In the long-term management or substitution therapy of heroin dependence, which drug is used to prevent withdrawal and drug craving without producing sharp peaks of euphoria?

Appeared in: NORCET-11 Prelims

Explanation

Methadone is a long-acting full agonist at the mu-opioid receptor used for opioid substitution therapy.
It prevents withdrawal and craving by maintaining stable opioid levels, avoiding sharp euphoria.
Methadone is administered orally and allows for normal daily functioning.
Reduces illicit opioid use, criminal behavior, and improves social integration.

Why Other Options Were Wrong

Option B: Diazepam is a benzodiazepine used for anxiety, muscle relaxation, and alcohol withdrawal, not for opioid substitution therapy.
Option C: Chlorpromazine is an antipsychotic used for psychiatric disorders and severe nausea, not for opioid withdrawal or maintenance.
Option D: Naloxone is an opioid antagonist used for acute opioid overdose reversal, not for long-term maintenance or craving prevention.

Related Visual

Comparison of methadone, buprenorphine, and naloxone in opioid dependence management, showing mechanism, route, and clinical use.

Clinical Relevance

Nursing practice connection: Knowing Long-acting opioid substitution therapy for heroin dependence helps nurses interpret findings accurately and avoid errors in routine assessment, medication administration, and patient teaching.
Methadone maintenance therapy is a cornerstone in opioid dependence management, reducing withdrawal, craving, and risk behaviors.
Nurses play a key role in monitoring for side effects (e.g., sedation, constipation, QT prolongation) and ensuring adherence.
What if? If naloxone were used instead, it would precipitate withdrawal and is only indicated for acute overdose, not maintenance.

How to Approach the Question

Identify the clinical scenario: long-term management of heroin dependence.
Recall which drugs are used for opioid substitution therapy.
Eliminate options that are not opioids or not used for maintenance (e.g., benzodiazepines, antipsychotics, antagonists).
Select the agent that prevents withdrawal and craving without causing euphoria.

Concept Tested & Keywords

Concept Tested: Long-acting opioid substitution therapy for heroin dependence
Stem keywords: long-term management, heroin dependence, substitution therapy, withdrawal, drug craving, euphoria
Lead-in keywords: used to prevent withdrawal and drug craving, without producing sharp peaks of euphoria
Clinical cues: Focus on maintenance therapy, not acute withdrawal or overdose

Question ID

Q1AVmpygZK7pp8srZvMrPh

Reference Book

E6 Pharmacology Katzung 16e p. 921-923

E6 Kaplan Sadock's Synopsis of Psychiatry-2022 (pp 1-3768 of 3768) p. 951-953

E6 Robert Boland, Marcia L. Verduin - Kaplan and Sadock's Comprehensive Text of Psychiatry-Wolters Kluwer Health (2024) (pp 1-16525 of 16525) p. 4596-4598

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