Uppers Downers All Arounders: Chapter 4

T or F Allodynia is a painful response to a normally pain-free stimulus, often as a result of long-term opiate/opoid use.

ANSWER: True p. 4.14

Why is it dangerous to combine an opioid with a downer like alcohol, barbiturates, or benzodiazepines? A. because the combination of depressants increases the potential for respiratory depression, overdose, and death B. because it is a combination of licit and illicit drugs C. because they increase heart rate and respiration and can cause a heart attack D. because they increase the potential of the user's becoming chemically dependent

ANSWER: A. Combination use of downers results in additive and synergistic depressant effects. Pages 4.25, 4.38, 4.44

One of the symptoms of chronic opiate use is itchy skin. A. true B. false

ANSWER: A. True Page 4.18

Z-hypnotics like Sonata, Ambien, and Imovane, are short-acting, but they are thought to have a higher risk of addiction than most benzodiazepines. A. true B. false

ANSWER: B. False. Page 4.42

Which of the following statements are true about the way opioids affect the brain's neurochemistry? #1. Opioids act like endorphins. #2. Opioids can block substance P. #3. Opioids block dopamine to prevent pain. #4. Opioids only limit physical pain. A. statements 1 and 2 only B. statement 2 only C. statement 4 only D. statements 1, 2, and 3 only

ANSWER: A. statements 1 and 2 only. Pages 4.2, 4.13

In addition to alcohol and opioids, other depressant drugs include which of the following? #1. over-the-counter and look-alike downers, including antihistamines #2. skeletal muscle relaxants #3. sedative-hypnotics, including benzodiazepines #4. anabolic steroids A. drugs 1, 3, and 4 only B. drugs 1, 2, and 3 only C. drugs 2, 3, and 4 only D. drugs 1, 2, 3, and 4

ANSWER: B. Pages 4.2

The synergistic effect of drugs refers to A. the hallucinations produced by psychedelics B. the combination of two or more depressant drugs, which magnifies their effect on the CNS C. the canceling effect that occurs when you take two or more drugs (e.g., one upper and one downer) D. the length of time a drug is detectable in urine

ANSWER: B. The combination of two or more depressant drugs, which magnifies their effect on the CNS. Pages 4.25, 4.44

Which of the following statements about opioids is true? A. Alcohol can help counteract the stimulant effects of opioids. B. There is almost no limit to the level of opioid tolerance a human can develop. C. Opioid use is self-limiting. D. Synthetic opiate prescription drugs, such as OxyContin, are not addictive.

ANSWER: B. Tolerance to opiates/opioids develops rapidly, with users being able to tolerate great amounts within just a few days. Page 4.19

Which of the following statements is true regarding the activation of the dopaminergic reward/control system? #1. It prevents the development of addictive behavior. #2. It releases a surge of pleasure that encourages repetition of behaviors intended primarily for survival. #3. It is largely responsible for drives to have sex, eat, and drink (water as well as alcohol). #4. It is activated by dopamine. A. statements 1, 3, and 4 only B. statements 2 and 3 only C. statements 2, 3, and 4 only D. statements 1 and 2 only

ANSWER: C. Page 4.17

Withdrawal from opiates produces symptoms that are the opposite of the drug's effects. Considering this fact, which of the following symptoms would be expected from opiate withdrawal? #1. bone, joint, and muscular pain #2. insomnia and anxiety #3. high blood pressure, rapid pulse, and tachycardia #4. pinpoint pupils A. symptoms 1, 3, and 4 only B. symptoms 2 and 3 only C. symptoms 1, 2, and 3 only D. symptoms 1 and 2 only

ANSWER: C. Page 4.20

Of the following semi-synthetic/synthetic opiate drugs, which is not a correct match with the trade pharmaceutical name listed after it? A. oxycodone | Percodan, Percocet B. oxycodone | OxyContin C. diacetylmorphine | Suboxone D. hydrocodone | Vicodin

ANSWER: C. Suboxone is a combination of buprenorphine and naloxone. Pages 4.30

Which of the following statements concerning cross-tolerance of and cross-dependence on drugs are true? #1. As tolerance to a depressant drug develops, the user also develops tolerance to other downers. #2. As tissue dependence on a depressant drug develops, the user also develops dependence on other drugs in its same chemical family. #3. As tolerance to a drug develops, the user can also develop tolerance to other drugs he actually uses from different chemical families. #4. As tissue dependence on a drug develops, the user can also develop dependence on other drugs in a different chemical family. A. statements 1, 3, and 4 only B. statements 1, 2, and 3 only C. statements 2, 3, and 4 only D. statements 1, 2, 3, and 4

ANSWER: D. Page 4.44

Naltrexone is prescribed for which of the following uses? #1. to break the cycle of addiction to opioids and prevent relapse #2. to break the addiction to alcohol and reduce alcoholic cravings #3. to break the cycle of cocaine addiction and reduce cravings for cocaine #4. to support smoking cessation and break nicotine addiction A. uses 1, 3, and 4 only B. uses 1, 2, and 3 only C. uses 2, 3, and 4 only D. uses 1, 2, 3, and 4

ANSWER: D. Pages 4.32-4.33

Treatment for addiction to opiates, including synthetics and semi-synthetics, is most successful when which of the following are included? #1. physical detoxification #2. psychological correction #3. medication/replacement therapy #4. participation in a recovery community A. treatments 1, 3, and 4 only B. treatments 1, 2, and 3 only C. treatments 2, 3, and 4 only D. treatments 1, 2, 3, and 4

ANSWER: D. The combination of all four of these factors is considered the most successful means of sustained recovery for addiction to opiates. Pages 4.25, 4.30

Human beings have naturally occurring (endogenous) opioids, which cause many of the same effects as those caused by taking opioid drugs (exogenous opioids). A. true B. false

ANSWER: A. True Page 4.12-4.13

Acute withdrawal from heroin is not as life-threatening as acute withdrawal from alcohol or sedative-hypnotics. A. true B. false

ANSWER: A. True Page 4.20

Death from depressants (e.g. opioids) overdose usually involves severe respiratory depression. A. true B. false

ANSWER: A. True. Severe respiratory depression is the major cause of depressant drug overdose death. P. 4.21

Heroin and morphine are considered long-acting opioids. A. true B. false

ANSWER: A. false. Page 4.20

Which of the following drugs is an opioid antagonist that may be used to prevent an opioid overdose? A. naloxone B. tramadol C. amphetamine D. methamphetamine

ANSWER: A. naloxone. Page 4.7

How long can withdrawal symptoms following detoxification and abstinence from long-acting opioids such as methadone persist? A. for a few hours B. for the first 24 to 48 hours after detoxification C. for 14 days or more after detoxification D. for three to six months or longer after detoxification

ANSWER: C. for 14 days or more after detoxificaiton Page 4.20