q:
Methadone is thought to be effective because it
a. blocks just 25-35 percent of opioid receptor sites, enough to prevent cravings for these drugs over extended periods of time.
b. binds to narcotic analgesic molecules in the blood, preventing them from forming chemical bonds with blood proteins and thus being more easily removed from the circulation.
c. is able to block 50 percent of the mu receptor sites without activating them.
d. activates only the kappa opioid receptor sites, causing dysphoria should the individual abuse opioids.
Q:
Methadone was originally used as aa. narcotic analgesic developed for use in World War II.b. way to interrogate captured prisoners, which is to say a truth serum.c. compound to enhance the effects of the amphetamines being administered to German combat soldiers in World War II.d. experimental narcotic analgesic that was found to be more dangerous than morphine.
Q:
One major problem with the use of clonidine in opioid withdrawal is that it a. can induce hypertension.b. reduces the risk of other compounds being abused.c. increases the risk of drop in blood pressure (increasing risk of patient falls). d. is prone to induce psychotic episodes.
Q:
All of the following have been found to be true about "ultra rapid" methods of narcotics withdrawal EXCEPT
a. it exposes patients to the risk of drug-induced coma.
b. patients receive opiate antagonists after coma is induced.
c. it is more effective in helping the client achieve long-term abstinence than traditional methadone-assisted withdrawal.
d. it is no more effective in helping the client achieve long-term abstinence than traditional methadone-assisted withdrawal.
Q:
In the event of an opiate overdose, the best treatment appears to be _____administered under a physician's supervision.a. Narcanb. aprizalole c. naltrexone d. Haldol
Q:
Nineteen different pharmaceuticals have been tried in experimental trials as possible pharmacological treatments for cocaine abuse or addiction. According to your text, which of the following is true?a. Only one has proven effective.b. None have been identified as being consistently effective, as yet. c. Electro-convulsive therapy (ECT) appears promising at this time. d. Desipramine has proven effective.
Q:
The most effective pharmacological treatment for amphetamine addiction is a. topiramate.b. modafinil.c. naltrextone.d. waiting to be discovered.
Q:
There has been research of late suggesting that a. acamprosate is not effective.b. the diagnosis of alcoholism is usually in error.c. first-degree relatives of a person with a substance use disorder are as much at risk for the development of a substance use disorder as the identified patient.d. the medication Cipro is useful in treating alcohol use disorders.
Q:
Acamprosate has been found to interact witha. the selective serotonin reuptake inhibitors (SSRIs). b. tricyclic antidepressants.c. certain cardiac medications such as the "beta" blockers.d. no known medications as of yet.
Q:
The side effect profile of which compound allows it to be administered during the acute phase of the alcohol withdrawal syndrome?a. Naltrexoneb. Acamprosate c. Vivitrold. Disulfiram
Q:
One study cited by your text found that 50 percent of patients who had been administered naltrexone a. relapsed within 3 months of starting treatment with this medication.b. experienced adverse effects that required the medication be discontinued on the advice of a physician. c. stopped taking it within the first 30 days.d. experienced intense cravings for alcohol.
Q:
The alcohol-disulfiram reactiona. begins 3-5 hours after the alcohol was ingested. b. can be fatal under certain conditions.c. results in abnormally slow respiration.d. can cause sensory disturbances such as hallucinations.
Q:
The ______benzodiazepines are the compounds of choice for controlling the alcohol withdrawal syndrome.a. short acting or intermediate acting b. ultra short acting or short actingc. ultra short duration or intermediate acting d. intermediate duration or long duration
Q:
The first line of medications to treat the alcohol withdrawal syndrome are the a. CNS stimulants like methylphenidate.b. hallucinogens like the peyote cactus. c. benzodiazepines.d. antidepressants.
Q:
A danger when using a pharmaceutical as an adjunct to the treatment of an addiction to drugs is that the a. physician prescribing the drug must guess at the effective dose.b. patient is already enamored with drugs, and pharmacotherapy might serve as a relapse trigger. c. synergistic effect between pharmaceuticals prescribed is rarely taken into account.d. psychopharmaceuticals utilized might work at cross purposes with the treatment staff's goals.
Q:
The development of pharmaceuticals specific to substance use disorders has been delayed becausea. those regions of the brain involved in the addictions are so widespread that no single pharmaceutical, or combination of pharmaceuticals, can work on every one.b. pharmaceutical companies view the demand as too limited to make the development of such medications worthwhile.c. the current generation of medications is sufficient to treat conditions associated with substance use disorders. d. there are new medications under development which should revolutionize the treatment of substance use disorders.
Q:
The most successful treatment for nicotine dependence at this time seems to be a. nicotine patches.b. Chantix (varenicline).c. Wellbutrin (bupropion).d. Inversine (mecamylamine).
Q:
Transdermal nicotine patches have been found to be _________ successful in treating nicotine dependence. a. minimallyb. moderately c. extremelyd. completely not
Q:
Your client informs you that he is currently taking Suboxone. You know that this is used in the treatment of ________ dependence. a. methamphetamineb. alcohol c. opiated. nicotine
Q:
Amber has overdosed on heroin and has just been rushed to the hospital. She has been given the drug Narcan to help stop the potentially fatal symptoms of the overdose. Amber has been administered this druga. intravenously. b. orally.c. intramuscularly.d. through any of these methods, depending on how acute her symptoms are.
Q:
In addition to treatment for heroin, research is being conducted to see if methadone may also be effective in treating _________ dependence. a. nicotineb. cocaine c. alcohold. marijuana
Q:
Immunological therapies are being studied for the treatment of __________ addiction. a. cocaineb. benzodiazepines c. alcohold. heroin
Q:
Ondansetron appears to help in the treatment of AUDs by a. making the user sick when mixed with alcohol.b. decreasing cravings.c. blocking the subjective pleasurable experience of alcohol. d. all of these answers.
Q:
Research has found that _____of individual with AUDs prescribed naltrexone relapsed within the first 12 weeks of treatment.a. 10 percent b. 22 percent c. 37 percentd. 50 percent
Q:
About ________ of those prescribed disulfiram take it as prescribed. a. 7 percentb. 15 percent c. 20 percent d. 45 percent
Q:
There are ________ approved medications used to treat alcohol use disorders. a. fourb. tenc. twenty seven d. hundreds of
Q:
An advantage of using the anticonvulsant carbamazepine over benzodiazepines for the treatment of alcohol withdrawal is that ita. is not addictive. b. is not sedating.c. creates nausea in the user. d. is much cheaper.
Q:
Discuss the debate regarding whether complete abstinence should be the goal of treatment.
Q:
What are some of the factors that may become the foundation upon which a client's recovery might be established?
Q:
What are the challenges for the substance abuse rehabilitation professional when dealing with a client in the precontemplation stage of recovery.
Q:
Describe the voucherbased reinforcement treatment programs.
Q:
Discuss the factors that may surround the decision to seek treatment for a person with a SUD.
Q:
Of those able to abstain from cocaine for 12 weeks, up to _____ will remain drugfree for the first 6 months following treatment. a. 60 percentb. 80 percentc. 10 percentd. 15 percent
Q:
What percentage of those opioid-dependent people who only completed "detox" program return to the abuse of chemicals within 6 months?a. 75 percent b. 90 percent c. 10 percent d. 25 percent
Q:
During the ___ stage, the client is ready to change his or her attitude and behavior within a specific time frame, usually within the next month. a. preparationb. precontemplationc. preactiond. ready to go