Substance Abuse

According to the DSM-5 TR, what replaces the terms 'abuse' and 'addiction' when referring to problematic substance use?

Which of the following best describes the concept of 'tolerance' in the context of substance use disorders?

What is the estimated percentage of adults aged 18 or older with both AMI (Any Mental Illness) and an SUD (Substance Use Disorder) in the past year?

A patient reports recurring visual disturbances long after discontinuing use of a recreational drug. Which of the following conditions is most likely?

According to the DSM-5 TR diagnostic criteria for SUD (Substance Use Disorder) how many criteria must be met to achieve a diagnosis?

A patient presents with a strong desire or urge to use a substance, which impacts their ability to focus on daily tasks. Which of the following SUD criteria does this represent?

Which of the following best describes 'early remission' from a Substance Use Disorder (SUD)?

Which of the following is a common withdrawal symptom associated with stimulant use?

According to the information provided, which of the following is most commonly associated with flashbacks?

Which of the following illicit drugs is most commonly used in America?

A patient presents with complaints of cyclical vomiting, abdominal pain, and chronic cannabis use. Which of the following conditions is most likely?

Which of the following interventions is LEAST likely to be included in the treatment of Cannabinoid Hyperemesis Syndrome?

What is the mechanism of action of stimulant drugs like cocaine and amphetamines?

A patient presents with paranoia, delusions, and violent behavior after using a substance. Which of the following substances is most likely the cause?

Which of the following is the MOST appropriate initial step in managing a patient presenting with acute stimulant toxicity?

Which intervention would be MOST appropriate for a patient experiencing stimulant withdrawal?

A patient presents with restlessness, nervousness, insomnia, flushed face, diuresis, and muscle twitching. Which substance use disorder is most likely?

Which of the following is the primary mechanism of action of benzodiazepines?

A patient presents with autonomic hyperactivity, hand tremor, insomnia, and tactile hallucinations. Which of the following substances is MOST likely the primary substance of abuse?

Compared to barbiturates, how are benzodiazepines different?

What is the reversal agent for a benzodiazepine overdose?

Compared to benzodiazepines, how do hypnotics (sleeping pills) differ?

Which of the following is NOT a potential long-term effect of inhalant use?

What is the primary mechanism of action of alcohol?

A patient is brought to the emergency department with altered mental status. Which of the following findings from the exam would be most concerning for alcohol intoxication?

What is the significance of considering carbamazepine or valproic acid during rapid benzodiazepine taper?

What key elements are assessed by the CAGE questionnaire?

According to the diagnostic criteria, what constitutes 'binge drinking' for women?

A patient with a history of chronic alcohol use presents with confusion, ophthalmoplegia, and ataxia. Which of the following interventions is MOST critical?

Which of the following findings would warrant inpatient admission for alcohol detoxification?

According to the information presented, what is the recommended first-line medication for relapse prevention in alcohol use disorder?

A patient is prescribed disulfiram (Antabuse) for alcohol use disorder. What education should the provider give the patient for this medication?

A patient has recently been prescribed acamprosate for alcohol use disorder. What critical information should the provider give the patient about this medication?

What is the MOST concerning adverse effect of MDMA (Ecstasy) use, requiring immediate medical attention?

A patient is brought to the emergency department exhibiting severe agitation, hallucinations, hypertension, and hyperthermia. They are suspected of MDMA (Ecstasy) overdose. Which of the following is the MOST appropriate initial treatment?

You're evaluating a patient who admits to regular heavy alcohol use. They report experiencing the following symptoms approximately 5 days after their last drink: agitation, hallucinations, disorientation, tachycardia, and fever. Which of the following is the MOST appropriate intervention?

A 24-year-old male presents to the clinic complaining of red eyes, increased appetite, memory problems. What class of drug is he most likely using?

During an evaluation, a patient describes experiencing 'visual snow,' halos around objects, and geometric patterns. They deny current substance use but admit to experimenting with recreational drugs in the past. Which condition is MOST likely causing these symptoms?

Which of the following best describes 'Kindling' as it relates to alcohol withdrawal?

A patient presents with symptoms of serotonin syndrome. Which of the following list of signs and symptoms are most likely to indicate this?

A 30-year-old female presents to the clinic with increased paranoia, hallucination on her skin as if bugs crawling underneath and marks on her skin from constantly picking. There is also reports of poor dentition. What substance is she most likely abusing?

A patient in the ED is suspected of alcohol withdrawal. The decision is made to use the SHOT assessment. It’s determined that use of benzodiazepines is indicated, What is the SHOT score needed to come to this determination?

Which of the following medications used to treat ETOH relapse can trigger hepatotoxicity and required that LFT’s be checked?

Which combination of substances poses the GREATEST risk of overdose and death due to synergistic respiratory depression?

A patient is suspected of PCP use, but his urine drug screen comes back negative for PCP. What is the most likely reason for the discrepancy, assuming the patient is being truthful about the timing of their use?

According to available data, what percentage of individuals aged 12 or older with a substance use disorder did not receive treatment in 2021?

Approximately what percentage of adults have co-occurring Any Mental Illness (AMI) and a Substance Use Disorder (SUD)?

What is the estimated percentage of individuals aged 12 or older with a substance use disorder?

Which of the following best defines 'tolerance' in the context of substance use?

According to the DSM-5 TR, how many criteria must be met during a 12-month period for a diagnosis of Substance Use Disorder (SUD)?

A patient has discontinued substance use and has not used in the last 5 months, but still reports cravings. What specifier would apply?

What distinguishes 'sustained remission' from 'early remission' as a Substance Use Disorder (SUD) specifier?

A patient reports experiencing vivid, recurrent flashbacks after discontinuing use of a recreational drug. This condition is most likely attributed to:

A patient with a history of substance use presents with a recent onset of psychosis. What is the MOST crucial step in determining the appropriate diagnosis?

What is the estimated percentage of the adult population with an Alcohol Use Disorder?

A patient is diagnosed with a substance use disorder because they have an increasing amount of time spent using the substance. Under which category of diagnostic criteria would that fall?

According to the presented information, what is the most commonly used illicit drug in America?

Which of the following substances is LEAST likely to result in severe withdrawal symptoms?

Which of the following best describes what it means for a street drug to be 'laced'?

A patient presents with a history of daily cannabis use exceeding one year, complaining of chronic nausea, cyclical vomiting, and abdominal pain. Which of the following should be considered?

What is the primary mechanism of action by which stimulant drugs such as cocaine and amphetamines exert their psychoactive effects?

A patient is observed to have pupillary constriction. Which of the following substance withdrawals might this suggest?

Which of the following illicit drugs is associated with nasal septum perforation?

Which of the following best describes the long-term risks associated with cocaine use?

Which of the following best describes the mechanism of action of synthetic cathinones?

Which of the following is associated with the greatest potential for abuse and has no accepted medicinal qualities?

What is a potential sign or symptom of MDMA (Ecstasy) use? Use the mnemonic for methamphetamine as a guide (but for MDMA).

Which of the following best describes dissociative drugs?

Which of the following are naturally occurring hallucinogens?

Hallucinations, especially of geometric patterns, are most closely correlated with:

Which CAGE questionnaire question directly assesses the 'Guilt' element?

Which substance is correctly paired with its mechanism of action?

Which of the following best describes the effects of diminished saliva production of one's oral health, especially for methamphetamine users?

A patient is being assessed for Delirium Tremens. Which findings are part of the typical physical exam findings?

A patient is experiencing serotonin syndrome as a result of MDMA use. Which constellation of symptoms is most indicative of this condition?

Which feature distinguishes Wernicke's encephalopathy from Korsakoff syndrome in alcohol-related brain injury?

According to the provided information, which of the following statements accurately describes the use of thiamine when treating Wernicke's encephalopathy?

What is the initial step in managing a patient presenting with acute PCP intoxication?

Which of the following is the MOST appropriate course of treatment for a patient presenting with stimulant intoxication?

A patient presents with known history of ETOH abuse. Under which instances should they automatically be admitted for inpatient detox?

According to the information provided, which medication for alcohol relapse prevention requires monitoring of kidney function?

For which of the following substances is disulfiram indicated?

Which of the following effects is associated with activation of 5-HT2 receptors?

Which of the following is a sign of MDMA toxicity?

Which of the following is an effect of alcohol use that creates both calm as well as increased tolerance?

Which medication may be considered as helpful for multiple withdrawals and neuroprotection?

Which commonly misused substance that is technically legal has potential signs and symptoms consisting of restlessness, nervousness, excitement, insomnia, flushed face, diuresis, GI upset and muscle twitching?

Which of the following is the most commonly used illicit drug in the United States?

According to DSM-5 TR criteria, which of the following is a diagnostic category for Substance Use Disorder?

Which of the following best describes the term 'tolerance' in the context of substance use disorders?

Hallucinogen Persisting Perception Disorder (HPPD) is most commonly associated with which of the following recreational drugs?

Which of the following best describes the intended mechanism of action of MDMA?

A patient presents with what appears to be a PCP overdose and is becoming violent. Which of the following symptoms would confirm suspicion of PCP intoxication?

Methamphetamine's mechanism of action differs from cocaine in which of the following ways?

In the United States drug scheduling system, which category defines substances with the highest potential for abuse and no accepted medicinal qualities?

A patient reports using 'poppers' to enhance sexual experiences. What class of inhalants are they most likely using?

A patient is being evaluated for a potential substance use disorder. They report spending a significant increasing amount of time obtaining and then using the drug. Under which DSM-5 TR category would this symptom fall?

Which of the following distinguishes Wernicke's encephalopathy from Korsakoff syndrome?

Which of the following correctly matches a drug with its primary mechanism of action?

What is the primary treatment goal when using benzodiazepines to manage alcohol withdrawal?

According to the information provided, under which circumstance should a patient with a history of alcohol abuse automatically be admitted for inpatient detoxification?

What is a potential sign or symptom of MDMA (Ecstasy) use, based on the mnemonic?

According to the information included, what differentiates synthetic cathinones from other stimulants?

A patient presents symptoms suggestive of cannabinoid withdrawal. How many of the listed symptoms are necessary to consider this diagnosis? Symptoms: irritability, anxiety, insomnia, decreased appetite, restlessness, depressed mood, abdominal pain, shakiness, sweating

Which of the following medications requires monitoring of kidney function due to its renal clearance?

A patient presents with agitation, hyperthermia, hyperreflexia, anxiety, and myoclonus. Which of the following is the MOST likely diagnosis?

A patient asks what they should expect if they take Disulfiram to maintain alcohol abstinence. Which of the following is the correct answer?

Which of the following best describes the primary mechanism of action of opioid medications?

Which of the following opioids is considered to be 50 to 100 times stronger than morphine?

According to the provided information, approximately what percentage of drug overdose deaths in 2021 involved opioids?

Which of the following is a common physiological effect associated with opioid use, represented by the 'M' in the mnemonic 'ARM PEN CD'?

Which of the following is a potential consequence of chronic opioid use due to the downregulation of mu and delta receptors?

Which of the following routes of administration is LEAST likely to be associated with 'track marks'?

Needle exchange programs are associated with which of the following positive outcomes?

According to the presentation, opioid withdrawal is typically described as:

In the mnemonic 'STOP TRYING Joints' for opioid withdrawal symptoms, 'O' represents:

A patient with suspected opioid withdrawal has a COWS score of 9. According to the COWS scale interpretation provided, this score indicates:

Which of the following medication classes is categorized as an opioid receptor partial agonist and is used in medication-assisted treatment (MAT) for opioid use disorder?

Lofexidine, used for managing autonomic symptoms of opioid withdrawal, belongs to which pharmacological class?

Which medication for opioid use disorder is described as having a 'ceiling effect' that reduces the chances of overdose?

Suboxone, a combination medication for opioid use disorder, contains buprenorphine and which other medication?

For a patient with short-acting opioid use, such as heroin, how long is the recommended waiting period after the last use before initiating buprenorphine/naloxone (Suboxone) to avoid precipitated withdrawal?

According to the provided information, which of the following practitioners is qualified to prescribe buprenorphine for opioid use disorder?

As of June 2023, what is the new requirement for all practitioners with a DEA license to prescribe buprenorphine?

Methadone is described as which type of opioid receptor agonist?

Which of the following is a more severe potential side effect associated with methadone compared to other opioids?

Which medication for opioid use disorder is a full opioid receptor antagonist and is available in a long-acting injectable formulation (Vivitrol)?

Which of the following is the primary purpose of Prescription Drug Monitoring Programs (PDMPs)?

Naloxone (Narcan) is a full opioid receptor antagonist used primarily for:

What is the recommended initial dose of naloxone for opioid overdose via intravenous, intramuscular, subcutaneous, or endotracheal tube administration?

After administering naloxone for opioid overdose, for how long should a patient be observed for potential 'rebound' opioid toxicity?

Which of the following is a safe discharge criterion after naloxone administration for opioid overdose?

Urine drug screens are described as 'presumptive' until confirmed by which type of test?

Which of the following drugs is LEAST likely to be detected on a routine urine drug screen?

According to Table 2, approximately how long can amphetamine be detected in urine after last use?

Which of the following over-the-counter medications is listed as a potential cause of false-positive results for amphetamines on an immunoassay urine drug screen?

Which of the following is a criterion for involuntary admission under the Marchman Act related to substance abuse impairment?

Which of the following is considered an 'enabling behavior' when dealing with a person with substance use disorder?

When interacting with a loved one struggling with substance use, which of the following communication strategies is recommended?

Which of the following is a recommended support group for families of individuals with substance use disorders?

In the 'AEIOU TIPS' mnemonic for altered mental status, 'TIPS' stands for which categories?

Which professional association is specifically mentioned as a P.A. group focused on addiction medicine?

Which of the following websites is recommended as a resource for families affected by alcoholism?

Sufentanil and remifentanil are described as being how many times stronger than morphine?

Carfentanil, a fentanyl analog, is described as being approximately how many times stronger than morphine?

In Florida, failing to consult the Prescription Drug Monitoring Program (E-FORCSE) is considered:

Which of the following is NOT a component of the COWS (Clinical Opiate Withdrawal Scale)?

According to the information provided, which of the following best describes the 'gateway drug' theory in the context of heroin use?

A patient in opioid withdrawal exhibits prominent piloerection and reports a sensation of cold, clammy skin. Which descriptive term best captures this combination of symptoms?

A patient is started on buprenorphine/naloxone in the emergency department for opioid use disorder. They are being discharged with a prescription and referral for follow-up. According to the protocol described, when should this follow-up appointment ideally occur?

Which of the following opioid medications is derived directly from the poppy plant?

Which of the following is a synthetic opioid?

Which of the following best explains the significance of "track marks" in the context of heroin use?

A patient with a history of intravenous drug use is diagnosed with right-sided endocarditis. Which of the following substances is MOST likely associated with this condition?

Which of the following statements accurately describes the relationship between needle exchange programs (NEPs) and drug use?

What is a common physical symptom associated with opioid withdrawal, characterized by goosebumps and often accompanied by a cold, clammy sensation?

A patient undergoing opioid withdrawal exhibits the following symptoms: sweating, tremor, mydriasis, piloerection, and joint pain. According to the opioid withdrawal mnemonic 'STOP TRYING Joints', which symptom is represented by the letter 'O'?

What is the expected impact to a patient who has been using heroin for several weeks, after initial administration of buprenorphine?

A patient is being assessed for opioid withdrawal using the Clinical Opiate Withdrawal Scale (COWS). Which of the following parameters is evaluated by the COWS?

A patient is being treated for Opioid Use Disorder (OUD) with buprenorphine. Which of the following is a potential benefit of using buprenorphine over full opioid agonists like heroin or methadone?

Which of the following routes of administration is available for buprenorphine?

Which of the following describes a potential risk associated with buprenorphine use?

A patient with Opioid Use Disorder (OUD) is prescribed Suboxone (buprenorphine/naloxone) for outpatient management. What is the primary purpose of including naloxone?

A patient is being transitioned from heroin to buprenorphine/naloxone (Suboxone) in the emergency department. How long should the patient wait after their last use of heroin, before initiating Suboxone?

As of June 2023, what action must all practitioners with a DEA license take to be eligible to prescribe buprenorphine for opioid use disorder?

A patient is started on methadone for opioid use disorder. Which characteristic of methadone is most accurate?

Which of the following medications used in the treatment of Opioid Use Disorder (OUD) can cause cardiac arrhythmias e.g. prolonged QT interval?

Which of the following medications is a full opioid receptor antagonist used for relapse prevention in opioid use disorder and is administered as a monthly injection?

What is the primary goal of Prescription Drug Monitoring Programs (PDMPs)?

Which medication that reverses opioid overdoses will likely require multiple doses to revive the patient?

After administering naloxone to a patient experiencing an opioid overdose, what is the recommended minimum observation period to monitor for potential 'rebound' opioid toxicity?

A patient is successfully revived with naloxone after an opioid overdose. Which of the following Glasgow Coma Scale (GCS) scores would be considered a safe discharge criterion?

Urine drug screens (UDS) are useful for detecting drug use; how are they described until further testing?

Which of the following opioids is LEAST likely to be detected on a routine urine drug screen and may require a specific assay for detection?

Under the Florida law (Marchman Act), what is a criterion for involuntary admission for substance abuse impairment?

A family member consistently calls their adult child's workplace to report them as sick, enabling them from the consequences of their substance use. This behavior is best described as:

When interacting with a loved one struggling with substance use, which approach is generally recommended?

If a family member is looking for support to help them through a loved one’s alcohol addiction, which US based non-profit organization would be most appropriate?

A first-year medical student asks a seasoned P.A. specializing in addiction medicine about resources for professional development and networking. Which of the following organizations would the P.A. most likely recommend?

Sufentanil and remifentanil are synthetic opioids. Approximately how many times stronger are they than morphine?

Is it legal to prescribe Carfentanil?

Which of the following substances is commonly associated with Hallucinogen Persisting Perception Disorder (HPPD), characterized by flashbacks of drug-induced perceptual disturbances?

What medication is FDA-approved as a Prescription Digital Therapeutic (PDT) to treat Substance Use Disorders (SUDs), including cannabinoid use disorder?

A patient experiencing opioid withdrawal presents with severe anxiety, yawning, joint pain, dilated pupils, and gastrointestinal distress. Which medication class can provide symptomatic relief by targeting autonomic dysfunction?

For a diagnosis of Substance Use Disorder according to DSM-5 TR criteria, how many symptoms must be present within the past 12 months?

The most common cause of death from opioid use is:

Which opioid medication used in Medication-Assisted Treatment (MAT) is a partial agonist at opioid receptors, thus offering a ceiling effect and reduced risk of overdose?

A patient presents with acute opioid overdose. Which medication will rapidly reverse opioid effects?

Which drug is identified as having extremely potent opioid properties, being 10,000 times stronger than morphine, and primarily used for veterinary anesthesia?

Which of the following substance groups typically have little to no withdrawal symptoms?

A healthcare provider treating substance use disorders should reference the Prescription Drug Monitoring Program (PDMP) to:

Which opioid Medication-Assisted Treatment (MAT) has a prolonged QT interval as a potential severe side effect?

Which symptom would NOT typically be expected during cannabinoid withdrawal?

A patient experiencing stimulant withdrawal will most likely present with:

Which drug has been reported anecdotally to decrease alcohol cravings, although it is primarily indicated for diabetes and weight loss?

According to DSM-5 TR, the condition characterized by excessive caffeine intake (>250 mg) causing restlessness, insomnia, tachycardia, and other symptoms is termed:

A 22-year-old patient presents with agitation, elevated blood pressure, dilated pupils, bruxism, and symptoms resembling serotonin syndrome after attending a music festival. Which illicit drug is most likely responsible?

Which of the following is considered the first-line pharmacological treatment for preventing relapse in alcohol use disorder, and can be started while the patient is still drinking?

An individual is experiencing withdrawal symptoms from chronic cannabis use. Which medication could effectively manage symptoms such as nausea, vomiting, and cyclical abdominal pain associated with cannabinoid hyperemesis syndrome?

An adolescent frequently inhales substances such as glue or spray paint to achieve euphoria. Which of the following is a major risk associated with long-term inhalant use?

Which clinical tool is commonly used in healthcare settings to screen for problematic alcohol consumption and includes questions about guilt feelings, morning drinking, and attempts to cut down?

A patient receiving long-term treatment for Opioid Use Disorder (OUD) develops prolonged QT intervals on ECG. Which OUD medication is most likely implicated?

Which substance listed below is NOT typically detected on a standard urine drug screen panel and requires a separate test?

The primary neurotransmitter changes that occur in chronic stimulant use involve increased levels of:

The key differentiating symptom between opioid intoxication and opioid withdrawal is:

A patient presents to the ER unconscious with pinpoint pupils, decreased respiratory rate, and track marks on the arms. Immediate emergency treatment includes administration of:

A 30-year-old man develops severe anxiety, sweating, tremors, seizures, and hallucinations 3 days after his last alcoholic drink. This acute, life-threatening condition is best termed:

What symptom would be considered uncommon or rare during stimulant intoxication?

In treating alcohol withdrawal syndrome, the Clinical Institute Withdrawal Assessment (CIWA) scale determines the necessity for administering:

A patient being treated for alcohol use disorder begins vomiting violently after consuming alcohol. Which medication is likely causing this reaction?

A patient prescribed benzodiazepines long-term decides to abruptly stop taking them and experiences severe tremors, anxiety, insomnia, and a seizure. The safest clinical response is:

Which opioid is a fully synthetic, potent analgesic, approximately 50-100 times stronger than morphine, and is frequently implicated in overdose deaths?

Which treatment for opioid withdrawal has fewer hypotensive side effects, is more expensive, but has similar effectiveness to clonidine?

The most reliable confirmatory testing method following an initially positive urine drug screen is:

Which drug overdose is uniquely associated with pinpoint pupils, respiratory depression, and sedation?

A healthcare provider using the mnemonic "ARM PEN CD" to remember opioid effects recalls the letter "C" specifically stands for:

A patient using heroin intravenously is at increased risk for which specific type of endocarditis?

According to the Marchman Act in Florida, involuntary treatment can be initiated if a patient:

Which opioid antagonist is incorporated into Suboxone (buprenorphine/naloxone) to prevent misuse?

Needle exchange programs (syringe service programs) have been shown to significantly:

What medical complication is commonly associated with chronic intravenous opioid use?

A patient in opioid withdrawal shows piloerection, yawning, rhinorrhea, and pupil dilation. These signs reflect hyperactivity of which autonomic nervous system branch?

Which drug's withdrawal is specifically associated with severe depression, lethargy, hypersomnolence, and increased appetite ("crash")?

When considering Medication-Assisted Treatment (MAT) for opioid use disorder, which agent has a risk of severe interactions with alcohol and sedatives, causing potentially lethal respiratory depression?

What is the most common illicit opioid, derived naturally from the poppy plant, associated with IV drug abuse and addiction?

According to recent CDC data (2021), opioid overdoses cause: