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Quiz 1 - Course 2H - SUDs in Adolescents with HIV-AIDS

 

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1)
In the Introduction, we learn that HIV-infected adolescents presenting for treatment typically demonstrate _________________ of co-occurring mental health symptoms or prior mental health diagnoses, which frequently precede the onset of problem substance use.
 
a moderate degree
a high degree
a low degree
 
2)
Marijuana and alcohol are used infrequently by HIV-infected adolescents, but use of heroin, methamphetamine, and cocaine is commonly reported.
 
True False
 
3)
Looking at section II. RISK FACTORS FOR SUBSTANCE USE IN HIV-INFECTED ADOLESCENTS ..... Many of the same individual, family, and social factors associated with increased risk for substance use in [healthy] adolescents are prevalent in HIV-infected adolescents.
 
True False
 
4)
In Table 1 (POTENTIAL RISK FACTORS FOR SUBSTANCE USE IN HIV-INFECTED ADOLESCENTS) ....... We see that HIV-infected adolescents with diagnoses of depression, anxiety, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and conduct disorder are MORE LIKELY to use substances than HIV-Infected youth with NO mental health diagnosis.
 
True False
 
5)
Still in Table 1 .... YMSM in this research publication means
 
Young Mothers with Symptoms of Manic Depression
Youth with Serious Mental Illness
Young Men Having Sex With Men
 
6)
Still in Table 1 . . . Looking at POTENTIAL RISK FACTORS FOR SUBSTANCE USE IN HIV-INFECTED ADOLESCENTS ...... which of the following is a true statement?
 
Children of HIV-infected parents have HIGH RATES of mental health diagnoses, placing them at additional risk for substance use.
Adolescents with diagnoses of depression, anxiety, post-traumatic stress disorder, attention-deficit/hyperactivity disorder, and conduct disorder are MORE LIKELY to use substances than adolescents with no mental health diagnosis.
Among YMSM, HIV-infected individuals may be MORE LIKELY to use substances, especially methamphetamine, compared to their non-infected peers
All of the above
Only the first and third answers above
 
7)
In section III. COMMUNICATING WITH ADOLESCENTS ABOUT SUBSTANCE USE ....... Which is a true statement?
 
Asking the patient what terms he/she uses -- such as, 'What do you call heroin?' 'Do you have a name for being on ecstasy?' -- can teach the healthcare provider what the adolescent knows about the drug scene.
When discussing substance use, use words and concepts appropriate to the patient’s cultural background and cognitive, linguistic, and emotional development.
It is important to assure the adolescent HIV patient that discussions about substance abuse will be kept confidential.
All of the above.
 
8)
In section IV BASELINE HISTORY AND SUBSTANCE USE SCREENING .... Which is NOT a true statement?
 
Clinicians should screen HIV-infected adolescents for substance use at baseline and every 3 months thereafter.
Screening for all levels of alcohol and other substance use in HIV-infected adolescents is important.
Even intermittent use of substances can interfere with adherence to medications, and RAISE the risk of drug-drug interactions, and REDUCE the patient’s ability to practice safer sex
In HIV-infected adolescents, the medical illness makes it impossible to accurately identify substance use or mental health diagnoses.
A nonjudgmental and caring approach to history-taking may elicit more accurate responses.
 
9)
In Table 2 -- QUESTIONS TO ASSESS ATTITUDES ABOUT AND FREQUENCY OF SUBSTANCE USE .... which is NOT a true statement?
 
Questions that target specific substances can elicit more accurate responses. For example: Did you smoke marijuana today, yesterday, recently? How many times do you smoke during the week? What do you like about it? What do you dislike about it?
Brief screening instruments are preferable in the clinic setting.
Patients who use multiple drugs will oftentimes discontinue the use of ALL drugs when they have been successful in discontinuing at least ONE of the drugs.
We should ask questions about use of over-the-counter and prescription medications ..... such as cough syrup (i.e., dextromethorphan), ephedrine, cognitive stimulants (e.g., methylphenidate and other 'study drugs'), anabolic steroids, prescription opiates, benzodiazepines, and family members’ prescriptions that he/she may access.
 
10)
Ongoing assessment is important. However, adolescent patients who express a lack of readiness to address the issue of substance use may not provide honest answers and may become alienated if they feel ongoing pressure to continually discuss the topic.
 
True False
 
11)
Still in section IV ..... which below is NOT true?
 
Unless there is a life-threatening medical emergency, drug testing should only be conducted with the knowledge and consent of the adolescent.
Testing for the presence of drugs in urine and blood tells us a great deal about the severity of use and the consequences of that use.
The patient should be told that drug testing is a part of the treatment plan and may provide useful information to the provider.
Drug monitoring cannot substitute for an ongoing therapeutic alliance with the adolescent.
 
12)
Moving to Section V - INTERVENTION STRATEGIES .... which is the best answer below?
 
For some adolescents, substance use may be a transient reaction to learning that they are HIV-infected or may be a result of parental substance use.
Determination of the most appropriate intervention recognizes the CONTEXT of the HIV-infected adolescent’s chronicity of use and degree of dependence.
Both of the above are true.
 
13)
The strategies discussed in Section V have proved to be highly effective interventions for addressing adolescent methamphetamine use.
 
True False
 
14)
Looking at HARM REDUCTION in Section V .... Clinicians may use _________________ for adolescents who are not ready, or not willing, to make abstinence a goal.
 
harm-reduction principles
the Matrix Model
 
15)
In section A - The HARM REDUCTION APPROACH ..... interventions may include the following:
 
the health effects of heavy substance use including binge-drinking, heavy or daily marijuana use, and polydrug use.
educating patients about the risk of drug-drug interactions, both between substances and between substances and HIV medications.
encouragement of behaviors that reduce HIV transmission risk (e.g., not sharing equipment used for administering substances, including straws for snorting and needles), and referral to syringe exchange programs as available.
ALL of the above
NONE of the above, for adolescents who are NOT READY to abstain from alcohol or other substances.
 
16)
In section B - BRIEF INTERVENTIONS ...... When used with HIV-infected adolescents, brief interventions for substance abuse may NOT be as effective as when used with non-infected adolescents
 
True False
 
17)
'Brief Interventions' are short-term, less intensive ALTERNATIVES to traditional substance use treatment modalities.
 
True False
 
18)
Regarding 'Motivational Enhancement Therapy' ....... which is NOT a true statement?
 
It combines motivational interviewing with cognitive-behavioral techniques, such as problem-solving.
A four-session motivational enhancement therapy intervention for HIV-infected adolescents and young adults aged 16 to 25 was shown to be effective in reducing alcohol use.
Although it reduces use of substances, this form of brief intervention DOES NOT result in improved health outcomes, such as a reduction in HIV viral load.
 
19)
Group Interventions for HIV-infected adolescents who use substances utilize a cognitive-behavioral approach which provides risk education and social-negotiating and problem-solving training.
 
True False
 
20)
Looking at Interventions - Section D. Pharmacotherapy, which is NOT a true statement?
 
With the exception of opioid agonist therapy and smoking cessation, the efficacy of pharmacotherapy for substance use has NOT been well established in adolescents.
Clinicians should refer injection drug-using adolescents for opioid-dependence treatment or more intensive levels of care as appropriate.
A review of existing studies of adolescents found that METHADONE has a higher retention rate than other modalities and may be more effective in reducing illicit drug use.
Most methadone maintenance programs have adequate resources for addressing co-occurring psychosocial and mental health concerns in adolescents.
 
21)
Moving to section VI ..... Effective psychotropic management of co-occurring mental health diagnoses can often aid in reducing substance use, including alcohol and marijuana - especially for depression and bipolar disorder.
 
True False
 
22)
Moving to section VII - REFERRAL FOR SUBSTANCE USE TREATMENT, Table 4 .... which is NOT listed as an INDICATION FOR HOSPITALIZATION OF HIV-INFECTED SUBSTANCE-USING ADOLESCENTS'?
 
Overdose that cannot be safely treated in the outpatient or emergency room setting (e.g., severe respiratory depression, coma)
Acute or chronic medical conditions that make detoxification in a residential or ambulatory setting unsafe
No availability of rapid admission into an outpatient treatment program
Risk for a severe or complicated withdrawal syndrome, including dependence on multiple drugs, history of delirium tremens
Marked psychiatric comorbidity with an acute danger to self or others
 
23)
Moving to section VIII. MAINTAINING THE SUBSTANCE-USING ADOLESCENT IN CARE .... which is a true statement? .
 
Patients with comorbid substance use and HIV infection are more likely to LEAVE medical treatment when they are given treatment goals that they are NOT READY to accept.
Including HIV patients early in the medical planning process may lead to more successful outcomes.
If a patient does not fully understand his/her HIV diagnosis and management, clinicians may need to address the patient’s substance use BEFORE engaging him/her in medical care.
All of the above.
Only the first and second answers above are true.
 
24)
For HIV patients in early recovery, clinicians SHOULD NOT ASK at each visit, about the 'date of last use' of substances, alcohol, and tobacco, because they may perceive this as intrusive.
 
True False
 

 

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