8 Hr MAT Training Test Bank with 100% Correct Answers |Latest 2023/2024

8 Hr MAT Training Test Bank with 100% Correct Answers |Latest 2023/2024 what ages are most affected by heroin overdose? ️ young adults (18-25 y/o) and middle adults what is the correlation between heroin and other drug use? ️ - 9/10 people who use heroin have used at least 1 other drug - 45% of people on heroin were addicted to prescription opioids what trends have occurred by reducing opioid prescriptions in last 5 years? ️ heroin use has gone up, so people are just switching to heroin and so people are ODing on heroin. how long does it take to OD on fentanyl? ️ seconds, where as heroin overdose took minutes. So pts will literally die where they used (often in secret in the bathroom). This is very dangerous because it can be released in the air if in powder and anyone that goes into the room can then OD. are females or males overdosing on heroin more? ️ much more males why is MAT important? ️ because places where MAT is implemented heroin deaths have decreased what are opiates vs opioids? ️ opiates: from opium poppy plant. Morphine, codeine. opioids: manufactures, semisynthetic or synthetic. - semisynthetic: heroin, buprenorphine - synthetic: methadone, fentanyl note: if you just draw opiates then heroin, buprenorphine, methadone fentanyl doesn't show up. Often pts use the opioids the most. You have to test specifically for buprenorphine. Heroin shows up as 1 way the first 6 hours after use and then shows up as morphine after that. If fentanyl shows up educate about the huge risk of OD. what happens when the brain is on drugs? ️ within 3 minutes there are chemical changes. The reward center is activated. DA is released to reinforce this behavior. Overtime this pathway remembers this, and the memory of this hijacks the brain so that the frontal lobe seeks that pleasure to feel normal. So initially its voluntary but over time its a compulsive act where without it you cannot feel pleasure. At first you get euphoria, but then you are just using the drug just to feel normal again because you are in withdrawals without it. And these drugs are all short acting so you are constantly trying to figure out where you will get the drug next. What is the most important aspect of recovery and staying sober? ️ Getting out of the environmental influences reminding you of use causing increased cravings. how do you explain buprenorphine tx to help pts understand that we will take tx 1 step at a time? ️ Think about those with HTN. If medications are just withdrawn there is no reason why we would think the disease wouldn't just come back. It is the same think with addiction. There are physical, likely permanent, changes in the brain. We don't know if coming off of medication will cause them to just have another relapse. So instead its preferred to just stay on medication. But if they are motivated we can try trials and see how it goes but if they need it long term that is completely fine just as being on an antihypertensive is okay. detox outcomes ️ low rates of retention in tx high rates of relapse post tx note: detox is not tx, tx is the aftercare of detox. There is less than 50% of abstinence at 6 months, and less than 15% at 12 months if they just do detox. This is why we do buprenorphine. what does MAT do? ️ alleviates physical withdrawal alleviates drg cravings restores brain changes what are the MAT options? How do they work? ️ Naltrexone: opioid antagonist Methadone: full opioid agonist Buprenorphine: partial opioid agonist note: theres not a 1 size fits all, try 1 of the other options if 1 doesn't work for the pt. whats protracted abstinence syndrome? ️ This is why people relapse. This occurs when their opioid receptor system is changed. They get generalized malaise, fatigue, insomnia, poor tolerance to stress and pain and they get opioid cravings. They get a conditioned trigger and then they relapse in order to feel normal again. what is suboxone vs probuphine? ️ suboxone: buprenorphine + naloxone (antagonist) to ward off attempts to get high by injecting. Naloxone would then induce withdrawal sxs. probuphine: implant with continuous delivery for 6 months what do you have to make sure they did before using naltrexone? ️ make sure they have already detoxed to avoid withdrawal. why don't we use methadone often? ️ gets to brain slowly but only available in approved outpatient programs and has to be dispensed daily. which option has the highest receptor binding affinity? ️ naltrexone, more than burpenorphine and methadone.