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1. Consideration of opioid therapy beyond _____ days requires reevaluation and discussion with patients of risks and benefits.
A. 30
B. 60
C. 90
D. 180
2. Risks for opioid use disorder start at any dose and increase in a dose dependent manner.
A. True
B. False
3. Prescribing long-acting opioids is recommended against:
A. For acute pain
B. As an as-needed medication
C. On initiation of long-term opioid therapy
D. All of the above
4. All of the following are absolute contraindications to initiating opioid therapy for chronic pain, except for:
A. Co-occurring medical or mental health conditions that increase risk
B. Life-threatening allergy to opioids
C. Active SUD
D. Elevated suicide risk
5. Which of the following may indicate need for more frequent follow-up?
A. Non-adherence to comprehensive pain care plan such as attendance at appointments.
B. Unexpected UDT and PDMP results.
C. Non-adherence to opioid prescription.
D. All of the above.
6. The best treatments for chronic pain are non-drug treatments such as psychological therapies and rehabilitation therapies and non-opioid medications.
A. True
B. False
7. In 2009, drug overdose became the second leading cause of injury-related death in the U.S., surpassed only by traffic accidents.
A. True
B. False
8. In a survey of patients prescribed opioids for chronic non-cancer pain and their family members, 34% of patients reported that they used the medication:
A. Because they thought they were “addicted” or “dependent” on opioid pain medication.
B. For “fun” or to “get high.”
C. Both (A) and (B).
D. None of the above.
9. OT has a limited role, primarily in the treatment of:
A. Severe acute pain
B. Post-operative pain
C. End-of-life pain
D. All of the above
10. Pain is all of the following, except for:
A. An unpleasant sensory and emotional experience associated with actual or potential tissue damage, or described in terms of such damage.
B. Always objective.
C. Always unpleasant and therefore an emotional experience.
D. Pain is all of the above.
11. Chronic pain is:
A. Often associated with changes in the central nervous system known as central sensitization.
B. Pain lasting 30 days or more.
C. Thought to involve primarily nociceptive processing areas in the central nervous system.
D. All of the above.
12. In the 2000s, the majority of people entering treatment for heroin use used prescription opioids as their first opioid.
A. True
B. False
13. All of the following are more likely to continue using opioids, except for:
A. Those with schizophrenia and bipolar diagnoses
B. Those 50 - 65 years of age
C. Those who are married
D. Those on higher doses of opioids
14. Which risk factors have the greatest impact for development of opioid-related adverse events?
A. Severe respiratory instability and sleep disordered breathing
B. Duration and dose of OT
C. Acute psychiatric instability and intermediate to high acute suicide risk
D. History of drug overdose and pain conditions worsened by opioids
15. A history of _____ is significantly associated with opioid-related toxicity / overdose and LOT has been associated with worsening symptoms.
A. Depression
B. PTSD
C. Suicidal behavior
D. All of the above
16. A history of overdose is a red flag and providers should proceed with utmost caution when considering LOT for these patients.
A. True
B. False
17. Which of the following combinations is dangerous?
A. Opioids with benzodiazepines
B. Fentanyl with CYP3A4 inhibitors
C. Methadone with drugs that can prolong the QT interval
D. All of the above
18. Which of the following is a sign of medication diversion?
A. A negative UDT for the prescribed opioids
B. Frequent requests for early refills
C. Atypically large quantities required to control pain
D. All of the above
19. For patients with an OUD, sudden discontinuation of opioids due to suspected diversion may place them at high risk for illicit opioid use and resulting opioid overdose.
A. True
B. False
20. LOT is an effective treatment modality for patients with migraine headaches, tension-type headaches, occipital neuralgia, and myofascial pain.
A. True
B. False
21. The itching that is caused by morphine’s release of histamine indicates the beginning stages of an allergic reaction and administration of morphine should be immediately stopped.
A. True
B. False
22. Generally, allergy to one opioid means the patient is allergic to other opioids.
A. True
B. False
23. Which of the following is a universal approach that should be used in the management of care for the patient regardless of the location from which that patient is transferred?
A. Each new patient should be provided with a full evaluation.
B. Previous medical records should be reviewed to determine what diagnostic and therapeutic options have already been tried.
C. It should be determined what the patient knows about current concerns related to OT and how comfortable he or she is with an approach that will be addressing opioid safety along with an integrated whole person approach to pain.
D. All of the above.
24. Until full record review and communication with the previous prescriber are completed, there are significant risks of taking over opioid prescribing unless it is with intent to taper.
A. True
B. False
25. The Stratification Tool for Opioid Risk Mitigation does which of the following?
A. It incorporates co-occurring medical and mental health conditions, SUD, opioid dose, co-prescribed sedatives, and information about prior adverse events and generates estimates of patients’ risk or hypothetical risk when considering initiation of opioid therapy.
B. It quantifies risk for poisoning or suicide-related events and for drug-related events, accidents, falls, and drug-induced conditions over a three-year window.
C. It provides suggestions as to what alternative treatments have not been tried and what risk mitigation strategies need to be applied.
D. All of the above.
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