Post Test - Stimulant Abuse Treatment
Text: Treatment for Stimulant Use Disorders
Treatment Improvement Protocol (TIP) Series 33
By: Richard Rawson, PhD.
Copyright © 2001 by:
Institute of Addiction Awareness
24881 Alicia Pkwy., #E-519
Laguna Hills, CA 92653
949-643-3802
A. RECOMMENDATONS - STIMULANT USE DISORDER
01. The Consensus Panel recommended _____________________ for treating stimulant users.
a. a 12 step approach
b. a cognitive-behavioral approach
c. a contingency management approach
d. all of the above
02. Initial assessments should be complete, thorough and repeated by various members of the treatment team to verify accuracy of information.
a. True
b. False
03. The Consensus Panel recommended treatment for:
a. 21 days.
b. 90 days.
c. 12 to 24 weeks.
d. 12 to 24 months.
04. The focus of the initial treatment engagement (1 to 2 weeks) is:
a. establishing structure and support.
b. achievement of abstinence.
c. both a. and b. above
d. none of the above
05. The lethal dose (LD50) of cocaine is __________ for 50 percent of novice users.
a. 0.5 grams
b. 1.0 grams
c. 1.5 grams
d. 2.0 grams
06. Which medication is given for calming an agitated client?
a. Intravenous diazepam or other benzodiazepine.
b. The antidepressant trazodone (Desyrel).
c. Diphenhydramine (Benadryl).
d. Fast-acting benzodiazepines such as lorazepam (Ativan) or diazepam (Valium).
07. Which medication is useful for the treatment of seizures?
a. Intravenous diazepam or other benzodiazepine.
b. The antidepressant trazodone (Desyrel).
c. Diphenhydramine (Benadryl).
d. Fast-acting benzodiazepines such as lorazepam (Ativan) or diazepam (Valium).
08. Which medication is useful for continuing agitation and persistent inability to fall asleep during withdrawal?
a. Intravenous diazepam or other benzodiazepine.
b. The antidepressant trazodone (Desyrel).
c. Diphenhydramine (Benadryl).
d. Fast-acting benzodiazepines such as lorazepam (Ativan) or diazepam (Valium).
09. Which medication can be used for its sedating properties?
a. Intravenous diazepam or other benzodiazepine.
b. The antidepressant trazodone (Desyrel).
c. Diphenhydramine (Benadryl).
d. Fast-acting benzodiazepines such as lorazepam (Ativan) or diazepam (Valium).
B. INTRODUCTION - STIMULANT USE DISORDER
10. People began to seek treatment for cocaine problems in what decade?
a. 1960s
b. 1970s
c. 1980s
d. 1990s
11. The cocaine epidemic peaked in what decade?
a. 1960s
b. 1970s
c. 1980s
d. 1990s
12. The cocaine epidemic began to decline in what decade?
a. 1960s
b. 1970s
c. 1980s
d. 1990s
13. Who extracted the pure, chemical, cocaine hydrochloride?
a. Timothy Leary
b. Alfred E. Neuman
c. Albert Niemann
d. Sigmund Freud
14. The original formula of Coca-Cola is believed to contain approximately how much cocaine per 100mL of fluid?
a. 2.5 mg
b. 5.0 mg
c. 0.25 grams
d. 0.50 grams
15. The smoking of base (coca paste) began where?
a. U.S.A.
b. Europe
c. South America
d. South Africa
16. Which cocaine preparation is most concentrated?
a. cocaine powder
b. coca paste
c. coca leaf
d. coca tea
17. At the peak of the cocaine epidemic in the mid-1980’s , a conservative estimate suggested how many Americans used cocaine regularly?
a. 1 million
b. 5 million
c. 8 million
d. 80 million
18. At the peak of the cocaine epidemic, what percentage of regular cocaine users had developed a serious cocaine dependence problem?
a. 3 to 5 percent
b. 5 to 8 percent
c. 15 to 18 percent
d. 18 to 50 percent
19. During World War II, which stimulant was used by soldiers to fight fatigue and enhance performance?
a. Dextroamphetamine (Dexadrine)
b. Methamphetamine (Methadrine)
c. both a. and b. above
d. none of the above
20. During the 1950s, truckers used which legally manufactured stimulant to stay awake on long hauls?
a. Dextroamphetamine (Dexadrine)
b. Methamphetamine (Methadrine)
c. both a. and b. above
d. none of the above
21. According to information available from the Drug Abuse Warning Network (DAWN), the estimated number of nationwide emergency room substance abuse related episodes involving MA has increased steadily since what year?
a. 1989
b. 1992
c. 1996
d. 1996
22. The ice form of MA first appeared in what area?
a. West Coast
b. Philippines
c. Hawaii
d. Seattle
23. The current use of cocaine/crack is:
a. increasing.
b. decreasing.
c. both a. and b. above
d. unknown
24. Particular problem groups for MA abuse are:
a. women, gay men and African-American males.
b. women, gay men and Asian-Pacific Islanders.
c. gay men, Asian-Pacific Islanders and African-Americans.
d. Asian-Pacific Islanders, African Americans and women.
25. The Comprehensive Methamphetamine Control Act was passed in what year?
a. 1990
b. 1992
c. 1994
d. 1996
C. HOW STIMULANTS AFFECT THE BRAIN AND BEHAVIOR
26. To date, investigators have identified as many as _____ risk factors for substance use and dependence.
a. 4
b. 16
c. 36
d. 72
27. Approximately ______________ different neurotransmitters have been identified in the human body.
a. 5 to 10
b. 10 to 50
c. 50 to 100
d. 100 to 500
28. The brain circuit that is considered essential to the neurological reinforcement system is called the:
a. Neurotransmitter dopamine.
b. Nucleus accumbens.
c. Ventral tegmental area.
d. Limbic reward system.
29. The use of cocaine and MA _________ the release of available dopamine in the brain.
a. increases
b. decreases
c. unknown
30. Studies have demonstrated that high doses of stimulants can have permanent neurotoxic effects by damaging neuron cell-endings in:
a. humans.
b. animals.
c. both a. and b. above
d. none of the above
31. ______________________________ have/has revealed subtle alterations in the dopamine receptors of stimulant users’ brains.
a. Magnetic resonance imaging (MRI)
b. Positron emission tomography (PET)
c. Electroencepalograms (EEGs)
d. none of the above
32. The pattern of frequently repeated dosing is known as:
a. bingeing.
b. tweaking.
c. both a. and b. above
d. none of the above
33. The major influence of cocaine on the dopamine system is its ability to:
a. directly stimulate the dopamine system.
b. block the synaptic reuptake of dopamine.
c. both a. and b. above
d. none of the above
34. Cocaine-induced cognitive deficits can last up to _____________ .
a. 3 months
b. 6 months
c. 4 years
d. lifelong
35. Numerous animal studies have demonstrated that MA can damage:
a. dopamine systems.
b. serotonin systems.
c. both a. and b. above
d. none of the above
D. APPROACHES TO TREATMENT
36. Almost all of the information about the use of psychsocial and pharmacological treatments for stimulant abuse has been gleaned from studies conducted with ________ users.
a. cocaine
b. MA
c. both a. and b. above
d. none of the above
37. Therapists working in the same clinic and using the same treatment approach:
a. have similar progress in their clients.
b. differ greatly in terms of the progress their clients make.
c. both a. and b. above
d. none of the above
38. Self-help participation in community reinforcement is:
a. mandatory.
b. often used as an effective means of developing a new social network.
c. both a. and b. above
d. none of the above
39. Empirical evidence for network psychotherapy is:
a. scarce.
b. available in the form of controlled trials.
c. none of the above
40. Controlled outcome studies have been reported supporting the efficacy of acupuncture for the treatment of cocaine or other stimulant use disorders.
a. True
b. False
41. The efficacy of long-term residential treatment for stimulant use disorders is strongly supported by empirical evidence.
a. True
b. False
42. ________________ have/has demonstrated reliable efficacy in reducing cocaine craving.
a. Fluoxetine (Prozac)
b. Maprotiline (Ludiomil)
c. both a. and b. above
d. none of the above
E. TREATMENT STRATEGIES
43. For treatment programs to effectively meet the needs of stimulant abusers, they must be viewed as:
a. patients.
b. clients.
c. customers.
d. helpless.
44. Craving has:
a. neurophysiological correlates.
b. biological underpinnings.
c. both a. and b. above
d. none of the above
45. In one site in Southern California, using the Matrix manual outpatient protocol, responses to outpatient treatment were __________ for MA and cocaine users.
a. widely varied
b. similar
c. identical
d. none of the above
46. The Matrix Centers clinics in Southern California found ________________ in “no shows” depending on who made the initial appointment.
a. a significant difference
b. no significant difference
c. none of the above
47. Research has shown that clients must be:
a. convinced of their powerlessness.
b. confronted with their denial.
c. welcomed and treated with respect.
d. all of the above
48. Confrontational strategies to break through denial:
a. are a requirement for a successful treatment.
b. may be dangerous with stimulant abusers.
c. both a. and b. above
d. none of the above
49. The most effective treatment format is:
a. individual therapy.
b. group therapy.
c. a collection of individual, group, didactic and conjoint sessions.
d. none of the above
50. Research has shown that:
a. substance treatment can have positive effects on marriage and relationships.
b. marital and relationship counseling can have positive effects on substance abuse treatment.
c. both a. and b. above
d. none of the above
51. Evidence from positron emission tomography (PET) scan research has provided tangible evidence in monkeys
that MA use produces very significant changes in brain functioning that last for more than:
a. 3 months.
b. 6 months.
c. 4 years.
d. 10 years.
52. Regarding alcohol/secondary substance use leading to stimulant relapse:
a. several studies have reported a relationship between alcohol use and cocaine relapse.
b. reports have supported a pattern of marijuana use for MA relapse.
c. both a. and b. above
d. none of the above
53. Returning to substance-abusing friends:
a. is associated with stimulant relapse.
b. is a primary reason for a stimulant users’ relapse.
c. is not associated with stimulant relapse.
d. none of the above
54. Sexual behavior associated with substance use is an important element contributing to stimulant relapse,
particularly for:
a. men.
b. women.
c. both a. and b. above
d. none of the above
55. Psychodynamic therapy should be initiated:
a. at time of admission.
b. when there is an explicit treatment need.
c. when psychodynamic factors are driving multiple relapses.
d. only after 12 months of abstinence.
F. MEDICAL ASPECTS OF STIMULANT USE DISORDERS
56. In a meta-analysis of 555 consecutive cocaine-related visits to hospital ERs, deaths occurred in ________
patients:
a. four
b. eight
c. sixteen
d. thirty-two
57. Chronic MA users may consume as much as ______ of the drug per day.
a. 10 grams
b. 15 grams
c. 25 grams
d. 50 grams
58. The lethal dose for MA:
a. is 30 mg.
b. is 400 mg.
c. is 500 mg.
d. has not been determined.
59. Most seized batches of MA have _________ purity.
a. 20 to 80 percent
b. 7 to 100 percent
c. 40 to 100 percent
d. 40 to 70 percent
60. Two outbreaks of poisoning in Oregon among intravenous MA users were caused by:
a. lead.
b. mannitol.
c. mercury.
d. quinine.
61. Binges typically last ____________ for cocaine users.
a. 12 to 18 hours
b. 2 to 3 days
c. both a. and b. above
d. 3 to 15 days
62. Binges typically last ____________ for MA users.
a. 12 to 18 hours
b. 2 to 3 days
c. both a. and b. above
d. 3 to 15 days
63. Anhedonia and dysphoria usually dissipate over a __________ week period for MA users.
a. 6 to 12
b. 6 to 18
c. 18 to 24
d. 24 to 36
64. Sensitization occurs when:
a. more of the drug is required to obtain the same effect.
b. less of the drug is required to obtain the same effect.
c. both a. and b. above
d. none of the above
65. In the management of a potentially lethal overdose, the drug ___________ may be used to treat _________.
a. naloxone (Narcan), respiratory depression
b. flumazenil (Romazicon), hyperthermia
c. dantrolene (Dantrium), hypothermia
d. dantrolene (Dantrium), hyperthermia
66. Phenothiazines (Thorazine, Mellaril) are useful for treating:
a. hyperthermia.
b. seizures.
c. chest pain.
d. none of the above
67. For the minority of cocaine users who do complain of withdrawal symptoms, the crash lasts ___________ and
withdrawal persists from __________ .
a. 12 to 24 hours, 2 to 10 days
b. 12 to 24 hours, 1 to 2 weeks
c. 3 to 4 days, 1 to 5 weeks
d. 3 to 4 days, 1 to 10 weeks
68. The symptoms that occur when a chronic MA user stops taking the drug begin _________ after binge use
is terminated and may persist for ____________ .
a. 12 to 24 hours, 2 to 10 days
b. 12 to 24 hours, 1 to 2 weeks
c. 3 to 4 days, 1 to 5 weeks
d. 3 to 4 days, 1 to 10 weeks
69. Stimulant withdrawal __________ life threatening and _____________ require pharmacological intervention.
a. is, does
b. is, does not
c. is not, does
d. is not, does not
70. The greatest risk from stimulant abstinence syndrome is:
a. cardiotoxicity.
b. toxic psychosis.
c. seizures (convulsions)
d. doing harm to self or others.
71. “Cocaine dreams” may occur as late as ___________ after termination of stimulant use.
a. 8 to 9 days
b. 8 to 9 weeks
c. 8 to 9 months
d. 8 to 9 years
72. Cocaine toxicity affects:
a. the cardiovascular system.
b. the brain.
c. the liver.
d. nearly every organ system.
73. Cardiotoxicity has been observed in:
a. cocaine users.
b. MA users.
c. both a. and b. above
d. none of the above
74. ___________________ deficiencies occur in prenatally stimulant-exposed childred.
a. Behavioral
b. Cognitive
c. both a. and b. above
d. none of the above
75. Original reports described a threshold dose for eliciting a psychotic response as chronic administration of ______________ amphetamine daily.
a. 50 mg
b. 500 mg
c. 5 grams
d. 50 grams
76. A major perceived problem associated with __________ is the potential for sudden and intense violence.
a. cocaine/ampetamine abuse
b. amphetamine/MA abuse
c. cocaine/ampetamine addiction
d. amphetamine/MA addiction
77. Cocaethylene is formed in the liver when __________ is used in combination with _________ .
a. cocaine,methamphetamine
b. cocaine, alcohol
c. methamphetamine, alcohol
d. none of the above
78. The incidence of broken hands after fighting seems to be particularly high for ________ users.
a. cocaine
b. MA
c. both a. and b. above
d. none of the above
79. Benzoylecgonine has been found in urine as late as ___________ after last cocaine intoxication.
a. 24 hours
b. 3 days
c. 7 days
d. 22 days
80. Before a differential diagnosis of a coexisting psychiatric disorder (dual diagnosis) can be made, the client must be abstinent for some period of time, at least:
a. 3 to 4 weeks.
b. 3 to 4 months.
c. 6 to 12 months.
d. 18 to 24 months.
G. TREATMENT ISSUES FOR SPECIAL GROUPS AND SETTINGS
81. Intravenous cocaine users (ICUs) have a(n) ______________ risk of HIV infection compared to other
intravenous drugs users (IDUs).
a. equal
b. greater
c. smaller
d. unknown
82. ______________________ might better explain the higher risk of HIV infection related to substance abuse
among men who have sex with men (MSMs).
a. Sex networks
b. Sexual mixing patterns
c. both a. and b. above
d. none of the above
83. One study has found that in the population of persons with adult AD/HD _______________ had co-occurring
substance abuse disorders, which were discovered when the clients entered treatment for AD/HD.
a. 3 percent
b. 5 percent
c. 9 percent
d. 40 percent
84. Self-report data indicate that ___________ of persons in the criminal justice system are substance-dependent.
a. 22 percent
b. 52 percent
c. 72 percent
d. 92 percent
85. In recent studies of MA use, the percentage of female MA users appears __________ with samples
of cocaine or heroin users.
a. less than
b. the same as
c. higher than
d. unknown
86. MA use among women is _______________ .
a. the same as for males
b. growing in numbers
c. none of the above
d. unknown
87. The drug MA may result in ___________ for women.
a. increased libido
b. loss of sexual desire and the ability to achieve orgasm
c. none of the above
d. unknown
88. National studies__________________ by adolescents.
a. show low usage rates of MA
b. show low usage rates of cocaine
c. both a. and b. above
d. none of the above
89. Psychosis in adolescents using ice:
a. often occurs quickly.
b. can be difficult to distingish with schizophrenia.
c. both a. and b. above
d. none of the above
90. Physical health issues other than anorexia and dental problems, ________________ as they are in the
population of adults who use stimulants.
a. are not as prevalent in the adolescent population
b. are equally prevalent in the adolescent population
c. are more prevalent in the adolescent population
d. unknown