Addiction Medicine Treatment Planning Flashcards

A patient with opioid use disorder has chronic pain and requests buprenorphine. Which treatment planning consideration is MOST important?

Answer: Use a single agent that addresses both OUD and pain when possible

Buprenorphine is a partial agonist with analgesic properties and can address both OUD and chronic pain simultaneously, making it the preferred agent in co-occurring conditions.

When developing a treatment plan for a patient with stimulant use disorder, which pharmacological approach has the strongest evidence base?

Answer: No FDA-approved medications; behavioral therapies are primary

There are currently no FDA-approved medications for stimulant use disorder, making behavioral interventions such as contingency management the first-line treatment approach.

A treatment plan for a patient with severe alcohol use disorder should include which level of care according to ASAM criteria when the patient has a history of alcohol withdrawal seizures?

Answer: Medically managed intensive inpatient (Level 4)

A history of alcohol withdrawal seizures indicates high seizure risk, requiring medically managed intensive inpatient care (ASAM Level 4) for safe detoxification.

Which motivational interviewing technique is MOST appropriate early in treatment planning when a patient is ambivalent about change?

Answer: Exploring and reflecting the patient's own reasons for change

Reflecting the patient's own ambivalence and eliciting their intrinsic reasons for change is the core of motivational interviewing and is most effective during pre-contemplation and contemplation stages.

A patient with opioid use disorder is pregnant. Which treatment planning decision is MOST supported by evidence?

Answer: Initiate methadone or buprenorphine maintenance therapy

Methadone and buprenorphine maintenance are the evidence-based standards of care for opioid use disorder in pregnancy, reducing maternal relapse and improving neonatal outcomes.

When planning treatment for a patient with co-occurring PTSD and alcohol use disorder, which sequencing approach is currently recommended?

Answer: Integrate treatment for both conditions concurrently

Concurrent integrated treatment of co-occurring PTSD and AUD produces better outcomes than sequential approaches, as each condition reinforces the other.

A treatment plan includes extended-release naltrexone for alcohol use disorder. Which patient factor would be a contraindication to initiating this medication?

Answer: Active opioid dependence or recent opioid use

Naltrexone is an opioid antagonist and will precipitate acute withdrawal in patients with current opioid dependence; patients must be opioid-free for 7–10 days before initiation.