Addiction Treatment Modalities & Therapeutic Approaches Flashcards

Extended-release naltrexone (Vivitrol) for opioid use disorder offers which key clinical advantage over daily oral naltrexone?

Answer: Improved adherence due to monthly injection eliminating daily pill burden

Monthly injectable naltrexone removes the need for daily adherence decisions, substantially improving treatment compliance compared to oral formulations.

The Community Reinforcement Approach (CRA) for addiction treatment is primarily based on which theoretical framework?

Answer: Operant behavioral principles that identify and restructure environmental contingencies

CRA uses operant conditioning principles to rearrange social and environmental reinforcers so that a sober lifestyle becomes more rewarding than substance use.

A patient with severe alcohol use disorder presents during medically supervised withdrawal. Which benzodiazepine property is most important when selecting an agent for withdrawal management in a patient with advanced liver disease?

Answer: Minimal hepatic metabolism (e.g., oxazepam, lorazepam)

Oxazepam and lorazepam undergo direct glucuronidation rather than extensive hepatic oxidative metabolism, making them safer in patients with severe liver disease.

Which statement best describes the role of Twelve-Step Facilitation (TSF) therapy in addiction treatment?

Answer: It is a structured clinical intervention designed to promote engagement with AA/NA and acceptance of addiction

TSF is a manualized clinical approach that encourages patients to accept their addiction, engage in step work, and actively participate in 12-step mutual-help programs.

For a patient with co-occurring opioid use disorder and chronic pain, which treatment strategy is generally recommended?

Answer: Treat both conditions simultaneously, often with buprenorphine which provides analgesia while treating OUD

Buprenorphine is an ideal option for co-occurring OUD and chronic pain because it provides analgesia while simultaneously treating addiction, supporting integrated care.

Dialectical Behavior Therapy (DBT) adapted for substance use disorders emphasizes which core skill set as particularly relevant to addiction?

Answer: Distress tolerance and emotion regulation to cope with urges without using substances

DBT's distress tolerance and emotion regulation modules help patients manage intense negative emotions and urges that commonly trigger substance use without resorting to substances.

In medication-assisted treatment for OUD, which finding from the X:BOT trial is clinically significant?

Answer: Both buprenorphine and extended-release naltrexone were similarly effective once treatment was initiated, but naltrexone had a higher induction failure rate

The X:BOT trial found comparable outcomes for buprenorphine and extended-release naltrexone once patients were successfully inducted, but the naltrexone arm had significantly more induction failures due to the requirement for prior opioid abstinence.