NR546 Advanced Psychopharmacology Week 6: Test Your
Knowledge Quiz | (Latest 2026/2027 Update) Addiction
Medicine, MAT, Opioid Use Disorder, Alcohol Use Disorder,
Tobacco Use Disorder | Q&A | Grade A | 100% Correct
Verified Answers
Subject: Addiction Medicine – Opioid Use Disorder (MAT: Methadone, Buprenorphine, Naltrexone,
Naloxone, Clonidine); Alcohol Use Disorder (Naltrexone, Acamprosate, Disulfiram, Topiramate, Librium,
CIWA-Ar, Symptom-Triggered Benzodiazepine Dosing); Tobacco Use Disorder (Nicotine Replacement
– Gum, Lozenge, Patch, Nasal Spray, Inhaler; Bupropion Zyban; Varenicline Chantix); Neurobiology of
Addiction (Mesolimbic Dopamine Pathway, Genetics, Neuroanatomy, Tolerance, Dependence,
Withdrawal, Intoxication); Dual Diagnosis; Compulsivity vs Impulsivity (Cortico-Subcortical Circuits,
Ventral vs Dorsal Striatum); Endogenous Opioid System; Sedative Hypnotics; GHB; Hallucinogens
(5HT2A Agonists); Empathogens; OCD Treatment (SSRI first-line); "Bath Salts" (MDPV); Inhalants;
Stimulant Addiction (No approved treatments).
Source: NR546 Week 6 Quiz, Stahl's Essential Psychopharmacology, ASAM Guidelines.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
Addiction is often driven by the client's attempts to:
Correct Answer: Self-medicate an underlying mental health disorder (dual diagnosis).
1. Clients may use substances to alleviate distressing symptoms of anxiety, depression, PTSD, or
psychotic disorders. Up to 60% of adolescents in substance use treatment have another mental health
condition.
2. Common comorbidities: anxiety disorders, depression, bipolar disorder, psychotic illness, borderline
personality disorder, antisocial personality disorder.
Adverse effects associated with acute use of opioids (select all that apply)
Correct Answer: Itching, constipation, respiratory depression, urinary retention, sedation.
1. Opioid adverse effects: CNS depression, respiratory depression (life-threatening especially with
benzodiazepines, alcohol), constipation (most common), nausea/vomiting, pruritus, urinary retention,
miosis.
Morphine – prototype opioid agonist: indications, onset, duration
Correct Answer: Indicated for acute pain. Binds to opioid receptors in CNS, inhibiting ascending
pain pathways. Immediate release: variable absorption. IV onset 5-10 minutes, duration 3-5 hours.
Available as controlled release (MS Contin) and extended-release (Avinza). Produces CNS and
potentially life-threatening respiratory depression.
Fentanyl – characteristics
Correct Answer: Almost immediate onset IV, duration 0.5-1 hour. More potent than morphine (50-
100x), short duration. Preferred for those unable to tolerate morphine/hydromorphone and severe
hepatic/renal disease. Used in procedural sedation and general anesthesia. Conversion between
fentanyl products is NOT mcg for mcg.
, Methadone – clinical use and considerations
Correct Answer: Used in detoxification and maintenance treatment for opioid/heroin addiction.
Long-acting, occupies mu-opioid receptors, reduces craving, prevents withdrawal for 24 hours.
High abuse potential; only licensed opioid treatment programs or licensed inpatient hospital units
may dispense. Risk of life-threatening respiratory depression and QT prolongation. Equianalgesic
conversion individually variable (deaths reported). Requires wean to avoid withdrawal. Pregnancy:
risk/benefit necessary; fetal outcomes improved compared to illicit drug use, but may cause
decreased birth weight, length, head circumference.
Tramadol – unique features
Correct Answer: Opioid agonist that also blocks reuptake of serotonin and norepinephrine.
Indicated for acute pain, with added benefit for neuropathic and nociceptive pain. Lower risk of
constipation and dependence than other opioids, but has risk of serotonin syndrome.
Naloxone – use and limitations
Correct Answer: Pure antagonist for acute opioid overdose. IV reverses opioids, even in comatose
states. Available IM and intranasal. Short duration of action – patients can relapse into coma or
overdose; continued monitoring and potentially further doses or constant infusion needed.
Substance use disorder occurs when:
Correct Answer: The recurrent use of a substance causes clinically significant impairment,
including health problems, disability, or failure to meet responsibilities at home, work, or school.
Neurobiological factors contributing to substance use disorders: Genetics
Correct Answer: Between 40-60% of vulnerability may be attributed to genetic factors. Vulnerability
involves complex interactions between multiple genes and between genes and environment.
Specific genetic factors predispose to alcohol dependence and tobacco use. Epigenetic factors
influence whether genes associated with SUD are activated.
Neurobiological factors: Mesolimbic dopamine pathway
Correct Answer: Key pathway mediating reward. Connects ventral tegmental area (VTA) (dopamine-
producing) to ventral striatum/nucleus accumbens, amygdala, hippocampus, and prefrontal cortex.
Nucleus accumbens associated with motivation and reward. Conditions with impulsive/compulsive
behaviors (SUD, OCD, obesity) relate to inefficient processing in prefrontal cortex/striatal circuitry.
Tolerance, Dependence, Addiction, Withdrawal, Intoxication definitions
Correct Answer: Tolerance: decreased effect with repeated use; increasing doses required.
Dependence: adaptation so that physical symptoms occur when drug discontinued abruptly.
Addiction: change in behavior from biochemical changes, characterized by preoccupation and
repeated use despite negative outcomes. Withdrawal: physiological/psychological reactions when
substance stopped abruptly. Intoxication: changes in LOC, cognition, perception, judgment,
behavior after ingestion.
When assessing clients for substance use disorder, the PMHNP must ascertain:
Correct Answer: What substance the client is using; how much; how often; when last ingested.
Medication-Assisted Therapy (MAT) – definition and goals
Correct Answer: Clients use prescription medications as part of treatment plan for substance use
disorders. Substitutes drug of abuse with prescribed medication targeting same receptor. Goals:
improved survival, treatment retention, decreased illegal activity, increased quality of life, improved
birth outcomes, reduced HIV and Hep B/C infections.
Match MAT to client: Bernita – 64yo, heroin use 6 years, unemployed, no insurance. Needs daily
attendance.
Correct Answer: Methadone (full μ-receptor agonist, long half-life, prevents withdrawal 24 hours).
Only administered in federally regulated opioid treatment programs (OTPs). Requires daily
attendance first several months. Good for client with flexibility to attend daily meetings.
Knowledge Quiz | (Latest 2026/2027 Update) Addiction
Medicine, MAT, Opioid Use Disorder, Alcohol Use Disorder,
Tobacco Use Disorder | Q&A | Grade A | 100% Correct
Verified Answers
Subject: Addiction Medicine – Opioid Use Disorder (MAT: Methadone, Buprenorphine, Naltrexone,
Naloxone, Clonidine); Alcohol Use Disorder (Naltrexone, Acamprosate, Disulfiram, Topiramate, Librium,
CIWA-Ar, Symptom-Triggered Benzodiazepine Dosing); Tobacco Use Disorder (Nicotine Replacement
– Gum, Lozenge, Patch, Nasal Spray, Inhaler; Bupropion Zyban; Varenicline Chantix); Neurobiology of
Addiction (Mesolimbic Dopamine Pathway, Genetics, Neuroanatomy, Tolerance, Dependence,
Withdrawal, Intoxication); Dual Diagnosis; Compulsivity vs Impulsivity (Cortico-Subcortical Circuits,
Ventral vs Dorsal Striatum); Endogenous Opioid System; Sedative Hypnotics; GHB; Hallucinogens
(5HT2A Agonists); Empathogens; OCD Treatment (SSRI first-line); "Bath Salts" (MDPV); Inhalants;
Stimulant Addiction (No approved treatments).
Source: NR546 Week 6 Quiz, Stahl's Essential Psychopharmacology, ASAM Guidelines.
Format: Q&A Guide with Clinical Rationale | Verified Answers | Grade A Guaranteed
Addiction is often driven by the client's attempts to:
Correct Answer: Self-medicate an underlying mental health disorder (dual diagnosis).
1. Clients may use substances to alleviate distressing symptoms of anxiety, depression, PTSD, or
psychotic disorders. Up to 60% of adolescents in substance use treatment have another mental health
condition.
2. Common comorbidities: anxiety disorders, depression, bipolar disorder, psychotic illness, borderline
personality disorder, antisocial personality disorder.
Adverse effects associated with acute use of opioids (select all that apply)
Correct Answer: Itching, constipation, respiratory depression, urinary retention, sedation.
1. Opioid adverse effects: CNS depression, respiratory depression (life-threatening especially with
benzodiazepines, alcohol), constipation (most common), nausea/vomiting, pruritus, urinary retention,
miosis.
Morphine – prototype opioid agonist: indications, onset, duration
Correct Answer: Indicated for acute pain. Binds to opioid receptors in CNS, inhibiting ascending
pain pathways. Immediate release: variable absorption. IV onset 5-10 minutes, duration 3-5 hours.
Available as controlled release (MS Contin) and extended-release (Avinza). Produces CNS and
potentially life-threatening respiratory depression.
Fentanyl – characteristics
Correct Answer: Almost immediate onset IV, duration 0.5-1 hour. More potent than morphine (50-
100x), short duration. Preferred for those unable to tolerate morphine/hydromorphone and severe
hepatic/renal disease. Used in procedural sedation and general anesthesia. Conversion between
fentanyl products is NOT mcg for mcg.
, Methadone – clinical use and considerations
Correct Answer: Used in detoxification and maintenance treatment for opioid/heroin addiction.
Long-acting, occupies mu-opioid receptors, reduces craving, prevents withdrawal for 24 hours.
High abuse potential; only licensed opioid treatment programs or licensed inpatient hospital units
may dispense. Risk of life-threatening respiratory depression and QT prolongation. Equianalgesic
conversion individually variable (deaths reported). Requires wean to avoid withdrawal. Pregnancy:
risk/benefit necessary; fetal outcomes improved compared to illicit drug use, but may cause
decreased birth weight, length, head circumference.
Tramadol – unique features
Correct Answer: Opioid agonist that also blocks reuptake of serotonin and norepinephrine.
Indicated for acute pain, with added benefit for neuropathic and nociceptive pain. Lower risk of
constipation and dependence than other opioids, but has risk of serotonin syndrome.
Naloxone – use and limitations
Correct Answer: Pure antagonist for acute opioid overdose. IV reverses opioids, even in comatose
states. Available IM and intranasal. Short duration of action – patients can relapse into coma or
overdose; continued monitoring and potentially further doses or constant infusion needed.
Substance use disorder occurs when:
Correct Answer: The recurrent use of a substance causes clinically significant impairment,
including health problems, disability, or failure to meet responsibilities at home, work, or school.
Neurobiological factors contributing to substance use disorders: Genetics
Correct Answer: Between 40-60% of vulnerability may be attributed to genetic factors. Vulnerability
involves complex interactions between multiple genes and between genes and environment.
Specific genetic factors predispose to alcohol dependence and tobacco use. Epigenetic factors
influence whether genes associated with SUD are activated.
Neurobiological factors: Mesolimbic dopamine pathway
Correct Answer: Key pathway mediating reward. Connects ventral tegmental area (VTA) (dopamine-
producing) to ventral striatum/nucleus accumbens, amygdala, hippocampus, and prefrontal cortex.
Nucleus accumbens associated with motivation and reward. Conditions with impulsive/compulsive
behaviors (SUD, OCD, obesity) relate to inefficient processing in prefrontal cortex/striatal circuitry.
Tolerance, Dependence, Addiction, Withdrawal, Intoxication definitions
Correct Answer: Tolerance: decreased effect with repeated use; increasing doses required.
Dependence: adaptation so that physical symptoms occur when drug discontinued abruptly.
Addiction: change in behavior from biochemical changes, characterized by preoccupation and
repeated use despite negative outcomes. Withdrawal: physiological/psychological reactions when
substance stopped abruptly. Intoxication: changes in LOC, cognition, perception, judgment,
behavior after ingestion.
When assessing clients for substance use disorder, the PMHNP must ascertain:
Correct Answer: What substance the client is using; how much; how often; when last ingested.
Medication-Assisted Therapy (MAT) – definition and goals
Correct Answer: Clients use prescription medications as part of treatment plan for substance use
disorders. Substitutes drug of abuse with prescribed medication targeting same receptor. Goals:
improved survival, treatment retention, decreased illegal activity, increased quality of life, improved
birth outcomes, reduced HIV and Hep B/C infections.
Match MAT to client: Bernita – 64yo, heroin use 6 years, unemployed, no insurance. Needs daily
attendance.
Correct Answer: Methadone (full μ-receptor agonist, long half-life, prevents withdrawal 24 hours).
Only administered in federally regulated opioid treatment programs (OTPs). Requires daily
attendance first several months. Good for client with flexibility to attend daily meetings.
