CADC Infectious Diseases and Medical Complications of Substance Use — Questions and Answers
Question 1: Which bloodborne infection is the most prevalent among people who inject drugs?
- Hepatitis C (Correct answer)
- Hepatitis A
- Influenza
- Lyme disease
Correct answer: Hepatitis C
Hepatitis C is spread efficiently through shared needles and other injection equipment and is the most common bloodborne infection among people who inject drugs. Testing and linkage to curative antiviral treatment are important parts of care.
Question 2: Research on syringe services programs (SSPs) shows that they:
- Increase drug use among participants
- Reduce HIV and HCV transmission without increasing illegal drug use (Correct answer)
- Have no effect on disease transmission
- Replace the need for any treatment referral
Correct answer: Reduce HIV and HCV transmission without increasing illegal drug use
Syringe services programs are an evidence-based harm-reduction strategy that lowers HIV and hepatitis C transmission, and they often connect participants with treatment, testing, and other services, without increasing drug use.
Question 3: Which screening is routinely recommended for clients entering congregate residential substance use treatment settings?
- Tuberculosis screening (Correct answer)
- Cholesterol screening
- Bone density scan
- Vision screening
Correct answer: Tuberculosis screening
TB spreads more easily in congregate settings, and people with substance use disorders and HIV have higher risk. Programs typically screen with symptom review plus a tuberculin skin test or IGRA blood test.
Question 4: A client with long-term heavy alcohol use presents with confusion, unsteady gait, and abnormal eye movements. Which deficiency is most likely involved?
- Vitamin C
- Iron
- Thiamine (vitamin B1) (Correct answer)
- Vitamin D
Correct answer: Thiamine (vitamin B1)
The triad of confusion, ataxia, and ophthalmoplegia suggests Wernicke's encephalopathy, caused by thiamine deficiency in chronic alcohol use. It is a medical emergency treated with thiamine, and it can progress to Korsakoff syndrome.
Question 5: Daily oral pre-exposure prophylaxis (PrEP) is used to:
- Cure existing HIV infection
- Reduce the risk of acquiring HIV in people who are HIV-negative (Correct answer)
- Treat hepatitis C
- Reduce cravings for opioids
Correct answer: Reduce the risk of acquiring HIV in people who are HIV-negative
PrEP is a medication regimen taken by HIV-negative people at risk of exposure that substantially lowers the risk of HIV infection when taken consistently. Counselors can support awareness, referral, and adherence.
Question 6: A client discloses sharing needles and asks about testing. What is the most appropriate counselor response?
- Refuse to discuss it until the client stops using
- Provide nonjudgmental education on risk reduction and refer for HIV and hepatitis testing and care (Correct answer)
- Tell the client's employer
- Advise the client to wait until symptoms appear
Correct answer: Provide nonjudgmental education on risk reduction and refer for HIV and hepatitis testing and care
Counselors should offer nonjudgmental, accurate information on risk reduction and make timely referrals for testing, vaccination, and treatment, while protecting the client's confidentiality under applicable laws such as 42 CFR Part 2.
