Ethical, Legal, & Regulatory Considerations in Addiction Medicine Flashcards
7 cards from real ADM practice questions. Tap to flip, then mark Knew It or Still Learning — missed cards come back until you master them.
Read the first 7 Ethical, Legal, & Regulatory Considerations in Addiction Medicine flashcards as text
A state legislature passes a law requiring physicians to report all patients in methadone maintenance treatment to a state registry. This law most likely conflicts with:
Answer: 42 CFR Part 2 federal confidentiality regulations
42 CFR Part 2 provides strict federal confidentiality protections for SUD treatment records that generally preempt conflicting state laws requiring broader disclosure.
An addiction medicine specialist is asked to serve as an expert witness for the prosecution in a drug trafficking case involving a former patient. The most significant ethical concern is:
Answer: Dual relationship conflict and potential breach of former patient confidentiality
Serving as a prosecution witness against a former patient creates a dual relationship conflict and risks unauthorized disclosure of treatment information obtained in a confidential therapeutic context.
The SUPPORT for Patients and Communities Act (2018) changed prescribing rules for buprenorphine by:
Answer: Allowing nurse practitioners and physician assistants to obtain waivers to prescribe buprenorphine for OUD
The SUPPORT Act extended DATA 2000 waiver authority to nurse practitioners and physician assistants, expanding the prescriber workforce for buprenorphine treatment of OUD.
A patient with severe alcohol use disorder who lacks decision-making capacity is brought to the ED. No advance directive exists and no family is available. The physician's ethical framework for treatment decisions should rely on:
Answer: The best interest standard given the absence of known preferences
When a patient's prior preferences are unknown and no surrogate is available, the best interest standard guides treatment decisions toward what a reasonable person in that situation would want.
Mandatory reporting of suspected child abuse discovered during a confidential addiction treatment session is best described as:
Answer: Required by state child abuse reporting laws, which generally supersede SUD confidentiality protections in this specific context
State mandatory child abuse reporting laws typically override 42 CFR Part 2 protections, as confirmed by federal guidance indicating child abuse reporting is an exception to SUD confidentiality rules.
Which ethical concept is most relevant when an addiction medicine physician continues to prescribe opioids to a patient with OUD who demands them, despite clinical evidence that the patient is not benefiting and may be harmed?
Answer: Non-maleficence requires the physician to reconsider treatment despite patient demand
Non-maleficence — the obligation to avoid causing harm — takes priority when treatment is causing harm; clinicians are not obligated to provide requested treatments that are not clinically indicated.
Under the Consolidated Appropriations Act of 2023, the X-waiver requirement to prescribe buprenorphine for OUD was eliminated, meaning that now:
Answer: Any licensed practitioner with DEA Schedule III authority may prescribe buprenorphine for OUD without a separate waiver
Elimination of the X-waiver means any DEA-registered practitioner with authority to prescribe Schedule III controlled substances may prescribe buprenorphine for OUD, subject to state law and patient limits.