Detox Substance Withdrawal Management 2 — Questions and Answers
Question 1: Which medication is used to reduce alcohol craving and maintain abstinence after medical detox is complete?
- Naltrexone (Vivitrol) (Correct answer)
- Diazepam
- Buprenorphine
- Clonidine
Correct answer: Naltrexone (Vivitrol)
Naltrexone blocks opioid receptors involved in alcohol reward, reducing craving and relapse rates in post-detox abstinence maintenance.
Question 2: What characterizes nicotine withdrawal according to US clinical guidelines?
- Irritability, anxiety, difficulty concentrating, and strong cravings within 24 hours of cessation (Correct answer)
- Severe vomiting and tremors
- Hallucinations and paranoia
- Cardiac arrhythmias requiring hospitalization
Correct answer: Irritability, anxiety, difficulty concentrating, and strong cravings within 24 hours of cessation
Nicotine withdrawal symptoms are primarily psychological and cognitive, appearing within hours and peaking in the first 3 days.
Question 3: What is the purpose of 'comfort medications' (e.g., anti-nausea agents) in opioid withdrawal management?
- To relieve distressing but non-life-threatening symptoms, improving patient comfort and treatment retention (Correct answer)
- To directly block opioid receptors
- To prevent seizures from opioid withdrawal
- To replace opioid medications permanently
Correct answer: To relieve distressing but non-life-threatening symptoms, improving patient comfort and treatment retention
Adjunct comfort medications address nausea, diarrhea, and muscle cramps in opioid withdrawal, reducing suffering and improving program completion rates.
Question 4: Which phenomenon causes a person tolerant to one CNS depressant to also be tolerant to others?
- Cross-tolerance (Correct answer)
- Physical dependence
- Neuroadaptation
- Polydrug synergy
Correct answer: Cross-tolerance
Cross-tolerance occurs when tolerance to one CNS depressant (e.g., alcohol) confers tolerance to pharmacologically similar drugs (e.g., benzodiazepines) through shared receptor mechanisms.
Question 5: What is the first-line pharmacotherapy for nicotine dependence recommended in US clinical guidelines?
- Nicotine replacement therapy (NRT) or varenicline (Correct answer)
- Opioid agonist therapy
- Benzodiazepines
- Antipsychotics
Correct answer: Nicotine replacement therapy (NRT) or varenicline
NRT (patch, gum, lozenge) and varenicline (Chantix) are first-line evidence-based treatments for nicotine cessation per USPHS guidelines.
Question 6: What brain neurotransmitter system is most dysregulated in opioid withdrawal, causing the physical symptoms?
- Norepinephrine (locus coeruleus hyperactivation) (Correct answer)
- Serotonin depletion
- Dopamine excess
- GABA upregulation
Correct answer: Norepinephrine (locus coeruleus hyperactivation)
Opioid withdrawal is driven by locus coeruleus hyperactivation and massive norepinephrine release, causing the sympathetic storm of withdrawal symptoms.
Detox Substance Withdrawal Management 2
Which medication is used to reduce alcohol craving and maintain abstinence after medical detox is complete?