Addiction Medicine Certification Addiction Medicine Recovery & Relapse Prevention 2 — Questions and Answers
Question 1: Which cognitive-behavioral therapy technique is specifically designed to help patients identify high-risk situations for relapse?
- Functional analysis (Correct answer)
- Systematic desensitization
- Flooding
- Aversion therapy
Correct answer: Functional analysis
Functional analysis identifies the antecedents, behaviors, and consequences that precede substance use, helping patients recognize high-risk situations.
Question 2: A patient in recovery reports experiencing anhedonia, fatigue, and strong cravings six weeks after stopping cocaine use. This presentation is most consistent with:
- Post-acute withdrawal syndrome (PAWS) (Correct answer)
- Major depressive disorder
- Acute withdrawal
- Adjustment disorder
Correct answer: Post-acute withdrawal syndrome (PAWS)
PAWS is characterized by prolonged symptoms including anhedonia, fatigue, and cravings lasting weeks to months after acute withdrawal resolves.
Question 3: According to Marlatt's relapse prevention model, which factor is considered the most proximal trigger for relapse?
- High-risk situation
- Negative emotional state
- Abstinence violation effect (Correct answer)
- Decreased self-efficacy
Correct answer: Abstinence violation effect
The abstinence violation effect — guilt and cognitive dissonance after a lapse — is the most proximal factor leading from a lapse to full relapse in Marlatt's model.
Question 4: Which pharmacological agent is FDA-approved for preventing relapse specifically in alcohol use disorder by reducing craving through glutamate modulation?
- Acamprosate (Correct answer)
- Naltrexone
- Disulfiram
- Topiramate
Correct answer: Acamprosate
Acamprosate reduces glutamate hyperactivity during protracted abstinence, decreasing craving and supporting relapse prevention in alcohol use disorder.
Question 5: In the Transtheoretical Model, a patient who acknowledges a substance use problem and intends to change within the next 6 months is in which stage?
- Contemplation (Correct answer)
- Preparation
- Action
- Pre-contemplation
Correct answer: Contemplation
Contemplation is defined by awareness of a problem and intention to change within 6 months but without commitment to immediate action.
Question 6: A patient with opioid use disorder on buprenorphine maintenance reports a relapse after losing their job. Which intervention is MOST appropriate at this point?
- Continue buprenorphine and address psychosocial stressors (Correct answer)
- Discontinue buprenorphine and refer to detox
- Increase buprenorphine dose immediately without assessment
- Switch to methadone without further evaluation
Correct answer: Continue buprenorphine and address psychosocial stressors
Relapse during MOUD does not indicate treatment failure; continuing medication while addressing the underlying psychosocial trigger is the evidence-based response.
Question 7: Which self-help recovery program uses a secular, evidence-based approach and teaches rational emotive behavior therapy principles rather than spiritual steps?
- SMART Recovery (Correct answer)
- Narcotics Anonymous
- Celebrate Recovery
- LifeRing Secular Recovery
Correct answer: SMART Recovery
SMART Recovery (Self-Management and Recovery Training) uses rational emotive behavior therapy and motivational techniques instead of the 12-step spiritual model.
Addiction Medicine Certification Addiction Medicine Recovery & Relapse Prevention 2
Which cognitive-behavioral therapy technique is specifically designed to help patients identify high-risk situations for relapse?