16 HOUR MAT WAIVER CONTENT TEST EXAM SOLUTION 2022

16 HOUR MAT WAIVER CONTENT TEST EXAM SOLUTION 2022 Dopamine release leads to subjective feelings of ______ - pleasure, reward Why would addiction be considered a disease? - Dz= a disorder of structure or function that produces specific signs or symptoms Addiction has defined causes (genetics, environment) and observable consequences (behavioral, biological) underlying change in brain circuits may persist beyond detoxification, particularly in individuals with severe disorders. (varies with drugs and intensity of use. Amphetamine may take a year of abstinence to regain brain dopamine functionality) Should buprenorphine be prescr ibed from Emergency rooms? - Twice as likely to follow -up for addiction treatment vs referral alone What studies support group/social interactions in recovery? - Skinner box with rats: they use more drugs when caged than when in group 65% of vietnam sold iers that were addicted in vietnam did not use opioids on return to USA. physical exam should always include - looking for injection site marks -pupils -bowel sounds -neuro exam lab tests at OUD evaluation - HCV, HIV, LFTs, pregnancy test, urine drug scr eening Most common formulation of methadone - liquid concentrate or powder used in OTPs -tablets MC outside of OTPs define detox program and goal - narcotic drug is dispensed in decreasing doses, not exceeding one hundred and eighty days, "to alleviate a dverse physiological or psychological effects incident to withdrawal from the continuous or sustained use of a narcotic drug," with the ultimate goal of bringing a patient to a narcotic drug -free state What did CARA (Comprehensive Addiction and Recovery A ct) 2016 accomplish? - CARA temporarily expands the types of practitioners who may dispense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treatment or detoxification treatment without being separately registered as a narcotic tre atment program. Whereas prior to the CARA, only qualified physicians were permitted to dispense narcotic drugs in this manner, the CARA now temporarily permits certain nurse practitioners and physician assistants to qualify to do so. Timing of buprenorphi ne induction - Pt should be in mild to moderate withdrawal at time of induction. Use COWS assessment (Clinical Opiate Withdrawal Scale) -COWS ≥ 8 , 11 or 12 not unreasonable -COWS< 8 ok if UDS is neg and no self -reported opioid use in past 3 days -Write Buprenorphine prescription ahead of time so pt can bring it to office and avoid prior-authorization issues How many mg can pt get on day 1 of buprenorphine induction? - 12 mg how l ong is induction phase with buprenorphine/naloxone ? - 1-3 days addiction - a chronic, relapsing brain disease that is characterized by compulsive drug seeking and use, despite harmful consequences Why is addiciton considered a brain dz? - Drugs change t he brain, they change its structure and how it works. Those brain changes can be long lasting and lead to many harmful, often self -destructive, behaviors brain areas affected - amygdala: emotional responses nucleus accumbens: reward center cortex: our und erstanding of drug denial vs. lying - denial: your perception is off and you act in accordance with your perception lying: you know something is wrong and fabricate story to clear you of guilt DSM criteria for SUD - 1. Loss of control 2. Physiological c hanges 3. Consequences of use SUD= ≥ 2/3 in past year resulting in distress or impairment 1&2 were formerly termed "dependence" 3 was formerly termed "abuse" Are tolerance and withdrawal diagnostic for SUD? - no, anyone could experience those after a course of therapy smoking vs injecting cocaine, which gets to the brain first? - same rate 1914 Harrison Act - Illegal to sell or give away opium or coca or deri vatives without written order on an IRS form What year methadone approved by FDA for detox? maintenance? - 1970, 1973