NR547/ NR 547 Study Guide Week 5
to Week 8 Differential Diagnosis in
Psychiatric-Mental Health
Substance use disorder occurs when:
<<<ANSWER>>>the recurrent use of a substance, such
as alcohol or drugs, causes clinically significant
impairment
-including health problems, disability, or failure to meet
responsibilities at home, work, or school
Tolerance <<<ANSWER>>>With repeated ingestion of
a drug, the drug shows decreased effect. Increasing
doses are required to achieve the effects noted with the
original administration
Dependence <<<ANSWER>>>State of adaptation
produced with repeated administration of certain drugs
,so that physical symptoms occur when the drug is
discontinued abruptly.
Addiction <<<ANSWER>>>A change in behavior
caused by biochemical changes in the brain after
continued substance use characterized by preoccupation
with and repeated use of a substance despite of negative
outcomes.
Withdrawal <<<ANSWER>>>Physiological and
psychological reactions that occur when the use of a
substance is stopped abruptly.
Intoxication <<<ANSWER>>>Condition following the
ingestion of a substance resulting in changes in level of
consciousness, cognition, perception, judgment, and
behavior.
Bernita is a 64-year-old who has been using heroin for 6
years. She is currently unemployed and lives with her
daughter in the city center. She does not have health
insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Methadone
,Methadone is a full μ-receptor agonist with a long half-
life, which can prevent withdrawal symptoms for 24
hours and provide steady control of cravings throughout
the day. It is only administered in methadone federally
regulated opioid treatment programs (OTP). Methadone
clinics incorporate psychosocial interventions and
require daily attendance for the first several months, so
this is a good option for a client that has the flexibility
to attend daily meetings. Use of methadone in MAT for
opioid use disorder helps extend client survival. When
patients stop methadone, they have a high likelihood of
relapsing, even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing
prescription oxycodone. He is employed but is on
probation at work for increased absenteeism. He desires
MAT but is concerned about his roommates stealing his
medication to get high.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Buprenorphine plus
naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is
a mu opioid receptor antagonist and can therefore block
the effects of buprenorphine; however, because
naloxone has poor sublingual bioavailability, it does not
, interfere with buprenorphine's effects when used
properly. Naloxone does have good parenteral
bioavailability; thus, if one tries to administer the
buprenorphine/naloxone formulation intravenously,
naloxone will prevent any rewarding effects from
buprenorphine, making this drug a less desirable street
drug. Suboxone is a good option for a client who may
not be able to leave work for medication dosing, as it
does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin,
and booze" regularly. She lives in a rural area and is
employed part-time. She has a history of poor
compliance with past treatments.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Naltrexone
Naltrexone blocks mu opioid receptors, preventing
exogenous opioids from binding there and thus
preventing the pleasurable effects of opioid
consumption. This medication also reduces alcohol
consumption through modulation of opioid systems,
thereby reducing the reinforcing effects of alcohol. For
those patients with alcohol use disorder, who have poor
adherence to a regimen, and are unable to maintain
to Week 8 Differential Diagnosis in
Psychiatric-Mental Health
Substance use disorder occurs when:
<<<ANSWER>>>the recurrent use of a substance, such
as alcohol or drugs, causes clinically significant
impairment
-including health problems, disability, or failure to meet
responsibilities at home, work, or school
Tolerance <<<ANSWER>>>With repeated ingestion of
a drug, the drug shows decreased effect. Increasing
doses are required to achieve the effects noted with the
original administration
Dependence <<<ANSWER>>>State of adaptation
produced with repeated administration of certain drugs
,so that physical symptoms occur when the drug is
discontinued abruptly.
Addiction <<<ANSWER>>>A change in behavior
caused by biochemical changes in the brain after
continued substance use characterized by preoccupation
with and repeated use of a substance despite of negative
outcomes.
Withdrawal <<<ANSWER>>>Physiological and
psychological reactions that occur when the use of a
substance is stopped abruptly.
Intoxication <<<ANSWER>>>Condition following the
ingestion of a substance resulting in changes in level of
consciousness, cognition, perception, judgment, and
behavior.
Bernita is a 64-year-old who has been using heroin for 6
years. She is currently unemployed and lives with her
daughter in the city center. She does not have health
insurance.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Methadone
,Methadone is a full μ-receptor agonist with a long half-
life, which can prevent withdrawal symptoms for 24
hours and provide steady control of cravings throughout
the day. It is only administered in methadone federally
regulated opioid treatment programs (OTP). Methadone
clinics incorporate psychosocial interventions and
require daily attendance for the first several months, so
this is a good option for a client that has the flexibility
to attend daily meetings. Use of methadone in MAT for
opioid use disorder helps extend client survival. When
patients stop methadone, they have a high likelihood of
relapsing, even 10 years after starting treatment.
Antoine is a 34-year-old who has been abusing
prescription oxycodone. He is employed but is on
probation at work for increased absenteeism. He desires
MAT but is concerned about his roommates stealing his
medication to get high.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Buprenorphine plus
naloxone (Suboxone)
In combination with naloxone (Suboxone): naloxone is
a mu opioid receptor antagonist and can therefore block
the effects of buprenorphine; however, because
naloxone has poor sublingual bioavailability, it does not
, interfere with buprenorphine's effects when used
properly. Naloxone does have good parenteral
bioavailability; thus, if one tries to administer the
buprenorphine/naloxone formulation intravenously,
naloxone will prevent any rewarding effects from
buprenorphine, making this drug a less desirable street
drug. Suboxone is a good option for a client who may
not be able to leave work for medication dosing, as it
does not need to be taken under direct observation.
Lisa is a 29-year-old who admits to using "pills, heroin,
and booze" regularly. She lives in a rural area and is
employed part-time. She has a history of poor
compliance with past treatments.
prescribe the proper medication:
Methadone
Buprenorphine
Buprenorphine plus naloxone (Suboxone)
Naltrexone <<<ANSWER>>>Naltrexone
Naltrexone blocks mu opioid receptors, preventing
exogenous opioids from binding there and thus
preventing the pleasurable effects of opioid
consumption. This medication also reduces alcohol
consumption through modulation of opioid systems,
thereby reducing the reinforcing effects of alcohol. For
those patients with alcohol use disorder, who have poor
adherence to a regimen, and are unable to maintain
