Deck 13: Opioids

Question 1

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.

Answer 1

D

Question 2

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

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

Answer 2

A

Question 3

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.

Answer 3

C

Question 4

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 5

Which is the least potent member of the opiate family?

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

Question 6

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 7

Which Canadian or Canadian institution is responsible for the statement "Allowing and/or encouraging people to inject heroin into their veins is not harm reduction, it is the opposite...."?

A) Brain Mulroney
B) Stephen Harper
C) A Supreme Court of Canada judgement
D) Tony Clement

Question 8

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 9

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 10

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

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

Question 11

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 12

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.

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 of the following is not medically available in Canada?

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

Question 15

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

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

Question 16

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 17

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 18

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 19

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 20

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 21

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 22

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 23

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 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

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

A) The user overdoses and almost dies.
B) The person is trying the drug for the first time.
C) Withdrawal symptoms are alleviated by another injection.
D) The user sees a needle or syringe.

Question 26

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

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

Question 27

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 which of the following?

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

Question 28

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 29

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 30

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 31

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 32

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 33

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

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

Question 34

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 35

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 Inisite down, as well as the attempt of the government to interfere with other safe injection sites in Canada.

Question 36

How many individual stalls are there at Insite?

A) Six
B) Twelve
C) Twenty four
D) Thirty six

Question 37

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 38

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 39

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 40

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 41

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

Question 42

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

Question 43

In Canada approximately how many people are 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 44

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

Question 45

Seizures of drugs are an excellent way to measure drug use trends.

Question 46

Harm reduction strategies include safe injection sites such as Insite.

Question 47

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

Question 48

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

Question 49

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 50

What is the primary and secondary active agent in opium?

Question 51

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

Question 52

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

Question 53

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

Question 54

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

Question 55

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

Question 56

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

Question 57

Opium smoking was widespread in China by 200 BC.

Question 58

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

Question 59

Antitussive is a medication used to suppress or relieve coughing.

Question 60

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 61

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

Question 62

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

Question 63

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

Question 64

What do nonprescription cough remedies contain and what role does it play?

Question 65

Provide examples of: opioids naturally occurring, synthetic, and semi-synthetic opioids

Question 66

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

Question 67

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

Question 68

Describe how both positive reinforcement and negative reinforcement contribute to the development of dependence on opioid drugs.

Question 69

Explain the purpose of Insite, its services, and the benefits derived by the community due to its existence.

Question 70

What is important to know regarding opioid overdoses?

Question 71

Describe the sequence of appearance of some of the Abstinence Syndrome Symptoms.

Question 72

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

Question 73

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