Treatment Modalities and Interventions Flashcards

A patient with opioid use disorder is being considered for medication-assisted treatment. Which medication requires a DEA waiver (X-waiver) for outpatient prescribing by physicians?

Answer: Buprenorphine/naloxone

Buprenorphine for OUD treatment in outpatient settings historically required a DEA X-waiver, though regulations have evolved; methadone for OUD must be dispensed through opioid treatment programs.

When using motivational interviewing, a nurse reflects back a patient's ambivalence by saying 'So on one hand you want to quit drinking, but on the other, alcohol helps you cope with stress.' This technique is called:

Answer: Double-sided reflection

A double-sided reflection explicitly acknowledges both sides of ambivalence, helping the patient hear their own conflicting statements.

A patient in early alcohol withdrawal presents with tremors, diaphoresis, and anxiety. Which pharmacological agent is the gold standard for managing alcohol withdrawal symptoms?

Answer: Benzodiazepines

Benzodiazepines are the gold standard for alcohol withdrawal due to their cross-tolerance with alcohol at GABA receptors, preventing seizures and delirium tremens.

Which psychosocial intervention uses a structured 12-step philosophy and emphasizes peer support and spiritual growth as components of recovery?

Answer: Alcoholics Anonymous facilitation therapy

Twelve-step facilitation therapy is based on the AA philosophy and actively engages patients in 12-step community programs emphasizing peer support and spirituality.

A nurse is implementing contingency management for a patient with stimulant use disorder. The core mechanism of this intervention is:

Answer: Using vouchers or prizes to reinforce abstinence

Contingency management uses operant conditioning—rewarding verified abstinence with vouchers or prizes—to reinforce drug-free behavior.

Extended-release naltrexone (Vivitrol) is appropriate for a patient who:

Answer: Has completed opioid detoxification and is opioid-free

Naltrexone must only be initiated after full opioid detoxification to avoid precipitated withdrawal; patients must be opioid-free for 7–10 days before starting.

Which level of care on the ASAM continuum involves medically managed intensive inpatient services (Level 4)?

Answer: Hospital-based programs with 24-hour physician availability

ASAM Level 4 is medically managed intensive inpatient treatment, requiring 24-hour physician-directed care in a hospital or equivalent setting.