Question 1

October 16, 2019

Question:

A 20-year-old female presents to you in urgent care experiencing nausea, vomiting, sweating, diffuse pain, irritability, and tremulousness. She reports that she has been using fentanyl intranasally daily for two months. Her last use was two days ago. She is seeking medication to help address her withdrawal symptoms and wants to initiate long-term pharmacotherapy for opioid use disorder.

Which of the following medications can be provided in a primary care setting, will address her withdrawal symptoms, and is evidence-based for the long-term treatment of opioid use disorder?

Answers

Answer:

Methadone

Correct Answer?

Explanation:

Answers

Answer:

Buprenorphine

Correct Answer?

Explanation:

Rationale: Buprenorphine can be provided in a primary care setting, will address her withdrawal symptoms, and is evidence-based for the treatment of opioid use disorder (choice B). As a partial opioid agonist, it binds to the mu-opioid receptor and relieves symptoms of withdrawal, as well as cravings for opioids. Buprenorphine not only manages symptoms of acute withdrawal, but is also an effective long-term treatment for opioid use disorder.
Methadone is a full opioid agonist and like buprenorphine, it is effective at managing acute opioid withdrawal and is also an effective long-term treatment for opioid use disorder. However, methadone cannot be prescribed for the treatment of opioid use disorder in the United States; it can only be dispensing in a qualified opioid treatment program (choice A).
Clonidine, an alpha-2-agonist, can reduce symptoms of opioid withdrawal, but is not an effective long-term treatment for opioid use disorder (choice C). Naloxone is an opioid antagonist used for overdose reversal, that should be offered to all individuals with opioid use disorder. It can be prescribed in primary care. However, it does not treat withdrawal and is not an effective treatment for opioid use disorder itself, only for opioid-related overdose (choice D).

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Answer: