Rosh Psychiatry Board Practice Exam

What is the most appropriate therapy for a young man who has developed a dependence on opioids after an injury?

1. Buprenorphine/naloxone

2. Duloxetine

3. Extended release oxycodone

4. Gabapentin

The correct answer is: Buprenorphine/naloxone

The most appropriate therapy for a young man who has developed a dependence on opioids after an injury is buprenorphine/naloxone. This combination medication is specifically designed to treat opioid use disorder. Buprenorphine is a partial opioid agonist that helps to alleviate withdrawal symptoms and cravings by binding to the same opioid receptors in the brain that other opioids do, but it triggers less of a euphoric effect. This makes it a suitable option for individuals looking to reduce their opioid use or seeking recovery from dependence. Naloxone is included in this formulation to prevent misuse; if taken in a way not prescribed, naloxone can precipitate withdrawal, which discourages intravenous use. This combination therapy not only aids in mitigating the symptoms of opioid dependence but also offers a safer alternative compared to full agonists, reducing the risk of overdose. Other options, such as duloxetine, extended-release oxycodone, and gabapentin, do not address the underlying opioid dependence. Duloxetine is an antidepressant that may have some utility in managing certain types of pain but is not effective for opioid dependence. Extended-release oxycodone is an opioid itself and would likely exacerbate the dependence issue rather than alleviate it. Gabapentin is an