Massachusetts Medical Society: Question 1

Question 1

 

Question:

 

Ms. Smith is a 32 yo woman with a past medical history significant for opioid use disorder and hepatitis C who presents for evaluation. She has had prior episodes of recovery and feels she has benefited from use of naltrexone IM injections. She has, however, relapsed many times and after her most recent relapse and she would like to discuss other options.

She is concerned that taking buprenorphine would not represent “true recovery,” because “it is just replacing one drug for another.” You counsel her that for someone with opioid use disorder as she does, taking buprenorphine is a form of ________________, due to the changes in her brain. The buprenorphine would allow her to function normally with reduced cravings for opioids and without euphoria. This is in contrast to ________________, in which individuals exhibit ongoing use of a substance despite ongoing adverse consequences resulting from that use.

 

 

 

 

Answers

Answer:

Addiction, dependence
 

 

Correct Answer? 

 

Explanation:


 

 

Answers

Answer:

Substance use disorder, addiction
 

 

Correct Answer? 

 

Explanation:

 

Answers

Answer:

Dependence, addiction
 

 

Correct Answer? 

 

Explanation:

Addiction and dependence are separate and distinct conditions that are often poorly understood by patients and clinicians alike. Stigma and misinformation may prevent patients from considering buprenorphine as a therapeutic option. It is important to counsel patients clearly and carefully about how the medications work and what all of their options are for treatment. According to the American Society of Addiction Medicine, “Addiction is a primary, chronic disease of brain reward, motivation, memory and related circuitry. Dysfunction in these circuits leads to characteristic biological, psychological, social and spiritual manifestations. This is reflected in an individual pathologically pursuing reward and/or relief by substance use and other behaviors. Addiction is characterized by inability to consistently abstain, impairment in behavioral control, craving, diminished recognition of significant problems with one’s behaviors and interpersonal relationships, and a dysfunctional emotional response.” Dependence refers to the state of needing a certain drug in order to function normally. When the drug is taken away, the person experiences distressing symptoms of withdrawal.

 

Citation: Ballantyne JC, Sullivan MD, Kolodny A. Opioid Dependence vs Addiction: A Distinction Without a Difference?. Arch Intern Med. 2012;172(17):1342–1343. PMID: 22892799

 

 

Answers

Answer:

Addiction, tolerance
 

 

Correct Answer? 

 

Explanation:

 

 

Format:

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