10-Question Quiz on Addiction Rx

Methadone (an opioid agonist) and buprenorphine (a partial opioid agonist) are the currently recommended treatments for patients addicted to opioids who require opioid maintenance therapy. But even though there is good evidence to support the efficacy of each for this purpose, authors of a recent review in the Cleveland Clinic Journal of Medicine believe that both are still misunderstood and underutilized.

How much do you know about the characteristics, risks vs benefits, and regulations surrounding each? This 10-question quiz will tell and, we hope, teach along the way.

1. Recent estimates indicate that 2.23 million people in the United States have opioid use disorder. Approximately how many of those use heroin?

A. 254,000

B. 426,000  

C. 762,000

D. 900,000

Answer: B. 426,000 (use heroin) 1.8 million use prescription opioids

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2. The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, lists 11 diagnostic criteria for opioid addiction, formerly opioid use disorder-how many need to be present to make the diagnosis? 

A. 2 c

B. 3

C. 4

D. 5

Answer: A. 2 of the 11 diagnostic criteria for opioid addiction must be present to make a diagnosis

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3. In what timeframe must the 2 or more diagnostic criteria for opioid addiction have been present in order to make the diagnosis of opioid addiction?A. 6 months

B. 12 months

C. 18 months

D. 24 months

Answer B. 12 months
 

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4. The most common adverse effects of methadone are lightheadedness, dizziness, sedation, nausea, vomiting and sweating. The most serious risk is unintentional overdose which can be fatal with a single dose of:

A. 15 mg

B. 25 mg

C. 30 mg

D. 40 mg
 

Answer: C. 30 mg

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5. In most patients, the daily dose of methadone required to eliminate withdrawal and cravings is:

A. 15 – 30 mg

B. 30 – 60 mg

C. 60 – 120 mg

D. 100 – 120 mg


Answer: C. 60 – 120 mg

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6. Under the Controlled Substances Act, both methadone and buprenorphine are classified as Schedule II substances.

A. True

B. False

Answer: False (buprenorphine is classified as a schedule III substance)

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7. In most patients, the daily dose of buprenorphine required to adequately control opioid cravings is up to:A. 24 mg/day

B. 32 mg/day

C. 40 mg day

D. None of the above

Answer: 32 mg/day

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8. The buprenorphine subdermal implant provides the daily equivalent of how much buprenorphine for how long?

A. 8 mg, 3 months

B. 8 mg, 6 months

C. 10 mg, 3 months

D. 10 mg, 6 months

Answer: B. 8 mg, 6 months

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9. Which one of the following statements about buprenorphine is false?

A. Patients must have a diagnosis of opioid addiction to be prescribed buprenorphine but are not required to carry the diagnosis for a year before treatment.

B. Buprenorphine has been associated with renal toxicity

C. Sublingual buprenorphine is usually combined with naloxone in a 4:1 ratio to deter intravenous use.

D. Buprenorphine is available in the US in sublingual form.

Answer: B. Buprenorphine has been associated with renal toxicity ( is False; buprenorphine has been associated with hepatotoxicity)

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Under the Drug Abuse Treatment Act of 2000, any physician may apply for a waiver to prescribe and dispense buprenorphine and may initially treat a maximum of 30 patients. After 1 year, a prescriber may apply to treat up to 100 patients.

10. Under new federal regulations, after 1 year of treating 100 patients, an application may be submitted to treat up to a maximum of how many patients?A. 150

B. 200

C. 225

D. 275

Answer: D. 275

For additional information please see the full article:

Modesto-Lowe V, Swiezbin K, Chaplin M, Hoefer G. Use and misuse of opioid agonists in opioid addiction. Cleve Clin J Med. 2017;84:377-384.