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Self-Assessment Questions


Substance Dependence: Review Questions

Shannon C. Miller, MD, CMRO

Dr. Miller is an Assistant Professor, Department of Psychiatry, Wright State University School of Medicine, Dayton, OH, and Uniformed Services University School of Medicine, Bethesda, MD; and the Residency Training Director, General Psychiatry, Wright-Patterson Air Force Base, OH.

Choose the single best answer for each question.

Questions 1 and 2 refer to the following case study.

An 18-year-old woman comes to the primary care clinic with her mother because of rapid onset of muscle aches, diarrhea, sweating, and a runny nose. The mother thinks that her daughter has influenza and reports that her daughter’s last menstrual period occurred the previous week. The patient is noticed yawning often because of self-reported insomnia; the mother says that the patient has not been sleeping well since becoming ill. Results of a urine drug screen are positive for 6-monoacetylmorphine; results of a confirmation test are still pending. The patient clarifies that she received a prescription 3 days ago for oxycodone and acetaminophen because of a badly sprained ankle.

1. Which of the following is the most likely diagnosis for this patient?
  1. Food poisoning
  2. Heroin addiction/dependence
  3. Influenza
  4. Pregnancy
  5. Prescription medicine withdrawal
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2. Which of the following is the single best approach in this patient’s treatment?
  1. Provide detoxification with clonidine
  2. Provide detoxification with lorazepam
  3. Provide detoxification with methadone
  4. Provide detoxification with naltrexone
  5. Do not detoxify; refer patient for opiate agonist therapy instead
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3. During a primary care visit, a 45-year-old man reports smoking 2 packs of cigarettes daily for the past 20 years. When asked if he is interested in quitting, he states, “I know it’s a problem, and I’d like to do something about it—but not now, maybe in 6 months or so. It would just be too hard right now.” Which of the following stages of change is he experiencing?

  1. Precontemplation
  2. Contemplation
  3. Preparation
  4. Action
  5. Termination
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