CASAC Pharmacology and Medication-Assisted Treatment 2

Question 1

What is the mechanism by which naloxone (Narcan) reverses an opioid overdose?

Accepted Answer

It competitively displaces opioids from mu-opioid receptors, rapidly reversing respiratory depression without producing any opioid effects of its own

Answer

It metabolizes the opioid in the bloodstream

Answer

It stimulates the heart to counteract the opioid's effects

Answer

It increases the body's natural endorphin production

Question 2

Which medication used in the treatment of alcohol use disorder reduces drinking by modulating the opioid system to decrease the rewarding effects of alcohol?

Accepted Answer

Naltrexone

Answer

Disulfiram

Answer

Acamprosate

Answer

Topiramate

Question 3

A client prescribed buprenorphine/naloxone (Suboxone) asks why naloxone is included in the formulation. What is the correct explanation?

Accepted Answer

Naloxone is included as an abuse deterrent — it is poorly absorbed sublingually (the intended route) but if the medication is injected, naloxone becomes active and precipitates withdrawal, discouraging misuse

Answer

Naloxone is the active ingredient that treats the addiction

Answer

Naloxone enhances the effects of buprenorphine

Answer

Naloxone is included to treat potential allergic reactions

Question 4

What is the rationale for using methadone maintenance treatment (MMT) rather than medically supervised withdrawal alone for opioid use disorder?

Accepted Answer

Research consistently shows that maintenance treatment produces better long-term outcomes than withdrawal alone, including reduced illicit drug use, reduced overdose deaths, reduced criminal activity, and improved retention in treatment

Answer

Methadone maintenance is cheaper than withdrawal management

Answer

There is no clinical rationale; withdrawal alone is always preferable

Answer

Methadone maintenance is only used for patients who refuse other treatments

Question 5

Which of the following is a significant pharmacological concern when prescribing medications for substance use disorders in a client who is pregnant?

Accepted Answer

Medication selection must weigh the risks of the medication against the risks of untreated addiction, with specific considerations including teratogenicity, neonatal withdrawal, and breastfeeding compatibility

Answer

Pregnant clients should never receive any medication for SUD

Answer

Pregnancy has no effect on medication decisions for SUD

Answer

Only herbal supplements should be used during pregnancy

Question 6

What pharmacological class does gabapentin belong to, and why is it increasingly used (off-label) in substance abuse treatment?

Accepted Answer

It is an anticonvulsant/neuropathic pain medication used off-label for alcohol use disorder because it reduces anxiety, insomnia, and cravings while having a generally favorable safety profile compared to benzodiazepines

Answer

It is an opioid used for pain management only

Answer

It is a benzodiazepine used for anxiety

Answer

It is an antidepressant used for depression during recovery