1. B. The most commonly used treatment and the most effective is to stabilize the patient with methadone and gradually reduce the maintenance dose until the patient is drug free. The administration of meperidine would reverse the abstinence syndrome but it is unlikely to help the patient terminate his opioid habit. The use of naltrexone would likely further precipitate the abstinence syndrome and without additional counseling, would not likely offer long-term benefit.

2. C. Abuse of stimulants can produce toxic psychosis that closely resembles schizophrenia. An agent such as haloperidol or a phenothiazine will provide im-

mediate relief of the symptoms. The fact that he is emaciated and hungry is evidence that he has been on a prolonged run with stimulants. The symptoms are very different from those seen with alcohol or with opioids.

3. A. Barbiturates are seldom prescribed. The lack of availability is a major reason these compounds are only rarely abused.

4. D. There are more than 10 million alcoholics in the United States alone. The numbers of individuals who abuse the other drugs listed are much lower.

5. D. These are classic features of opioid abstinence syndrome. The abstinence syndrome in chronic alcohol or barbiturate users consists of hallucinations, tremors, hyperthermia, and autonomic hyperactiv-ity. The abstinence syndrome for users of cocaine and amphetamine is not as stereotyped as for opi-oids or CNS depressants, such as alcohol and barbiturates.

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