Distinguishing Addiction and Dependence Disorders
7. Answer B. Urine toxicology is essential because various drugs of abuse
can induce various psychopathology, and all psychiatric diagnoses are
made by exclusion. A 12-lead EKG will not provide insight into the
presenting signs and symptoms but may guide medication selection. A
complete blood count will not help explain the presenting symptoms, and
any findings will require further investigation. The liver profile results
will not explain the current symptom presentation but may raise the index
of suspicion for further investigation.
Distinguishing Addiction and Dependence Disorders
Revised Text with Enhanced Transition Words
- Answer A. Evaluating for substance use disorder requires a comprehensive assessment of both the current level and the history of use. In addition, Suboxone should not be prescribed until the patient is in opioid withdrawal; otherwise, there is a risk of precipitated withdrawal. Furthermore, psychoeducation should be founded on the findings from the initial evaluation, which must occur first. Therefore, before referring a patient for any therapy, it is imperative to thoroughly understand the extent of the problem.
- Answer C. Naltrexone 380 mg IM offers the most effective option for addressing medication nonadherence and enhancing harm reduction. Conversely, oral agents, which the patient may choose to use at his discretion due to his history of nonadherence, are significantly less likely to be effective. Moreover, beginning methadone maintenance requires a high degree of adherence from the patient, making it a more complex option.
- Answer B. It is crucial to assess coping strategies prior to prescribing any treatment. Additionally, the patient should undergo a thorough assessment that takes into account the various risk factors for relapse. Only after this comprehensive evaluation can optimal relapse prevention strategies be effectively prescribed.
- Answer D. It is essential to recognize that stimulants of the central nervous system do not induce psychomotor retardation or memory impairment. In contrast, substances such as alcohol, opioids, and cannabis exhibit central nervous system depressant properties, which can lead to symptoms including inattention, dysphoria, disinhibition, cognitive impairment, and psychomotor retardation.
Distinguishing Addiction and Dependence Disorders
12. Answer A. Amphetamines stimulate the central nervous system and can
cause restlessness, agitation, grandiosity, aggressive behavior, and
emotional lability. Opioids, cannabinoids, and ketamine induce euphoric
feelings and blunting of affect.
13. Answer A. C-spine stabilization and head imaging are of paramount
importance in this intoxicated man who was involved in a motor vehicle
collision. Intoxication reduces his reliability as a historian and can impair
his pain sensation. Physiological needs and safety take priority over other
psychosocial needs. APA