16 hour, MAT waiver content Exam 2023 Graded A+
1. Dopamine release leads to subjective feelings of : pleasure, reward
2. Why would addiction be considered a disease?: Dz= a disorder of structure
or function that produces specific signs or symptoms
Addiction has defined causes (genetics, environment) and observable conse-
quences (behavioral, biological)
underlying change in brain circuits may persist beyond detoxification, particularly
in individuals with severe disorders. (varies with drugs and intensity of use. Am-
phetamine may take a year of abstinence to regain brain dopamine functionality)
3. Should buprenorphine be prescribed from Emergency rooms?: Twice as
likely to follow-up for addiction treatment vs referral alone
4. What studies support group/social interactions in recovery?: Skinner box
with rats: they use more drugs when caged than when in group
65% of vietnam soldiers that were addicted in vietnam did not use opioids on return
to USA.
5. physical exam should always include: looking for injection site marks
-pupils
-bowel sounds
-neuro exam
6. lab tests at OUD evaluation: HCV, HIV, LFTs, pregnancy test, urine drug
screening
7. Most common formulation of methadone: liquid concentrate or powder used
in OTPs
-tablets MC outside of OTPs
8. define detox program and goal: narcotic drug is dispensed in decreasing dos-
es, not exceeding one hundred and eighty days, "to alleviate adverse physiological
or psychological effects incident to withdrawal from the continuous or sustained
, 16 hour, MAT waiver content Exam 2023 Graded A+
use of a narcotic drug," with the ultimate goal of bringing a patient to a narcotic
drug-free state
9. What did CARA (Comprehensive Addiction and Recovery Act) 2016 ac-
complish?: CARA temporarily expands the types of practitioners who may dis-
pense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treat-
ment or detoxification treatment without being separately registered as a narcotic
treatment program. Whereas prior to the CARA, only qualified physicians were
permitted to dispense narcotic drugs in this manner, the CARA now temporarily
permits certain nurse practitioners and physician assistants to qualify to do so.
10. Timing of buprenorphine induction: Pt should be in mild to moderate with-
drawal at time of induction. Use COWS assessment (Clinical Opiate Withdrawal
Scale)
-COWS e 8 , 11 or 12 not unreasonable
-COWS< 8 ok if UDS is neg and no self-reported opioid use in past 3 days
-Write Buprenorphine prescription ahead of time so pt can bring it to office and
avoid prior-authorization issues
11. How many mg can pt get on day 1 of buprenorphine induction?: 12 mg
12. how long is induction phase with buprenorphine/naloxone ?: 1-3 days
13. addiction: a chronic, relapsing brain disease that is characterized by compul-
sive drug seeking and use, despite harmful consequences
14. Why is addiciton considered a brain dz?: Drugs change the brain, they
change its structure and how it works. Those brain changes can be long lasting
and lead to many harmful, often self-destructive, behaviors
15. brain areas affected: amygdala: emotional responses
nucleus accumbens: reward center
cortex: our understanding of drug
16. denial vs. lying: denial: your perception is off and you act in accordance with
your perception
lying: you know something is wrong and fabricate story to clear you of guilt
17. DSM criteria for SUD: 1. Loss of control
2. Physiological changes
1. Dopamine release leads to subjective feelings of : pleasure, reward
2. Why would addiction be considered a disease?: Dz= a disorder of structure
or function that produces specific signs or symptoms
Addiction has defined causes (genetics, environment) and observable conse-
quences (behavioral, biological)
underlying change in brain circuits may persist beyond detoxification, particularly
in individuals with severe disorders. (varies with drugs and intensity of use. Am-
phetamine may take a year of abstinence to regain brain dopamine functionality)
3. Should buprenorphine be prescribed from Emergency rooms?: Twice as
likely to follow-up for addiction treatment vs referral alone
4. What studies support group/social interactions in recovery?: Skinner box
with rats: they use more drugs when caged than when in group
65% of vietnam soldiers that were addicted in vietnam did not use opioids on return
to USA.
5. physical exam should always include: looking for injection site marks
-pupils
-bowel sounds
-neuro exam
6. lab tests at OUD evaluation: HCV, HIV, LFTs, pregnancy test, urine drug
screening
7. Most common formulation of methadone: liquid concentrate or powder used
in OTPs
-tablets MC outside of OTPs
8. define detox program and goal: narcotic drug is dispensed in decreasing dos-
es, not exceeding one hundred and eighty days, "to alleviate adverse physiological
or psychological effects incident to withdrawal from the continuous or sustained
, 16 hour, MAT waiver content Exam 2023 Graded A+
use of a narcotic drug," with the ultimate goal of bringing a patient to a narcotic
drug-free state
9. What did CARA (Comprehensive Addiction and Recovery Act) 2016 ac-
complish?: CARA temporarily expands the types of practitioners who may dis-
pense a narcotic drug in Schedule III, IV, or V for the purpose of maintenance treat-
ment or detoxification treatment without being separately registered as a narcotic
treatment program. Whereas prior to the CARA, only qualified physicians were
permitted to dispense narcotic drugs in this manner, the CARA now temporarily
permits certain nurse practitioners and physician assistants to qualify to do so.
10. Timing of buprenorphine induction: Pt should be in mild to moderate with-
drawal at time of induction. Use COWS assessment (Clinical Opiate Withdrawal
Scale)
-COWS e 8 , 11 or 12 not unreasonable
-COWS< 8 ok if UDS is neg and no self-reported opioid use in past 3 days
-Write Buprenorphine prescription ahead of time so pt can bring it to office and
avoid prior-authorization issues
11. How many mg can pt get on day 1 of buprenorphine induction?: 12 mg
12. how long is induction phase with buprenorphine/naloxone ?: 1-3 days
13. addiction: a chronic, relapsing brain disease that is characterized by compul-
sive drug seeking and use, despite harmful consequences
14. Why is addiciton considered a brain dz?: Drugs change the brain, they
change its structure and how it works. Those brain changes can be long lasting
and lead to many harmful, often self-destructive, behaviors
15. brain areas affected: amygdala: emotional responses
nucleus accumbens: reward center
cortex: our understanding of drug
16. denial vs. lying: denial: your perception is off and you act in accordance with
your perception
lying: you know something is wrong and fabricate story to clear you of guilt
17. DSM criteria for SUD: 1. Loss of control
2. Physiological changes
