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Management of Opioid Use Disorder Treatment

An Overview

doi: 10.1097/NOR.0000000000000547
Departments: CE Tests
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Registration Deadline: March 5, 2021

Provider Accreditation:

Lippincott Professional Development (LPD) will award 1.5 contact hours for this continuing nursing education activity. This activity has been assigned 1.5 pharmacology credits.

LPD is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center's Commission on Accreditation.

This activity is also provider approved by the California Board of Registered Nursing, Provider Number CEP 11749 for 1.5 contact hours. LWW is also an approved provider of continuing nursing education by the District of Columbia, Georgia, and Florida #50-1223.

Disclosure: The authors and planners have disclosed no potential conflicts of interest, financial or otherwise.

This article has been approved by the Orthopaedic Nurses Certification Board for Category B credit toward recertification as an ONC.

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Back to Top | Article Outline

CE TEST QUESTIONS

GENERAL PURPOSE: To provide information on the post-screening diagnosis and treatment of opioid use disorders (OUD) with an emphasis on medication-assisted treatment (MAT).

LEARNING OBJECTIVES/OUTCOMES: After completing this continuing education activity, you should be able to:

  1. Discuss the diagnosis of OUD and the management of opioid withdrawal and detoxification (detox).
  2. Select features of the medications used to treat OUD in MAT.
  1. If, after prolonged use of opioids, it takes a higher dose of the drug for an individual to achieve the same level of response achieved initially, the individual has developed
    1. addiction.
    2. dependence.
    3. tolerance.
  2. Which statement is true regarding addiction?
    1. Addiction is primarily associated with a lack of willpower and moral strength.
    2. All individuals who are physically dependent on opioids are also addicted to these drugs.
    3. Brain changes in addiction can produce cravings that lead to relapse years after the individual is no longer opioid dependent.
  3. Which statement is true regarding detox from OUD?
    1. Inpatient detox has higher rates of completion.
    2. Detoxification is the first step in the treatment of OUD.
    3. There is a higher relapse rate from outpatient than inpatient withdrawal management.
  4. In the “cold turkey” approach to detox, what is the likely progression of withdrawal signs and symptoms after the last dose of opioids?
    1. aching, sweating, and increased bowel motility likely to be prominent at approximately 8–12 hours
    2. increasingly uncomfortable, anxious, and agitated with increased sweating at approximately 8–12 hours
    3. symptoms reach maximum intensity over approximately 24–32 hours and then taper off
  5. Relapse rates are highest with which detox approach?
    1. symptomatic treatment with buprenorphine
    2. tapering methadone doses
    3. “cold turkey”
  6. As noted in the article, the medication often used to treat the abdominal cramping that may occur during detox is
    1. dicyclomine.
    2. buprenorphine.
    3. methocarbamol.
  7. Which of the following medications was approved by the FDA for the treatment of opioid withdrawal?
    1. clonidine
    2. lofexidine
    3. tizanidine
  8. Gowing et al. (2017) reported that patients receiving which of the following drugs had less severe signs and symptoms of withdrawal, fewer side effects, and were more likely to stay in treatment longer and complete treatment?
    1. clonidine
    2. buprenorphine
    3. lofexidine
  9. When comparing the use of methadone and buprenorphine for detox it is important to remember that
    1. methadone cannot be used if opioids are still in the system.
    2. if there is a high risk for dropping out of detox, the evidence favors using buprenorphine for maintenance.
    3. buprenorphine can precipitate withdrawal so it should only be used after withdrawal signs and symptoms are observed.
  10. The authors note that withdrawal management using methadone is typically completed within how many days?
    1. 6–10 days
    2. 12–14 days
    3. 30–60 days
  11. Compared to clonidine for detox, lofexidine
    1. produces more mood problems.
    2. is more sedating.
    3. does not produce hypotension.
  12. What would be the score on the Clinical Opiate Withdrawal Scale for a patient who just jogged around the detox facility and has the following signs and symptoms: flushed face; reports difficulty sitting still but is able to do so; mild, diffuse joint discomfort; stomach cramps; yawns twice during the assessment; and reports increasing anxiousness?
    1. 5
    2. 7
    3. 9
  13. A drug that fully stimulates the mu receptor is an opioid
    1. agonist.
    2. antagonist.
    3. partial agonist.
  14. An example of a partial agonist is
    1. naltrexone.
    2. methadone.
    3. buprenorphine.
  15. Which statement is true regarding methadone?
    1. It causes individuals to become addicted (to the methadone).
    2. It stays in the brain and body for days.
    3. It does not cause drowsiness.
  16. Patients typically stay on methadone for up to
    1. 3 months.
    2. 5 months.
    3. 3 years.
  17. Common drawbacks of treatment with mono-buprenorphine include the fact that it can
    1. easily result in overdose due to the lack of a ceiling effect.
    2. complicate pain treatment.
    3. cause cardiac dysrhythmias.
  18. There are minimal drug interactions with buprenorphine (with or without naloxone) except with
    1. sulfonylureas used to treat diabetes.
    2. central nervous system depressants.
    3. antihistamines.
  19. Because of its very short half-life, which of the following is not a viable treatment option for OUD other than to reverse opiate overdose?
    1. naloxone
    2. buprenorphine
    3. naltrexone
  20. Which statement is true regarding recovery from OUD?
    1. Recovery is complete when MAT has been completed.
    2. It is life-long and should include peer recovery support groups that are initiated during MAT.
    3. It ends after a short-term treatment plan that includes MAT and counseling and behavioral therapies.
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