Detox Co-occurring Disorders in Detox 2 — Questions and Answers
Question 1: A patient in opioid detox discloses suicidal ideation. What is the FIRST priority action?
- Note it in the chart and reassess next shift
- Immediately conduct a suicide risk assessment and implement a safety plan (Correct answer)
- Discharge the patient to a psychiatric facility immediately
- Administer a sedative to calm the patient
Correct answer: Immediately conduct a suicide risk assessment and implement a safety plan
Suicidal ideation requires immediate formal risk assessment and safety planning to determine the appropriate level of intervention.
Question 2: Which medication used for opioid use disorder also has evidence for treating co-occurring depression?
- Naloxone
- Naltrexone
- Buprenorphine (Correct answer)
- Methadone
Correct answer: Buprenorphine
Buprenorphine has demonstrated antidepressant properties in clinical studies, making it particularly useful for opioid use disorder patients with co-occurring depression.
Question 3: Post-traumatic stress disorder (PTSD) is particularly common in patients seeking detox for which substances?
- Caffeine and nicotine
- Opioids and alcohol (Correct answer)
- Cannabis only
- Inhalants and hallucinogens
Correct answer: Opioids and alcohol
PTSD frequently co-occurs with alcohol and opioid use disorders, as these substances are often used to self-medicate trauma-related symptoms.
Question 4: What is the primary reason antidepressants are generally not started during the acute detox phase?
- They interact with all detox medications
- Mood disturbances during acute withdrawal may resolve with abstinence, avoiding unnecessary medication (Correct answer)
- They are too expensive to use in detox settings
- Antidepressants require months to work so starting is pointless
Correct answer: Mood disturbances during acute withdrawal may resolve with abstinence, avoiding unnecessary medication
Many depressive symptoms during acute detox are withdrawal-related and may resolve spontaneously, so new antidepressants are typically deferred for psychiatric evaluation post-stabilization.
Question 5: Integrated dual diagnosis treatment addresses co-occurring disorders by:
- Treating mental health before starting addiction treatment
- Treating addiction first, then mental health sequentially
- Simultaneously addressing both substance use and psychiatric disorders in one treatment plan (Correct answer)
- Referring the patient to separate programs for each condition
Correct answer: Simultaneously addressing both substance use and psychiatric disorders in one treatment plan
Integrated treatment addresses both substance use and psychiatric disorders concurrently within one coordinated plan, producing better outcomes than sequential treatment.
Question 6: Attention-deficit/hyperactivity disorder (ADHD) increases the risk of substance use disorder primarily because:
- ADHD medications are inherently addictive
- Impulsivity and self-medication of inattention with stimulants or alcohol increases risk (Correct answer)
- ADHD reduces the brain's tolerance to substances
- ADHD patients lack access to addiction treatment
Correct answer: Impulsivity and self-medication of inattention with stimulants or alcohol increases risk
The impulsivity inherent to ADHD and the tendency to self-medicate attention symptoms with substances significantly elevates substance use disorder risk.
Detox Co-occurring Disorders in Detox 2
A patient in opioid detox discloses suicidal ideation.
What is the FIRST priority action?