Spring 02: Racism, Bias, Opioids

Question 1

Racial Justice equals (diversity/equity/equality).

Answer 1

Equity

Question 2

Disparity equals (inequity/inequality) and implies that there are (similarities/differences) between (individuals/population groups).

Answer 2

Inequality;
Differences;
Either individuals or groups

Question 3

T/F: Infant mortality is higher among AA non-smokers than among White smokers.

Answer 3

True

Question 4

T/F: being perceived as white is associated with better health, even within same educational level.

Answer 4

True

Question 5

Institutional racism is (micro/macro) racism.

Answer 5

Macro

Question 6

Interpersonal racism is (micro/macro) racism.

Answer 6

Micro

Question 7

T/F: inequity is synonymous with inequality.

Answer 7

False

Question 8

T/F: inequity is synonymous with disparity.

Answer 8

False

Question 9

T/F: inequity is a synonym of injustice and unfairness, which is qualitative in nature.

Answer 9

True

Question 10

Implicit bias is defined as the (X) that affect our (Y) in (conscious/unconscious) manner.

Answer 10

X = attitudes/stereotypes
Y = understanding, actions, decisions

Unconscious

Question 11

T/F: implicit bias can only be negative.

Answer 11

False - positive or negative

Question 12

T/F: everyone is susceptible to implicit bias.

Answer 12

True

Question 13

T/F: implicit biases produce behavior that may diverge from someone’s endorses principles and beliefs.

Answer 13

True

Question 14

List three things that can be responsible for our implicit biases.

Answer 14

1. Experiences influence perception
2. Media/societal structure
3. Limited interactions with certain groups/people

Question 15

We are more likely to rely on unconscious processes when we are (X).

Answer 15

X = stressed (high cognitive load, lack of sleep, etc)

Question 16

List some situations in health care that can be affected by implicit bias (and have been in the past).

Answer 16

1. Referrals
2. Pain med prescriptions
3. Providing treatment
4. Effectiveness of communication
5. Influence on diagnoses/expectations and outcomes

Question 17

T/F: microaggression if often intentional

Answer 17

False

Question 18

T/F: microaggression is directed at minority or non dominant group

Answer 18

True

Question 19

T/F: microaggression often consciously but subtly reinforces a stereotype

Answer 19

False - subtle, unintentional

Question 20

List three key things we can do to fight implicit bias.

Answer 20

1. Educate yourself (about history, present, and your unconscious beliefs)
2. Take action (I.e. Interact more with groups, change your perspective)
3. Be accountable

Question 21

Death from (cars/guns/drugs) has risen drastically, so that it is now the leading cause among those three causes.

Answer 21

Drugs (overdose)

Question 22

T/F: MA is among the lower half of states in terms of drug overdose deaths.

Answer 22

False - toward the top

Question 23

T/F: number of overdose deaths in MA continues to rise.

Answer 23

True

Question 24

T/F: Opioid deaths typically involve other drugs present as well.

Answer 24

True

Question 25

One reason for surge in opioids overdose is a transition to (X) drugs from opioids.

Answer 25

X = heroin and illicitly-made fentanyl

Question 26

One strategy to address opioids use is prescription "take back" event in which:

Answer 26

Unwanted prescription drugs can be deposited

Question 27

While all other countries have drop in all-cause mortality (ages 45-54), US has overall rise in recent years. What do we attribute this to?

Answer 27

Substance abuse/addiction

Question 28

T/F: All US states have seen an increase/surge in rate of drug overdose between 2010 and 2015.

Answer 28

True

Question 29

(X) drug, which is (natural/synthetic) and was not around in 2010, is really driving the deaths via opioids.

Answer 29

X = fentanyl | Synthetic

Question 30

Opioid deaths are usually (single/poly) substance.

Answer 30

Polysubstance

Question 31

T/F: In MA, prescription opioids are relatively low contributor, compared to other drugs, to opioid deaths.

Answer 31

True

Question 32

T/F: In all states, prescription opioids are relatively low contributor, compared to other drugs, to opioid deaths.

Answer 32

False - not all states

Question 33

One reason for surge in opioids overdose is the more erratic and deadly (X) drug supply.

Answer 33

X = heroin

Question 34

The (X) has come out with opioid prescription guidelines for chronic pain.

Answer 34

X = CDC

Question 35

The CDC recommends to avoid prescribing opioids and (X) drugs when (Y).

Answer 35

``` X = benzodiazepines Y = whenever possible ```

Question 36

CDC recommends re-evaluating chronic opioid treatment within (X) days/weeks/months of starting and then at least every (Y) days/weeks/months.

Answer 36

``` X = 1-4 weeks Y = 3 months ```

Question 37

Baltimore has shown that (increasing/decreasing) (X) has greatly decreased overdose deaths.

Answer 37

Increasing; | X = opioid agonist treatment

Question 38

A study in Norway showed that people on waiting list for (X) treatment are (Y) times more likely to die of overdose than people on (X) treatment.

Answer 38

``` X = opioid agonist Y = 4 ```

Question 39

What are examples of drugs used for opioid agonist treatment?

Answer 39

1. Buprenorphine | 2. Methadone

Question 40

The initial (acute) reason most people misuse opioids.

Answer 40

The high/euphoria

Question 41

The subsequent (chronic) reason most people misuse opioids.

Answer 41

Avoid withdrawal (to feel normal)

Question 42

List the four goals of medication treatment for opioid use disorder.

Answer 42

1. Relief of withdrawal 2. Opioid block 3. Reduce opioid craving 4. Restore reward pathway

Question 43

Opioid detox outcomes: (low/high) rate of retention in treatment.

Answer 43

Low

Question 44

Opioid detox outcomes: (low/high) rate of relapse. About (X)% abstinent at 6 months and about (Y)% abstinent at 12 months.

Answer 44

High; X = 50 Y = 15

Question 45

(Methadone/Buprenorphine) is a full agonist of opioids. (Methadone/Buprenorphine) is a partial agonist.

Answer 45

Methadone; Buprenorphine

Question 46

(X) is a pure opioid antagonist.

Answer 46

X = naloxone

Question 47

T/F: One strategy to address opioid overdose is having supervised injection facilities.

Answer 47

True

Question 48

An individual, over time, begins to believe what's said about his race. This is describing (X) level of racism.

Answer 48

X = internalized

Question 49

Microaggression is a(n) (X) level of racism.

Answer 49

X = interpersonal

Question 50

Less funding for school with students of color is a(n) (X) level of racism.

Answer 50

X = institutional

Question 51

Inequalities in power, access, and opportunities are examples of (X) level of racism.

Answer 51

X = structural

Question 52

(X) Act in (Y) year had major impact on substance abuse sentencing laws. It primarily targeted (Z) communities.

Answer 52

``` X = Anti-Drug Y = 1986 Z = black ```

Question 53

Anti-drug Act disproportionately criminalized (X) communities in which way?

Answer 53

X = black If you have a 500 grams cocaine (trafficking) you go to jail for the same time as 5 grams of crack cocaine (personal use)

Question 54

Marijuana use data shows that (blacks/whites) use it more.

Answer 54

Nearly equal

Question 55

Marijuana arrest data shows that (blacks/whites) arrested more.

Answer 55

Blacks, by nearly 10-fold difference

Question 56

Blacks arrested for marijuana use spend (more/less/equal) jail time as whites arrested for same reason.

Answer 56

More (20x longer)

Question 57

T/F: Rate of death increases significantly upon release of prison.

Answer 57

True

Question 58

Rate of death is almost (X) times (higher/lower) than the general population in the 2 weeks following release from prison.

Answer 58

X = 13 | Higher

Question 59

Rate of death following incarceration is almost (X) times (higher/lower) than the general population throughout life.

Answer 59

X = 3 | Higher

Question 60

Two main reasons for death after release from prison.

Answer 60

1. Overdose | 2. Heart disease

Question 61

T/F: Prisoners don't have health insurance.

Answer 61

False

Question 62

After release from prison, most people are (insured/uninsured) via:

Answer 62

Either medicare or uninsured

Question 63

For every year you spend in prison, your life expectancy drops by (X) years.

Answer 63

X = 2

Question 64

It costs (X) per year to incarcerate a prisoner.

Answer 64

X = 20,000

Question 65

In "million dollar blocks", there are (many/few) people that are regularly (X), so lots of money ends up going into (Y).

Answer 65

Many; X = arrested/incarcerated Y = incarcerating these blocks

Question 66

Individuals with HIV that are released from prison have significant (rise/decline) in continuing antiretroviral drugs. This leads to (X) phenomenon.

Answer 66

Decline; | X = viral rebound

Question 67

Lifetime risk of black gay men getting HIV is (X).

Answer 67

X = 1 in 2

Question 68

In mid 1980s-1990s (X) was the biggest killer of black men. Around 1995, (Y) was the big game-changer that saved many lives.

Answer 68

``` X = HIV Y = Combination therapy (as standard treatment) ```

Question 69

T/F: Combination therapy was drastic help for all communities equally.

Answer 69

False - help for all communities, but especially communities of color

Question 70

Since 1970s, the gap in life expectancy between races/genders has (increased/decreased).

Answer 70

Decreased by 1/3

Question 71

(X) is essential in combating health care disparities in minority communities.

Answer 71

X = public awareness

Question 72

The (X) Act of 2010 brought arrest disparity down from (Y) ratio to (Z) ratio.

Answer 72

``` X = Fair Sentencing Y = 100:1 Z = 18:1 ```