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A. seldom have AOD disorders b. are at an increased risk for AOD disorders c. progress quickly through AOD treatment d. "a" and "c" e. All of the above #2 Clients with co-occurring disorders should never be given psychotropic medications. True False #3 Which of the following statements are true? a. Psychiatric behaviors can mimic AOD use problems. b. Psychiatric and AOD use disorders can independently coexist. c. AOD use can exacerbate a psychiatric disorder. d. AOD use can mask psychiatric symptoms and syndromes. e. All of the above #4 A client with a co-occurring disorder can benefit from a treatment plan that: a. is coordinated among AOD, mental health, social and medical programs. b. focuses only on AOD treatment c. provides mental health and AOD services separately. d. focuses primarily on the severity of the mental health disorder. e. All of the above #5 The Integrated Treatment model is an approach that: a. is a unified and comprehensive treatment program b. refers clients to AOD treatment and then to mental health system. c. combines elements of both AOD and mental health treatment. d. "a" and "b" #6 Psychiatric disorders have a very narrow range of severity True False #7 Which of the following statements are true? a. All clients with co-occurring disorders require the same level of care b. The client's level of mental health and substance abuse serverity can vary independently on a continuum of low to high for each illness. c. All clients with co-occurring disorders should be treated in in-patient settings. d. "a" and "b" e. "a" and "c" #8 Among clients with AOD use problems and a mood disorder: a. many are users of heroin and methadone rather than other drugs b. a significant proportion has major depression c. Mood disorder symptoms that accompany withdrawal are often the result of the withdrawal. d. "a" and "b" e. All of the above #9 The stages of treatment for co-occurring disorders include: a. acute stabilization b. engagement and persuasion c. active treatment and relapse prevention d. recovery and rehabilitation e. All of the above #10 The most common psychiatric diagnoses among clients with AOD disorder are mood and anxiety disorders and reminyl.

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We're doing more hip and knee replacements than ever -- by a huge margin -- in this province, and it's important for people to understand that just as in any other area of health policy and health care delivery, we are always striving for continuous improvement. This area is no exception. The OASIS project -- for those of you who are fascinated by these things, OASIS is an acronym for Osteoarthritis Service Integration System -- is a very important project that aims at building best practices and best services around postoperative care in this province. It does more than that, but that is one of the very important things it does. In this area we have undertaken some very important initiatives, which I think really need to be noted. The $60.5 million that was recently announced for expanding and innovating in the area of hip and knee replacements is very important. We all know about the centre for surgical innovation at UBC, which will see 1, 600 additional hip and knee procedures done at UBC. It will have a huge impact on wait times in this province, and it's something that we should be very proud of. It's a model based on what we learned through the Richmond Hospital hip and knee project, which is the realignment and reorganization of hip and knee procedures in a way that productivity is dramatically improved in this area. I think all British Columbians can take enormous pride and satisfaction in that. At the same announcement we also provided funding for a new centre for hip health, and that will be at Vancouver General Hospital in partnership with UBC. That, we believe, will assist us in undertaking some innovative work. I think we're already leading Canada and probably much of the world in terms of falls prevention and other initiatives to ensure that we can minimize the number of frail elderly and others who will suffer hip and knee injuries as a consequence of falls. B.C. has been recognized nationally and internationally as a leader in the area of falls prevention. We issued a report recently -- the provincial health officer -- on the prevention of falls and injuries among the elderly. That's great. There is lots of leading-edge work being done, and the centre for hip health is the latest step to really build what we can offer in this area. [1040] Again, with the demographic challenge we face, with the aging society that is going to increasingly characterize our society over the next approximately 20 years, we need to continue with initiatives. An environmental scan for falls prevention initiatives in B.C. was published in 2005. The scan resulted in a reported 116 initiatives participating in falls prevention in B.C., as compared to 12 initiatives reported in the previous scan in 2001 -- a ninefold increase in reported falls prevention initiatives. There's lots of great work being done in this area, and I'm very proud of how the health authorities, the ministry and the universities are all moving towards better outcomes in this important area. With experience may realize that 0.75 mg is an excessive amount, orders for 0.25 mg could slip by more easily. After all, levothyroxine is available in a 0.3 mg tablet strength, although Facts and Comparisons mentions that the dose for hypothyroidism rarely should exceed 0.2 mg. Pharmacists must recognize the risks associated with dosing this product and provide feedback directly to prescribers if an excessive dose is suspected. Avoid decimal points and dose conversions by encouraging prescribers to order the medication the same way that manufacturers express the dose in micrograms, not milligrams. Since levothyroxine has a half-life of around seven days, hospital pharmacists should remind prescribers that it probably is unnecessary to change an oral dose to IV unless the patient is NPO for several weeks. Program computer systems to alert if the dose exceeds 200 mcg 0.2 mg ; daily. Finally, consider shelf labels to remind staff to check, if higher doses are prescribed. Beware of Mistaking Aripiprazole ABILIFY ; for a Proton Pump Inhibitor PPI ; Aripiprazole is an antipsychotic agent used to treat schizophrenia, but potential name confusion with drugs in the proton pump inhibitor class has been reported since FDA approved the drug last November. The thought may arise because the drug's generic name ends with "prazole, " which is similar to the name stem used within the PPI class such as omeprazole PRILOSEC ; , esomeprazole NEXIUM ; , rabeprazole ACIPHEX ; , lansoprazole PREVACID ; , and pantoprazole PROTONIX ; . Also, dose ranges for Abilify 10-30 mg daily ; are similar to PPIs, and Abilify is available in 10, 15, 20, and 30 mg tablets, which overlap with the 10-40 mg range of strengths available with PPIs. The importance of knowing indications, doses, and adverse effects of unfamiliar medications prior to ordering, dispensing, or administering them cannot be understated. 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