Substance Abuse and Addiction Quiz
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Questions and Answers

Which of the following symptoms could indicate someone is using drugs?

  • Changes in friends; friends are known drug users
  • Change in personal grooming habits
  • Excessive need for privacy; unreachable, secretive
  • All of the above (correct)
  • Which of these symptoms is most likely to be related to the physical effects of drug use?

  • Moodiness, irritability, unusual silliness, nervousness
  • Tremors or shakes of hands, feet or head (correct)
  • Drop in grades at school or performance at work
  • Difficulty in paying attention; forgetfulness
  • Which of these symptoms is NOT a direct indicator of drug use?

  • Change in friends; friends are known drug users (correct)
  • Possession of drug paraphernalia
  • Needle marks on lower arm, leg or bottom of feet
  • Runny nose; hacking cough
  • Which of the following can be a sign of a potential drug use problem?

    <p>All of the above (D)</p> Signup and view all the answers

    Which of the following is MOST likely to be a direct physical effect of drug use?

    <p>Irregular heartbeat (B)</p> Signup and view all the answers

    Which of the following is NOT a characteristic of addiction?

    <p>Caused solely by genetic factors (B)</p> Signup and view all the answers

    What is NOT a factor that contributes to addiction, as stated in the text?

    <p>Medical history of the patient (D)</p> Signup and view all the answers

    Which of the following brain reward pathways is involved in addiction as mentioned in the text?

    <p>All of the above (D)</p> Signup and view all the answers

    What drug class is NOT mentioned in the text as a common substance of abuse?

    <p>Antidepressants (B)</p> Signup and view all the answers

    What criteria is NOT listed under DEPENDANCE?

    <p>Hazardous situations (B)</p> Signup and view all the answers

    Which of the following is a physical sign that may indicate a substance abuse problem?

    <p>Sudden changes in physical appearance (C)</p> Signup and view all the answers

    What is a likely behavioral sign of substance abuse?

    <p>Changes in attitude and personality (B)</p> Signup and view all the answers

    Which of the following is NOT a factor that can influence the development of addiction?

    <p>Age of the individual (D)</p> Signup and view all the answers

    Which substance is classified as a stimulant?

    <p>Amphetamines (D)</p> Signup and view all the answers

    What is the most important aspect to consider when dealing with substance abuse?

    <p>Individualized assessment and treatment (C)</p> Signup and view all the answers

    What is the primary purpose of the CAGE screening tool?

    <p>Identify potential substance use disorder (B)</p> Signup and view all the answers

    Which of the following is NOT a physical exam finding that may indicate substance use disorder?

    <p>Normal blood pressure and heart rate (B)</p> Signup and view all the answers

    According to the provided text, which of the following is considered the most effective intervention for alcohol use disorder long term?

    <p>12-step program like Alcoholics Anonymous (A)</p> Signup and view all the answers

    Which of these laboratory tests is NOT commonly used in the diagnostics of substance use disorder?

    <p>Electrocardiogram (ECG) (C)</p> Signup and view all the answers

    Which of the following medications is used to reduce alcohol cravings and enhance GABA activity?

    <p>Campral (acamprosate) (C)</p> Signup and view all the answers

    Which of these is NOT a common symptom of opioid withdrawal syndrome?

    <p>Increased energy and motivation (D)</p> Signup and view all the answers

    Which of the following is a common behavior associated with potential substance use disorder?

    <p>Unexplained need for money or stealing money/items (B)</p> Signup and view all the answers

    What is the main purpose of using medications like Librium (chlordiazepoxide) during alcohol withdrawal?

    <p>To manage withdrawal symptoms like tremors and anxiety (D)</p> Signup and view all the answers

    What is the most effective way to manage opioid use disorder, according to the text?

    <p>Medications followed by 12-step programs like NA (D)</p> Signup and view all the answers

    Which of the following is NOT a common diagnostic test used to screen for substance use disorder?

    <p>Electroencephalogram (EEG) (B)</p> Signup and view all the answers

    Which of the following medications can be used to treat opioid withdrawal?

    <p>Methadone (A), Clonidine (B), Buprenorphine (D)</p> Signup and view all the answers

    Which of the following is TRUE regarding the opioid epidemic?

    <p>The opioid epidemic began with the widespread use of opioids in the 1980s. (A)</p> Signup and view all the answers

    Which of the following statements is TRUE about Methadone?

    <p>It is an opioid agonist. (E)</p> Signup and view all the answers

    Which of the following can lead to increased access to buprenorphine for treatment of opioid addiction?

    <p>A patient may need a waiver from their primary care physician to receive buprenorphine. (D)</p> Signup and view all the answers

    What was the major contributing factor to the opioid epidemic?

    <p>The focus on pain management as a fifth vital sign. (D)</p> Signup and view all the answers

    Which of the following is a consequence of the widespread use of opioids?

    <p>Reduced quality of life for chronic pain sufferers. (C)</p> Signup and view all the answers

    What is the role of Naloxone in opioid overdose?

    <p>It is an opioid receptor antagonist that reverses the effects of the overdose. (D)</p> Signup and view all the answers

    Which statement best describes the trend regarding opioid prescribing?

    <p>Opioid prescribing has significantly decreased since the 1980s. (C)</p> Signup and view all the answers

    When did the government first impose taxes on opium derivatives?

    <p>1914 (C)</p> Signup and view all the answers

    Which of the following are considered widely abused substances in the United States?

    <p>Prescription painkillers (A), Alcohol (B), Nicotine (C)</p> Signup and view all the answers

    What term is used to describe the physical changes that occur due to drug dependence?

    <p>Tolerance (C)</p> Signup and view all the answers

    What was Bayer's marketing strategy for heroin in 1890?

    <p>Positioning it as a safe and effective remedy for children (D)</p> Signup and view all the answers

    Which of these is NOT a sign of Substance Use Disorder (SUD)?

    <p>Improved family relationships (A)</p> Signup and view all the answers

    Flashcards

    Substance Use Disorder (SUD)

    A maladaptive pattern of substance use leading to impairment or distress.

    Harrison Tax Acts of 1914

    The first federal attempt to regulate drug use, imposing taxes on opium derivatives.

    Opiates

    Substances derived from opium, used historically for pain relief.

    Addiction stigma

    The view that addiction is a moral issue rather than a medical one.

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    Synthetic opioids

    Man-made drugs like hydrocodone and oxycodone, emerged in the 1970's.

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    Sleep disturbances

    Inability to sleep or being awake at unusual times.

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    Appetite changes

    Loss or increase in appetite; changes in eating habits.

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    Lack of motivation

    General lack of energy, self-esteem, and

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    Addictive Disorders

    Chronic and relapsing conditions affecting brain pathways leading to dependence.

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    Pathophysiology

    Study of how brain functions change in addiction, involving multiple neurotransmitters.

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    Brain Reward

    System responsible for pleasure, involving dopamine and other neurotransmitters.

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    Common Substances of Abuse

    Types of substances commonly used such as opioids, stimulants, and sedatives.

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    Diagnostic Criteria for Abuse

    Criteria to diagnose substance abuse; one criterion in 12 months.

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    Diagnostic Criteria for Dependence

    Criteria for substance dependence; three or more in 12 months.

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    Tolerance

    Need for increased amounts of a substance to achieve desired effect.

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    Withdrawal

    Physical and mental symptoms that occur after stopping the use of a substance.

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    Physical Signs of Addiction

    Visible indicators of substance use, such as changes in health or behavior.

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    Behavioral Signs of Addiction

    Changes in attitude or personality not linked to other causes.

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    Overdose

    A condition resulting from taking a toxic amount of a substance, often drugs.

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    Naloxone

    An opioid receptor antagonist that reverses the effects of opioid overdose.

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    Methadone

    A full opioid agonist used for managing withdrawal symptoms and maintenance.

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    Buprenorphine

    A partial opioid agonist that can manage withdrawal and reduce cravings.

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    Clonidine

    An antihypertensive drug used to alleviate withdrawal symptoms.

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    Opioid Epidemic

    A crisis arising from widespread misuse of opioid medications.

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    Pain as a Vital Sign

    Pain was once treated as an essential measure of health, influencing opioid prescriptions.

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    Moodiness

    Sudden shifts in emotions; irritability and nervousness.

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    Physical coordination issues

    Slowed or staggering walk; poor balance or movement control.

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    Cold, sweaty palms

    Physical symptoms like shaking hands and sweating in palms.

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    Excessive need for privacy

    Avoiding social interaction; being secretive and unreachable.

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    Needle marks

    Visible signs on the body indicating drug use; often found on arms or legs.

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    CAGE Screening

    A tool used to identify potential alcohol problems based on four questions regarding behavior related to drinking.

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    DAST

    Drug Abuse Screening Test, used for assessing drug-related issues.

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    Red Flag Findings

    Physical exam signs indicating potential substance abuse, such as trauma or poor hygiene.

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    Alcohol Withdrawal

    Physical and psychological symptoms experienced by individuals when they suddenly reduce or cease alcohol intake.

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    Naltrexone

    A medication that blocks opioid receptors, reducing cravings for alcohol and opioids.

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    12-Step Programs

    Support groups such as Alcoholics Anonymous, promoting recovery from addiction through mutual help.

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    Antabuse

    A medication that causes adverse reactions when alcohol is consumed.

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    Medication for Co-morbidities

    Treatments for mental/physical health issues alongside primary substance use disorder management.

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    Individual Psychotherapy

    One-on-one therapy aimed at understanding and changing behaviors associated with addiction.

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    Residential Treatment Programs

    Inpatient programs providing intensive therapy for substance use disorders.

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    Study Notes

    Substance Use/Abuse History

    • Opiates derived from opium were used to treat ailments like cholera, smallpox, dental pain, and dysentery as far back as the Mayflower in 1620.
    • As late as 1890, Bayer promoted both aspirin and heroin as remedies for coughs, colds, and pain, even for children.

    Substance Use/Abuse Legislation and Stigma

    • The Harrison Tax Acts of 1914 were the first government attempts at drug legislation, taxing opium derivatives.
    • By 1920, medical professionals recognized the addictive nature of opiates.
    • Addiction was then viewed as a moral, not medical, issue, leading to its stigmatization.
    • The 1970s saw the rise of synthetic opiates like hydrocodone and oxycodone.

    Substance Use Disorder (SUD) Definitions

    • Substance Use Disorder (SUD) is a maladaptive pattern of substance use leading to impairment or distress in school, work, family, and physical/social difficulties.
    • Key terms include dependence (psychological or physiological), withdrawal, detoxification, and tolerance.

    Screening for Substance Abuse

    • The question arises as to what type of primary care visit should include screening for substance abuse.

    Substance Use Pathophysiology

    • Addiction is thought to result from interactions among genetic, temperamental, psychosocial factors, resources, and substance accessibility.
    • Changes in brain pathways and increased vulnerability to drug effects contribute to continued dependence.
    • Both a "brain reward" system and avoidance of withdrawal contribute to substance use.
    • Brain reward involves dopamine, norepinephrine, endogenous opioids (endorphins), GABA, serotonin, acetylcholine, and adrenergic systems.

    Common Substances of Abuse

    • The presented table lists various substances categorized by their effects on the central nervous system (CNS), such as opioids, stimulants, psychotomimetics (hallucinogens), inhalants, and anabolic steroids.
    • Examples of substances include alcohol, benzodiazepines, heroin, morphine, cocaine, amphetamines, LSD, PCP, cannabinoids, solvents, nitrous oxide, volatile nitrites, synthetic methadone, and fentanyl..

    Diagnostic Criteria for Abuse/Dependence

    • Abuse (1 or more in a 12-month period): failure to fulfill roles, hazardous situations, legal problems, and social/interpersonal issues.
    • Dependence (3 or more in a 12-month period): tolerance, withdrawal, increased use, efforts to cut down, excessive time on activities to get the drug, important social, occupational, or recreational activities, and continued use despite knowledge of negative consequences.

    Clinical Presentation: Signs and Symptoms

    • Physical and behavioral signs of substance abuse are highlighted in the notes.
      • Physical signs include: sleeplessness, unusual activity levels, appetite changes, physical symptoms, and hygiene deterioration.
      • Behavioral signs encompass attitude changes, academic/work performance decline, dishonesty, sudden mood shifts, and motivation loss.

    Screening Tools: CAGE and DAST

    • CAGE (Concern, Anger, Guilt, Eye-Opener) and DAST (Drug Abuse Screening Test) are presented as screening tools.

    Physical Exam: Red Flag Findings

    • Frequent absences from school/work and a history of trauma or accidents
    • Depression, anxiety, labile hypertension
    • Gastrintestinal issues, sexual dysfunction, and sleep disorders are also listed.
    • Physical signs like tremors, breath odor, enlarged/tender liver, and nasal/conjunctival irritation are significant symptoms.

    Diagnostic Tests

    • A range of diagnostic tests, some needing individualization, are suggested, including a complete blood count (CBC) with differential, comprehensive metabolic panel (CMP), drug screening, hepatitis panel, HIV, syphilis (RPR), thyroid stimulating hormone (TSH), and B-hCG, as needed.

    Management Strategies

    • Risk reduction strategies include inpatient detox, residential and outpatient treatment programs, Alcoholics Anonymous (AA), and Narcotics Anonymous (NA).
    • Medical management of comorbidities, psychotherapy, and pharmacological agents to reduce cravings and control dependence are also crucial components of comprehensive treatment.

    Pharmacological Management: Alcohol

    • 12-step programs are considered the most effective long-term management method for alcohol use disorders.
    • Pharmacologic interventions including Librium (chlordiazepoxide) or other benzodiazepines are frequently employed to treat alcohol withdrawal.
    • Naltrexone, Campral, and Antabuse are discussed as potentially helpful medications for cravings, GABA enhancement, and aversion therapy.

    Pharmacological Management: Opioids

    • Medications are the first-line treatment for opioid use disorder, supplemented by 12-step programs.
    • Naloxone is a first-line overdose reversal agent.
    • Methadone and buprenorphine, with or without naloxone, are used for withdrawal and maintenance phases.
    • Clonidine is an anti-hypertensive medication utilized for withdrawal management.

    NJ Stats (2016): Opioid Overdose Data and Rates

    • Data displays the significant increase in opioid-related overdose deaths in New Jersey from 1999 to 2016, contrasted with national figures.

    Opioid Epidemic: Background and Implications

    • The opioid crisis emerged from well-intentioned healthcare policies focusing on pain management as a vital sign, leading to over-prescription of opioids.
    • The risk-benefit ratio tilted heavily towards opioids, overlooking potential consequences.
    • Increased awareness of risks and restricted opioid use followed.

    Overprescription and the Epidemic's Path

    • Over-prescription of opioids occurred due to the mistaken notion of treating pain as a vital sign and the absence of complete awareness of the long-term risks.
    • Consequently, an opioid crisis emerged and caused addiction and death.

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    Description

    Test your knowledge on the symptoms and signs of substance abuse and addiction. This quiz will cover physical effects, behavioral indicators, and criteria involved in addiction. Knowing these aspects can help in identifying potential drug use problems in individuals.

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