Lesson 8

Question 1

MAT

Answer 1

Medication Assisted Treatment for opioid use disorders; barriers include stigma, access to prescription and hesitancy from providers who don’t feel confident prescribing

Question 2

Why does buprenorphine contain traces of naloxone?

Answer 2

Deter patients from dissolving and injecting it to get high

Question 3

COWS Score

Answer 3

Calculate the severity of opioid withdrawal

Question 4

Micro MAT Induction

Answer 4

Avoid precipitated withdrawal from bumping them from fully agonized to partially agonized state. Start on tiny doses that slowly kick drug from receptor w/o inducing withdrawal.

Question 5

Macro MAT Induction

Answer 5

8 mg all at once, useful when someone is in a severe state of withdrawal already, such as following an overdose treated w/ Narcan

Question 6

Xylazine

Answer 6

Contaminated fentanyl supply. Originally developed as hypotensive, now used as horse tranq. Not an opioid, can’t be reversed by Narcan.

Causes sedation and CNS depression, worsens hypoxia, causes skin wounds, prolongs effects of fentanyl.

Question 7

Tianeptine

Answer 7

“Gas station heroin”, antidepressant approved for major depressive disorder. Sold in gas stations as ZaZa and Tianna Red.

May also act on opioid receptors, should still administer Narcan.

Question 8

Ibogaine

Answer 8

Natural hallucinogenic, partial opioid agonist. Schedule 1 controlled substance.

Question 9

Nitazenes

Answer 9

Synthetic opioids with high potency and increased risk of overdose. Treat with Narcan.

Question 10

Kratom

Answer 10

Sold as dietary supplement. Acts on opioid, dopamine and serotonin receptors. Can be stimulant or relaxant.

Question 11

Medetomidine

Answer 11

Alpha-2 agonist that causes sedation, hypotension, hypoxia, hypothermia, diuresis. Increased effects when combined with other CNS depressants.

Found contaminating fentanyl supply. Used in ER and ICU for things like alcohol withdrawal when minor sedation is needed.

Question 12

Harm Reduction

Answer 12

Mitigating the danger of activities, alternative to abstinence only

Question 13

Continuum of Substance Use

Answer 13

Can fall anywhere between non-use and chaotic use, with regular use in the middle (not problematic if not impacting everyday life)

Question 14

Transtheoretical Model of Behavioral Change

Answer 14

Precontemplation –> Contemplation –> Preparation –> Action –> Maintenance –> Relapse

Upward spiral = learn from each relapse

Question 15

Principles of Harm Reduction

Answer 15

1. Participant centered services
2. Participant involvement
3. Participant autonomy
4. Pragmatism and realism
5. Culturally informed
6. Health and dignity

Question 16

Harm Reduction Strategies for Opioid Use

Answer 16

Safer drug use; overdose prevention; syringe exchange programs; MAT

Future = safe consumption sites, safer supply