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

Naloxone is a competitive opioid antagonist that binds to mu-opioid receptors with higher affinity than most opioids, rapidly displacing them and reversing respiratory depression.

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

Naltrexone reduces alcohol's rewarding effects by blocking mu-opioid receptors, which mediate part of alcohol's pleasurable reinforcement through endogenous opioid release.

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 added as a tamper-resistant measure: when taken sublingually as directed, naloxone has minimal effect, but if injected, it precipitates withdrawal, deterring intravenous misuse.

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

Evidence overwhelmingly supports maintenance treatment over withdrawal-only approaches, with maintenance producing significantly better outcomes across multiple domains.

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

Medication decisions in pregnant clients with SUD require careful risk-benefit analysis considering teratogenicity, neonatal effects, and the significant risks of untreated addiction to both mother and fetus.

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC - Credentialed Alcoholism and Substance Abuse Counselor Practice Test

CASAC Pharmacology and Medication-Assisted Treatment 2