Opioid use disorder — MCCQE Part 1 MCQ

Correct answer: E — Offer opioid agonist therapy such as buprenorphine/naloxone or methadone with harm-reduction support

Offer opioid agonist therapy such as buprenorphine/naloxone or methadone with harm-reduction support is best because OAT reduces mortality and overdose risk. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Naloxone kit and safer-use counselling are part of care.

Reference: CRISM national opioid use disorder guideline