Key Insights on Substance Use
14. Answer C. The Clinical Opioid Withdrawal Scale (COWS) helps
quantify the symptoms of opioid withdrawal to guide symptom
management or Suboxone induction. The Clinical Institute Withdrawal
Assessment of Alcohol Scale-Revised (CIWA-Ar) is used for alcohol
withdrawal symptom assessment. The Minnesota Multiphasic Personality
Inventory (MMPI) is a personality assessment. The Hamilton Rating
Scale for Depression (HAM-D) screens for depression.
15. Answer B. A negative emotional state is the most significant predictor of
relapse. Outcome expectancy, ineffective coping skills, and previous
history of relapse can also predict relapse but to a lesser degree than a
negative emotional state.
Key Insights on Substance Use
16. Answer B. Acute intoxication is characterized by disinhibition,
emotional lability, inattention, and impulsivity. Withdrawal symptoms
include tremor, anxiety, hyperreflexia, diaphoresis, and autonomic
hyperactivity. Sobriety is the quality of being congruent in mood and
affect with good impulse control, and situationally appropriate responses.
Manic is a state of abnormally elevated arousal, affect, and energy often
with accompanying mood lability.
17. Answer D. A lapse is a brief pause in sobriety, which may or may not
lead to relapse. Relapse is a reactivation of the disease or return to a
behavior consistent with substance use disorder after a prolonged period
of sobriety. Withdrawal is a substance-specific cluster of signs and
symptoms that occur when reducing or stopping the consistent use of the
substance. Intoxication is a state of near poisoning, manifesting signs of
inebriation (disinhibition, impaired cognition, delayed neurological
response time).
18. Answer A. Alprazolam has an 11-hour half-life; medications with shorter
half-lives are more likely to cause withdrawal symptoms if dependence
develops. Diazepam, clonazepam, and chlordiazepoxide have half-lives
>20 hours and are less likely to manifest withdrawal symptoms.
19. Answer D. Chlordiazepoxide is metabolized in the liver by cytochrome
P-mediated oxidation. Temazepam, lorazepam, and oxazepam are
metabolized by conjugation. They are less dependent on global liver
function and are preferred in patients with liver disease. APA