Deck 13: Opioids

Question 1

Which historical physician emphasized caution in the use of opium, but felt that it was almost a cure-all?

A) Dr. Thomas Sydenham
B) Galen
C) Aristotle
D) Paracelsus

Answer 1

B

Question 2

Which famous opium advocate stated, "without opium the healing art would cease to exist"?

A) Thomas De Quincey
B) Galen
C) Paracelsus
D) Dr. Thomas Sydenham

Answer 2

D

Question 3

What contributed to the spread of opium smoking in China?

A) A 1644 edict from the Emperor forbidding tobacco smoking
B) Religious opposition to the use of alcohol
C) Widespread planting of opium poppies in China
D) Miners and railroad workers returning from America brought the habit with them

Answer 3

A

Question 4

What are Vicodin and OxyContin examples of?

A) NSAIDs
B) Narcotic antagonists
C) Prescription opioids that are being misused and abused at increasing rates
D) Fake drugs sold over the Internet are actually placebo

Question 5

Approximately when and by whom was opium first reported to be used as a medicine?

A) The British, around 1600 AD
B) The Portuguese explorers, around 1400 AD
C) The Egyptians, around 1500 BC
D) The Romans, around 600 AD

Question 6

What did the 16^th century European physician Paracelsus, and later Dr. Thomas Sydenham promote the use of?

A) Heroin
B) Laudanum
C) Opium smoking
D) Pure codeine

Question 7

How would you recognize an opium poppy?

A) It could be pink in colour and more than a metre high with very small clusters of flowers.
B) It could be yellow in colour and more than a metre high with large flowers.
C) It could be yellow in colour and less than half a metre high with very small clusters of flowers.
D) It could be pink in colour and more than a metre high with large flowers.

Question 8

What did Friedrich Sertürner's 1806 published report state?

A) He discovered an active agent that was 50 times as potent as opium and it was morphium.
B) He discovered an active agent that was 10 times as potent as opium and it was morphium.
C) He discovered an active agent that was 10 times as potent as opium and it was heroin.
D) He discovered an active agent that was 50 times as potent as opium and it was heroin.

Question 9

Which of the following is NOT medically available in Canada?

A) Codeine
B) Morphine
C) Heroin
D) Oxycodone

Question 10

What does the scientific name Papaver somniferum refer to?

A) Methadone
B) The willow tree
C) The opium poppy
D) A research group studying sleep disorders

Question 11

Which is the least potent member of the opiate family?

A) Codeine
B) Morphine
C) Heroin
D) Opium

Question 12

What was it believed that Samuel Taylor Coleridge was experiencing when he wrote the beautiful and very well-known poem "Kubla Khan"?

A) An acid trip
B) A morphine stupor
C) An opium high
D) A cocaine high

Question 13

In addition to opium, what other ingredient(s) are found in the poppy?

A) Morphine
B) Codeine
C) Codeine and morphine
D) Codeine, morphine and nicotine

Question 14

Which region of the world was considered to be the major global producer of opium and heroin?

A) South and Southwest Asia
B) Laos and Thailand
C) Colombia and Mexico
D) China

Question 15

How was opium traditionally extracted from the poppy plant?

A) Whitewashing the leaves
B) Cutting the seed pods
C) Pounding the roots
D) Collecting and boiling the flowers

Question 16

In what year did the British government pass a bill that eventually ended the opium trade?

A) 1845
B) 1867
C) 1888
D) 1913

Question 17

In 1898, Bayer laboratories marketed diacetylmorphine tablets under which brand name?

A) Darvon
B) Sublimaze
C) Demerol
D) Heroin

Question 18

What was one outcome of the Opium War of 1839-1842?

A) The Chinese being allowed to continue to ship opium to India
B) American ships being prevented from trading with China for many years
C) The destruction of all poppy fields in Turkey
D) The island of Hong Kong becoming a British possession

Question 19

Who wrote the "Confessions of an English Opium-eater"?

A) Elizabeth Barrett Browning
B) Thomas De Quincey
C) Samuel Taylor Coleridge
D)
F) Scott Fitzgerald

Question 20

What are the two major active chemicals in opium?

A) Morphine and codeine
B) Heroin and cocaine
C) Paregoric and laudanum
D) Meperidine and oxycodone

Question 21

What does the Canadian Community Epidemiology Network on Drug Use (CCENDU) do?

A) It advises the Federal government regarding legislative amendments.
B) It is a institution under the International Narcotics Control Board that advices The Canadian Association of Police Chiefs.
C) It produces alerts and bulletins on drug use, trends, and topics of immediate concern
D) It conducts research in collaboration of Canadian universities.

Question 22

Which statement describes long-term exposure to opioid drugs?

A) Has not been clearly shown to produce damage to any tissue or organ system.
B) Causes damage to the mesolimbic dopamine system.
C) Can weaken the heart.
D) Is a common cause of kidney disease.

Question 23

The fact that animals with no history of opioid withdrawal will press a lever to self-administer low doses of intravenous morphine or heroin demonstrates what in our understanding of developing opioid dependence?

A) Withdrawal symptom
B) Positive reinforcement
C) Peer pressure
D) Tolerance

Question 24

Josh just injected his heroin. Similar to other users, how long will it be before he begins to feel ill?

A) One to three hours
B) Four to five hours
C) Six to eight hours
D) Ten to twelve hours

Question 25

Although pain relief is now the major medical use for opioids, they have been used to save many lives (especially in underdeveloped countries) because of their ability to do what?

A) Decrease violent behaviour
B) Lower blood pressure
C) Counteract diarrhea
D) Decrease bleeding

Question 26

Which of the following describes mu, kappa, and delta?

A) Three types of opioid receptor found in the brain
B) Three classes of natural brain chemicals that have effects similar to morphine
C) Enzymes in the brain that convert morphine into its active form
D) Three chemical classes of synthetic prescription opioids

Question 27

In Canada, from January to September 2017, there were at least 2,923 apparent opioid-related deaths. How many of these were deemed accidental?

A) 32%
B) 52%
C) 72%
D) 92%

Question 28

Which statement does NOT describe Insite?

A) It was a failed public health experiment.
B) It allowed illegal drugs on the premises.
C) Drug users who went there could not be arrested and prosecuted
D) It was an innovative and effective program

Question 29

Apart from their potential for abuse, opioids do have the beneficial medical use of all of the following EXCEPT which one?

A) Blood clotting
B) Pain relief
C) Easing of intestinal disorders
D) Cough suppression

Question 30

Which of these opioids is about 100 times as potent as morphine?

A) Codeine
B) Methadone
C) Pentazocine
D) Fentanyl

Question 31

How does the textbook describe an opioid withdrawal?

A) Similar to a bad case of intestinal flu
B) Similar to a panic attack
C) Similar to a hangover from alcohol
D) Similar to feeling associated with an untreated allergy

Question 32

Which of the following does NOT describe Cottonland?

A) Cottonland was based on a film on OxyContin overdoses in Nova Scotia Canada.
B) Cottonland's theme is related to OxyContin overdoses and the "green monster."
C) Cottonland is based on an undercover story that revealed the illegal route of OxyContin distribution from the American south to Nova Scotia and Quebec.
D) Cottonland is the journalistic story that exposed the death of 8 people who died of drug-related overdoses.

Question 33

In a heroin user, when can a negative reinforcement of drug-taking behaviour occur?

A) If the user overdoses and almost dies
B) When a person uses the drug for the first time
C) If the withdrawal symptoms start and they are alleviated by another injection
D) If the user sees a needle or syringe

Question 34

What type of drug is fentanyl?

A) Drug that masks the symptoms of heroin abuse
B) Form of Mexican heroin
C) Opiate antagonist used in heroin abuse treatment
D) Synthetic opiate

Question 35

Which of the following was associated with more than 100 deaths in Alberta alone in 2014?

A) Illegal codeine
B) Illegal fentanyl
C) Illegal methadone
D) Illegal pentazocine

Question 36

What have Siegel and his colleagues shown in animal studies regarding tolerance to opioids?

A) It is due to reduced absorption of the drug
B) It is not very great
C) It occurs after only a single exposure
D) It is partly due to conditioned protective reflexes

Question 37

What are naloxone and naltrexone?

A) NSAIDs.
B) Opioid antagonists.
C) Prescription opioids that are being misused and abused at increasing rates.
D) Fake drugs sold over the Internet that are actually placebos.

Question 38

In 2005, how did Canada rank in the world in its per capita consumption of Dilaudid?

A) First
B) Second
C) Third
D) Fourth

Question 39

How can enkephalins, endorphins, and dynorphins be described?

A) Three types of opioid receptor found in the brain
B) Three classes of natural brain chemicals that have effects similar to morphine
C) Enzymes in the brain that convert morphine into its active form
D) Three chemical classes of synthetic prescription opioids

Question 40

Which statement does NOT describe Fentanyl?

A) Canada ranks as the world's third-biggest consumer of Fentanyl after the United States and Columbia.
B) Fentanyl is thought to be up to 100 times more potent than morphine.
C) Fentanyl is 50 times more potent than heroin.
D) Fentanyl is responsible for major euphoric analgesic effects.

Question 41

You over hear a news story describing a court battle taking place regarding a Government and a safe injection site agency. In which city is this taking place?

A) Amsterdam
B) Berlin
C) San Francisco
D) Vancouver

Question 42

Why was an exception under Section 56 of the Controlled Drugs and Substances Act required at the Insite facility?

A) To allow the injection and sale of therapeutic heroin on the premises.
B) To allow those with criminal code convictions on the premises.
C) To allow the injection of illegal drugs on the premises.
D) To allow day passes to those who have been incarcerated to purchase and inject therapeutic heroin on the premises.

Question 43

Max, Joseph, Mary, and Lori are all taking part in either the NAOMI or SALOME study. What is the focus of this research?

A) The gender difference between adherences to methadone maintenance programs.
B) Heroin maintenance programs.
C) Methadone versus fentanyl maintenance treatment programs.
D) In-patient heroin withdrawal services followed by free supervised methadone maintenance services.

Question 44

When a heroin user performs a term called "skin-popping", what is a medical risk they face?

A) Hepatitis
B) Tetanus
C) Blood poisoning
D) Overdose

Question 45

Morphine and codeine are derived from the opium poppy, Papaver somniferum.

Question 46

Global illicit opium poppy cultivation grew 25% in 2009, resulting in a 15% increase in global opium production.

Question 47

Opium is produced and available for collection for only a few days of the plant's life.

Question 48

Opium smoking was widespread in China by 200 BC.

Question 49

What is the most common form of heroin use by male users?

A) Burning
B) Huffing
C) Snorting
D) Injecting

Question 50

Which of the following is NOT provided at Insite?

A) Sterile injecting equipment
B) Medical attention
C) Referral to primary health care services
D) Legal methadone to inject

Question 51

Which of the following will not be one of the randomly assigned groups for those participating in the NAOMI study?

A) Receive oral methadone maintenance treatment.
B) Receive an injection of hydromorphone.
C) Receive injection of codeine.
D) Receive prescription heroin.

Question 52

Canadian supply of opium and heroin comes primarily from South and Southwest Asia.

Question 53

Which is Insite?

A) One of two safe injection sites in Canada.
B) Canada's only heroin addiction treatment facilities.
C) Canada's only safe injection site in Canada.
D) Historical moment in Canada when the rights of harm reduction strategies were determined unconstitutional in Canada.

Question 54

Heroin was originally a brand name for diacetylmorphine, manufactured by Bayer laboratories.

Question 55

Opium is the MOST potent member of the opiate family.

Question 56

Which of the following describes the outcome of the battle to keep Insite open?

A) Insite lost every court battle until it reached the Supreme Court of Canada which rejected the Canadian Government's attempt to shut it down.
B) Insite won every court level battle including the final legal step when the Supreme Court of Canada rejected the Canadian Government's attempt to shut it down.
C) Insite lost its first appeal at the British Columbia Court of appeal, but Supreme Court of Canada rejected the Canadian Government's attempt to shut it down until 2018.
D) Supreme Court of Canada, which rejected the Canadian Government's attempt to shut Insite down, as well as the attempt of the government to interfere with other safe injection sites in Canada.

Question 57

Which statement describes the process of developing dependence on heroin?

A) It is so rapid it can occur after just one intravenous injection.
B) It seems to require three or more injections per day for several days.
C) It takes at least a month of use at relatively high doses.
D) It depends more on the dose than on how often the drug has been used.

Question 58

Which of the following describes the preferred injectable substance(s) in Canada?

A) Heroin
B) Methadone and heroin
C) Heroin and cocaine
D) Methadone and cocaine

Question 59

Heroin was originally marketed as a non-addictive cough suppressant that would replace morphine and codeine.

Question 60

According to your text, Canada has approximately how many people are considered injection drug users?

A) 25,000 to 50,000
B) 50,000 to 75,000
C) 75,000 to 125,000
D) 125,000 to 150,000

Question 61

Long-term use of opioid drugs has been clearly shown to damage both the liver and the brain.

Question 62

Describe three major medical uses for opioid drugs, and discuss how effective these drugs are for each use.

Question 63

Provide three facts that would support the statement: "Fentanyl -- Canada's Deadly Opioid Epidemic."

Question 64

The film Cottonland raises many questions and then asks how an entire community falls into despair.

Question 65

Where does the Canadian supply of opium and heroin come from, and what trends were stated in the text?

Question 66

What is methadone and describe, if any, its withdrawal symptoms.

Question 67

Harm reduction strategies include safe injection sites such as Insite.

Question 68

Several famous English authors wrote about the joys of opium; identify one of them.

Question 69

Antitussive is a medication used to suppress or relieve coughing.

Question 70

Withdrawal from opioid drugs has effects similar to a bad case of intestinal flu.

Question 71

Endorphins are morphine-like neurotransmitters found in the brain and pituitary gland.

Question 72

Scientific research that has shown prescription heroin is an effective treatment for patients suffering from severe addiction.

Question 73

Who was Dr. Thomas Sydenham, and what was his role in the development of opium?

Question 74

What is an opioid antagonist, and what is its role?

Question 75

Vicodin and OxyContin are prescription opioids that are being misused and abused at increasing rates.

Question 76

What is important to know regarding opioid overdoses?

Question 77

Insite was an experiment in population health, as such what specifically was it granted and why?

Question 78

What was Cottonland and what caused it?

Question 79

Naloxone and naltrexone are natural brain chemicals that have effects similar to morphine.

Question 80

What do Glee actors Cory Monteith and Philip Seymour Hoffman have in common?