Substance Abuse Among Older Adults Multiple Choice Identify the choice that best completes the statement or answers the question. ____ 1. Introduction To differentiate the severity of problems between an older drinker from a younger drinker the Panel recommends using which of the following terms: A. at-risk C. Both a and b B. problem drinkers D. Neither a or b ____ 2. People between the age of 40 and 65 consume more prescribed and over-the-counter medications than any other age group in the United States. A. True B. False ____ 3. The Consensus Panel recommends that older men consume no more than how many drinks per day? A. 0 C. 2 B. 1 D. 3 ____ 4. As opposed to Disulfirum, which is not recommended by the Consensus Panel as an effective pharmacotherapy for older patients, Naltrexone(ReVia) is preferred as it is better tolerated and may reduce relapses in older adults. A. True B. False ____ 5. According to the Panel, after a prolonged drinking episode, how long should signs of depression persist before antidepressant treatment is indicated? A. 1 week C. 1 month B. Several weeks D. 2 months ____ 6. Chapter 1 Disorders among the older population that mimic substance abuse and make diagnosis difficult could be: A. Diabetes C. Depression B. Dementia D. All of the above ____ 7. Several factors create barriers in the treatment of older substance abusing adults. These include: A. Ageism C. Clinician behavior B. Lack of Awareness D. All of the above ____ 8. Most older adults will readily accept a mental or psychiatric diagnosis, but not a medical diagnosis. A. True B. False ____ 9. Keeler and colleagues studied the effect of patient age and length of physician encounter. They found that the amount of time physicians spend with a patient: A. Decreases as the age of the patient increases B. Increases as the age of the patient decreases ____ 10. It is a common myth that older substance abusers do not benefit from treatment as much as younger patients. A. True B. False ____ 11. Women are prescribed and consume more psychoactive drugs than men, in particular: A. Barbiturates C. Enactogens B. Benzodiazepines D. Opiates ____ 12. This older minority population is considered at particularly high risk and more vulnerable to late-life drinking than previously thought. A. African-American C. Asian B. Hispanic D. Native-American ____ 13. Chapter 2 The primary substance of abuse among older adults is: A. Pain killers C. Alcohol B. Tobacco D. None of the above ____ 14. Which of the following age related changes significantly affect the way an older person responds to alcohol? A. Decrease in body water C. Slowing of metabolism B. Decreased tolerance D. All of the above ____ 15. This enzyme plays a key role in the metabolism of alcohol that occurs in the gastric mucosa. A. Acidophilus C. Salivary Amylase B. Alcohol dehydrogenase D. None of the above ____ 16. Due to age related physiological changes, alcohol consumption can exacerbate other serious problems among older adults. A. True B. False ____ 17. Alcohol use may have direct neurotoxic effects leading to a syndrome known as ARD, which stands for: A. Alcohol related death C. Alcohol related dementia B. Alzheimer’s related disease D. Anterograde related deficit ____ 18. In all cases studied, even small amounts of alcohol have been shown to be harmful. A. True B. False ____ 19. Two classic models of understanding alcohol problems, 1) the medical diagnostic model and 2) the at-risk, heavy, and problem drinking classification-include criteria adequate to diagnose many older adults with alcohol problems. A. True B. False ____ 20. Most clinicians rely on the conventional medical model defined in the DSM-IV for classifying the signs and symptoms of alcohol-related problems. A. True B. False ____ 21. To differentiate older drinkers, the Consensus Panel recommends using the terms at-risk and problem drinkers only. A. True B. False ____ 22. The NIAAA (National Institute on Alcohol Abuse and Alcoholism) recommends this guideline for low-risk drinking. A. No more than 2 drinks per week C. No more than 5 drinks per week B. No more than 1 drink per day D. None of the above ____ 23. Studies suggest three ways of categorizing problem drinking among older adults. The following is not one of those : A. early vs. late onset C. moderate drinking B. continuous versus intermittent D. binge drinking ____ 24. Early onset drinkers comprise the majority of older patients receiving treatment for alcohol abuse. A. True B. False ____ 25. Late onset alcoholism is often milder and more amenable to treatment than early onset drinking problems. A. True B. False ____ 26. In contrast to ongoing, continuous drinking, intermittent drinking refers to regular, perhaps daily heavy drinking that has: A. resumed after a stable period of abstinence C. resumed after a stable period of abstinence of 3 to 5 years or more. of 1 year or less B. resumed immediately following a treatment program D. None of the above ____ 27. Binge drinking is generally defined as: A. short periods of loss of control that alternate with longer periods of loss of control C. short periods of loss of control alternating with periods of abstinence and lighter periods of drinking B. short periods of abstinence with longer periods of loss of control D. None of the above ____ 28. A binge itself is defined as any drinking occasion in which an individual consumes more than: A. 2 or more standard drinks C. 4 or more standard drinks B. 3 or more standard drinks D. 5 or more standard drinks ____ 29. Studies suggest that oldermen more are much more likely than older women to have alcohol-related problems. A. True B. False ____ 30. Smokers require lower doses of benzodiazepines to achieve efficacy than do nonsmokers. A. True B. False ____ 31. Tobacco is the most common substance use disorder in the older adult. A. True B. False ____ 32. A recent study found that this combination of substances combine to create adverse drug reactions and is most common among older adults: A. Alcohol and nicotine C. Alcohol and over-the-counter medications B. Nicotine and psychoactive drugs D. Nicotine and caffeine ____ 33. Chapter 3 Adults can become physiologically dependent on psychoactive medications without meeting dependence criteria. A. True B. False ____ 34. The most consistently documented correlates of psychoactive prescription drug use are: A. Old age, home bound, and male gender C. Old age, poor physical health and female gender B. Poor physical health, male gender and social isolation D. Poor physical health, isolation and female gender ____ 35. Older women are nearly twice as likely as older men to develop a diagnosable anxiety disorder. A. True B. False ____ 36. Older patients with substance dependence disorders are less likely than younger drug addicts to have a dual diagnosis. A. True B. False ____ 37. Benzodiazepines have variable rates of absorption, with metabolism occurring primarily in the: A. Kidneys C. Stomach B. Liver D. Colon ____ 38. Most patients who withdraw from benzodiazepine use/abuse can maintain abstinence. A. True B. False ____ 39. Instead of relying on drugs as a first line approach, treatment should initially be directed toward any underlying disorder. A. True B. False ____ 40. Opioid withdrawal is considered life-threatening. A. True B. False ____ 41. Chapter 4 It is the recommendation of this Panel that every adult over the age of 60 be screened for alcohol and prescription drug abuse during his/her regular physical examination. A. True B. False ____ 42. Studies have shown the most common health problem among alcohol-dependent older adults is: A. Diabetes C. Alcoholic liver disease B. Cancer D. Sleep disorder ____ 43. The most common causes of dementia in older adults is: A. Alzheimer’s Disease C. Both a and b B. Vascular Dementia D. None of the above ____ 44. Delirium is an alteration of mental status that can be reversed with medical treatment. A. True B. False ____ 45. The Panel recommends this screening tool for use in general outpatient settings as a screen for depression among older patients. A. Geriatric Depression Scale C. Confusion Assessment Method B. Center for Epidemiological Studies Depression Scale D. Neurobehavioral Cognitive Status Examination ____ 46. Chapter 5 The Consensus Panel recommends the least intensive treatment options be explored first for the older adult patient. A. True B. False ____ 47. As a group, older adults tend to have a greater disdain for ‘drug addicts’ than the general population. A. True B. False ____ 48. Triage refers to: A. Organizing and prioritizing treatment service C. Patient matching B. Recommending placement for treatment D. All of the above ____ 49. The most commonly used patient placement criteria are found in the: A. DSM-IV C. CSAT B. ASAM-PPC-2 D. CAM Your Certificate of CEH’s ____ 1. Please choose one of the options below for receiving your certificate of CEH’s. A. United States Postal Service C. Fax B. E-mail License Type and # 1. We will need your mailing address or your Fax # if you chose either of these options for receiving your certificate of hours. 2. Please indicate your license type and #: For example: MFT#1234567 or CADC I #123456 Course Evaluation Please evaluate the course by choosing one of the responses below for each question. This data will help us to improve our program and meet certifying organization requirements. Thank you for allowing QUE to be your provider. A. Excellent C. Average B. Above Average D. Below Average ____ 1. 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